by Clare Wenham, Camila Abagaro, Amaral Arévalo, Ernestina Coast, Sonia Corrêa, Katherine Cuéllar, Tiziana Leone, Sandra Valongueiro
Social Science & Medicine, February 2021;270(113671)
- Zika affected reproductive decision-making, but did not impact abortion regulation.
- Epidemiological framing ignored reproductive dimensions of emergency responses.
- Conservative forces instrumentalized disability concerns to oppose abortion rights.
- Women sought abortions clandestinely, citing Zika as a justification.
- Abortion provision must form part of health emergency planning and response.
The Zika outbreak of 2015-17 is a lens to analyse the positioning of abortion within global health security. The sequelae of the virus almost exclusively affected newborn children, manifested through Congenital Zika Syndrome (CZS), and a focus on women at risk of, planning or being pregnant. At the global level, debate considered whether Zika would provide impetus for regulatory change for reproductive rights in Latin America, a region with some of the most restrictive abortion regulation in the world. However, regulatory change for abortion did not occur. We analyse why the Zika health emergency did not lead to any changes in abortion regulation through a multi-method analysis of the intersection between Zika, health emergencies and abortion in Brazil, Colombia and El Salvador. These case study countries were purposefully selected; each had Zika-infected women (albeit with differing incidence) yet represent diverse regulatory environments for abortion. Our comparative research is multi-method: framework analysis of key informant interviews (n=49); content analysis of women’s enquiries to a medical abortion telemedicine provider; and policy analysis of (inter)national-level Zika response and abortion policies. We consider this within the literature on global health security, and the prioritisation of a particular approach to epidemic control. Within this securitized landscape, despite increased public debate about abortion regulatory change, no meaningful change occurred, due to a dominant epidemiological approach to the Zika health emergency in all three countries and prominent conservative forces in government and within anti-abortion rights movements. Simultaneously, we demonstrate that regulation did not deter all women from seeking such services clandestinely.
VISUAL: A representation of the surface of the Zika virus, Kuhn and Rossmann research groups, Purdue University, USA