Zika exposes abortion conflict

Aborting her baby, even if it were legal in Brazil, would have been the easy way out, says Hilda Venancio Silva.

Venancio's three-month-old son Matheus was one of a growing number of children born with microcephaly, an abnormally small head that restricts brain development.

"Never. Never. Never," she says, speaking from her home in a poor community in Recife, the heart of the epidemic in northeast Brazil. "Regardless of whether it is diagnosed during pregnancy, I would never accept abortion, ever. There are two paths to take: Either you take responsibility or you take an easy way out."

Since the sudden increase in cases of the birth defect has been linked to the spread of the mosquito-borne Zika virus, women's reproductive rights have fallen under the spotlight.

Governments across Latin America have taken the extraordinary step of advising women to consider postponing pregnancy until the spread of the disease is controlled. Yet where abortion is against the law, the advice has exposed the complicated conflict between prevailing conservative attitudes and the needs and rights of women.

Abortion in Brazil is illegal with three exceptions: where the mother's life is at risk, in cases of rape or when the fetus has anencephaly, in which the skull does not form and the fetus is unlikely to survive.

The anencephaly exception was added to the law in 2012 after eight years of campaigning and deliberations. Debora Diniz, an anthropologist at the bio-ethics institute Anis, led the calls for the amendment and is now taking fresh proposals to the Supreme Court to allow mothers to terminate pregnancies in cases of microcephaly.

"We want access to contraception, early diagnosis and the possibility of choosing abortion, if that is her choice," Diniz says. "No one is talking about just legalizing abortion.

"What we don't want, once again, is a negligent state. We don't want a state resolving this epidemic and leaving history to be resolved by women in the privacy of their families. We want a state that takes them in."

Not necessarily about religion

But Brazil remains internally conflicted over abortion. While a poll last year suggested that seven out of ten are against abortion in any circumstance, there are estimates that up to a million illegal terminations take place in Brazil every year.

Congresswoman Jandira Feghali, who authored the amendment to allow abortions in cases of anencephaly, blamed the difficulty in decriminalizing abortion on the conservative, religious caucus in Congress.

Yet for the women taking these decisions, faith appears to play a minor role.

The National Abortion Survey, carried out by Diniz in 2010, found that one in five women had an abortion by the end of their reproductive life. And while religious values prevail publicly, the study found that two-thirds of the women who had abortions were Catholic.

"The incidence of abortion between women of different religions is practically the same," the survey found. "No significant difference was observed between religious groups."

Similar rates of abortion were found elsewhere in Latin and Central America.

Research in Colombia, which is the second most affected country by Zika after Brazil and which has similar restrictions on abortion, found that in 1992, more than 22 percent of women ended their pregnancies.

Similarly, almost 22 percent of women between 15 and 55 in Mexico City had tried to induce an abortion at least once, according to a study in 2001. Other research estimated the incidence of abortion in Mexico, where terminations are only permissible to save the mother's life or in cases of rape or incest, to be around 16 percent.

Urgent need for legal decision

But allowing abortion in cases of microcephaly is further complicated by the fact that the condition is not normally identified until much later in the pregnancy and can only be properly diagnosed at birth.

"A woman who is pregnant and wants to have an illegal abortion does it early in the first weeks and no one knows socially that she is pregnant," Diniz added. "A woman who faces a diagnosis of microcephaly is in an advanced stage of her pregnancy in which she is socially a future mother."

Added to the moral dilemma of late-term abortions is the socio-economic factor, which means that those without the means to afford a safe abortion in a country where it is legal are left to the mercy of unregulated, clandestine clinics.

"We know that, once again, women with financial resources are terminating in good conditions," said Carla Batista, of the Latin American and Caribbean Committee for the Defense of Women's Rights (Cladem). "And those who don't have resources are risking their lives. Even more so if we think that microcephaly is not detectable before the first 12 weeks of pregnancy. And having a late termination can bring more risks to the life of the women who resort to it."

The "Women's Rights Action" led by Diniz, which seeks to broaden the abortion law, will go to the Supreme Court within the next month while scientists and researchers study the virus to better inform the fight against the spread.

And in the meantime, pregnant women are simply advised to take precautions to protect themselves from mosquitoes.

"I really want to believe that in this scenario of the world watching us, for the first time we managed to recognize that women must be a priority to decide, to welcome, to protect," Diniz said.

"We are not dealing with an abstract, constitutional question of life or no life. We are facing urgent needs; of a child who has been born and will need multiple assistance or a woman in the middle of her pregnancy who receives a diagnosis and does not want to commit a crime.

"If the decision takes a long time, we will only amplify the consequences of this epidemic in all senses."