Diniz, Debora

Madeiro, Alberto

Medeiros, Marcelo

English

Cadernos Espinosanos (E-Journal)

1https://doi.org/10.11606/s1518-8787.2021055003053Letter to the EditorRev Saude Publica. 2021;55:6Abortion after the Zika virus epidemic in Northeast BrazilDebora DinizI , Marcelo MedeirosII , Alberto MadeiroIIII Universidade de Brasília. Faculdade de Direito. Brasília, DF, BrasilII Princeton University. Program of Latin American Studies. Princeton. New Jersey, USAIII Universidade Estadual do Piauí. Núcleo de Pesquisa e Extensão em Saúde da Mulher. Teresina, PI, BrasilTo the Editor: Northeast Brazil was the epicenter of a Zika virus outbreak between 2015 and 2016. During the epidemic, health officials have urged women to avoid pregnancy. Data from 2016 show that 66% of women from the Northeast avoided becoming pregnant during the epidemic1. However, most pregnancies in low socio-economic areas are unplanned2. Therefore, it is possible that not all women were able to prevent pregnancy and, instead, avoided the risk of congenital Zika syndrome by undergoing an unsafe abortion, since abortion is illegal in Brazil. To study the possible impact of the Zika outbreak on abortion in Northeast Brazil, we conducted a representative household survey of 1,008 women, combining interviewer-administered and self-administered questionnaires (anonymous, using the ballot-box technique).The data showed there was a decline of abortions in 2019, when compared with similar surveys in 2010 and 2016. About 12% of women in 2019 declared having had at least one abortion in their lives, compared with 18% in 2017 and 20% in 2016. Despite the decline, our results show that abortion is frequent in the region. However, we did not identify any important differences in the abortion rates related to the Zika virus epidemic. Abortion rates in 2017–2018 were similar among women who had experienced (2.8%) or had not experienced (2.5%) the symptoms of Zika, dengue or chikungunya. In addition, we found no evidence that the higher prevalence of children with the congenital Zika syndrome born from low-educated women is the result of a lack of resources to have an abortion3. On the contrary, abortion rates are higher among these women. This suggests the higher prevalence of the syndrome may be a combination of fewer resources to avoid pregnancies and more exposure to environmental risks.As the structural conditions for a new Zika outbreak remain unaltered, these results suggest that a strategy to control the congenital syndrome must go beyond official behavioral recommendations and include broad reproductive health measures, as well as access to contraceptives and to safe abortion.REFERENCES1. Diniz D, Medeiros M, Madeiro A. Brazilian women avoiding pregnancy during Zika epidemic. J Fam Plann Reprod Health Care. 2017;43(1):80. https://doi.org/10.1136/jfprhc-2016-1016782. Le HH, Connolly MP, Bahamondes L, Cecatti JG, Yu J, Hu HX. The burden of unintended pregnancies in Brazil: a social and public cost analysis. Int J Womens Health. 2014;6:663-70. https://doi.org/10.2147/IJWH.S615433. Castro MC, Han QC, Carvalho LR, Victora CG, França GVA. Implications of Zika virus and congenital Zika syndrome for the number of live births in Brazil. Proc Natl Acad Sci USA. 2018;115(24):6177-82. https://doi.org/10.1073/pnas.1718476115Correspondence: Debora Diniz Caixa Postal 8011 70670-973 Brasília, DF, Brasil E-mail: d.diniz@anis.org.brReceived: Aug 14, 2020Approved: Aug 25, 2020How to cite: Diniz D, Medeiros M, Madeiro A. Abortion after the Zika virus epidemic in Northeast Brazil. Rev Saude Publica. 2021;55:6. https://doi.org/10.11606/s1518-8787.2021055003053Copyright: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided that the original author and source are credited.http://www.rsp.fsp.usp.br/2Abortion after the Zika virus epidemic Diniz D et al.https://doi.org/10.11606/s1518-8787.2021055003053Funding: International Planned Parenthood Federation/Western Hemisphere Region 2018/2019 (no number/process).Authors’ Contribution: Study design and planning: DD, MM, AM. Data collection, analysis and interpretation: DD, MM, AM. Writing of the manuscript and approval of the final version: DD, MM, AM. Public responsibility for the content of the article: DD, MM, AM.Conflict of Interest: The authors declare no conflict of interest.

Abortion after the Zika virus epidemic in  Northeast Brazil

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Abortion after the Zika virus epidemic in Northeast Brazil

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Cadernos Espinosanos (E-Journal)