For years, most Americans have opposed abortions late in pregnancy.

Zika could change that, potentially undermining support for a national ban on abortion after 20 weeks of pregnancy as more women infected with the virus find themselves in the crosshairs of the abortion wars if they choose to end their pregnancies.



Pregnant women with the Zika virus are at risk of giving birth to babies with devastating brain damage, which can be detected only around 18 to 20 weeks — and often much later than that. More than 1,200 pregnant women have been diagnosed with the virus in the U.S. so far, mostly in Puerto Rico. And with the numbers climbing in Florida, the nation’s top health official urged pregnant women and their sexual partners to avoid nonessential travel to all of Miami-Dade County.


Yet 14 states, including Texas and Alabama, which are both at risk for Zika outbreaks, outlaw abortions after 20 weeks. And anti-abortion activists are determined to extend those bans to all 50 states, or to get Congress to pass a sweeping national law.

While Zika has yet to factor into the strategies of anti-abortion advocates and lawmakers, there are signs that it is weakening public opposition to late-term abortions — perhaps in the same way that a German measles outbreak once brought the debate over legalizing abortion into the mainstream in the 1960s.



An Aug. 5 Harvard University-STAT poll found only 23 percent of American adults believe a woman should have access to abortion after 24 weeks of pregnancy. But that opposition softened notably when the question was framed in terms of Zika.

The poll found support for access to abortion after 24 weeks of pregnancy more than doubled, to 59 percent, if a woman is told her baby has a serious risk of microcephaly, the severe birth defects that result from the virus. That moderation occurred across the political spectrum, although a partisan divide was still evident — 72 percent of Democrats and 48 percent of Republicans supported access to abortion in that situation.

“Maybe the Zika epidemic and its implications for pregnant women will help us shine a light on the exactly tragic situation in which you have these abortions,” said Rep. Diana DeGette (D-Colo.), co-chairman of the House Pro-Choice Caucus.

Anti-abortion advocates acknowledge the heartbreak of such pregnancies, but say that doesn’t change their position. Sen. Marco Rubio of Florida said earlier this month that “all human life should be protected by our law, irrespective of the circumstances or condition of that life” — a stance he acknowledged was difficult.

Many lawmakers over the years have opposed allowing exceptions in anti-abortion legislation for severe fetal abnormalities.

“I would certainly hope that our country would not turn to the mindset that we kill a baby because there is or may be a disability,” said Carol Tobias, president of National Right to Life. “This isn’t going to change anything that we’re doing.”

The Supreme Court has ruled that states can impose limits on abortion only after a fetus is viable outside the womb, now considered to be about 23 to 24 weeks of pregnancy. The vast majority of states do restrict when an abortion can be done — typically they are prohibited anywhere from 20 weeks to viability.

Some of those laws — particularly bans before 20 weeks — are in conflict with the high court's ruling. So far, the justices have refused to take up the laws, but many have been blocked by lower courts.

In any case, late-term abortions are rare: Only about 1.3 percent of the approximately 1 million abortions in the United States each year are done after 21 weeks of pregnancy, according to the Guttmacher Institute, a research organization that supports abortion rights. There is no data on how many are the result of a catastrophic fetal diagnosis.

The public generally opposes abortions late in pregnancy. Polls show that the more advanced a pregnancy, the greater the drop-off in public support to access. A 2012 Gallup poll — the most recent available from Gallup — found that 80 percent of people believe abortion should be illegal in the last three months of pregnancy. Nearly two-thirds said it should be illegal in the second trimester, more than twice as many who said it should be illegal in the first trimester.

The immediate impulse of most people is to oppose late-term abortions, even if they support access to the procedure early on, said Tresa Undem of PerryUndem, a public opinion researcher who holds focus groups on issues such as abortion.

But those attitudes may change when people get additional information, such as a devastating fetal diagnosis, she said, citing the most recent Harvard-STAT poll.

"You ask about one more layer and you get a different answer," Undem said. "If you scratch one centimeter below the surface on an abortion question in a poll, you're going to get a truer sense of attitudes."

Zika's impact on fetal development hasn’t changed the positions of anti-abortion lawmakers like Sen. Marco Rubio of Florida. | AP Photo

Dr. Willie Parker, an abortion provider in the South and the board chairman of Physicians for Reproductive Health, hasn’t yet seen a patient with Zika. But he has seen patients in states with abortion bans after 20 weeks get tragic diagnoses after that cutoff.

“Even if you have the financial wherewithal to cross the borders … it really is placing women in this perilous position when they get this devastating diagnosis, yet they can’t do anything about it,” he said. “It’s unconscionable that women will have to continue pregnancies when we know the outcome will be devastating.”

If international experience is a guide, desperate women find their own ways to end pregnancies. In South and Central America, where some countries ban abortion in all circumstances, an online nonprofit that mails abortion medications directly to women saw demand spike after Zika became widespread.

Requests from countries with Zika infection rose between 36 and 108 percent over the baseline period, according to a study in the New England Journal of Medicine.

And there is historic precedent for a disease to bring the abortion debate to the forefront.

Fifty years ago, an outbreak of German measles, also known as rubella brought the then-obscure issue of abortion into the mainstream. Like Zika, rubella has little effect on healthy adults but can cause birth defects when a woman is infected during pregnancy.

Media coverage about white, middle-class and married women who sought abortions during the outbreak helped to reduce the stigma of the procedure and also to demystify it, said Leslie Reagan, who wrote a book about the epidemic.

“The epidemic spread across the country and the whole country was warned about the possibility of 20,000 ‘damaged babies’ — that’s what they called them — being born,” Reagan said. “There had been no conversation in public, in politics ... that treated abortion as something respectable and something that might be done for decent reasons. But this generated public discussion and petitions and eventually led to changing laws in the states.”

A decade later, the Supreme Court’s Roe v. Wade decision legalized abortion.

Tobias doesn’t expect the same liberalization of abortion laws and points out that opposition to abortion is much stronger today than it was then.

“In the 60s, the pro-life movement was not nearly as active and organized,” she said.

Besides changing public perceptions about abortion, the German measles outbreak also led to the birth of about 20,000 children with congenital rubella syndrome, with varying degrees of heart problems, blindness or deafness. That spike led to changes in how the public perceived disabilities, ultimately helping to spur passage of a 1975 law that guaranteed public schooling for all children with disabilities, Reagan said.