Women who live in some Latin American countries where the Zika virus is spreading are increasingly seeking access to abortion — even though, in many instances, abortion is illegal or restricted. Since November 17th, 2015, when the Pan American Health Organization (PAHO) issued an epidemiological alert about Zika, the number of requests for abortion medications has increased significantly, sometimes even doubling, scientists have found.

The Zika virus causes microcephaly, a condition in which babies conceived by infected moms are born with abnormally small heads. Since no Zika vaccine has been approved, some infectious disease specialists think that delaying or avoiding pregnancies is the only safe way to avoid giving birth to babies with brain damage. The PAHO alert prompted several Latin American countries to declare national emergencies, caution citizens about Zika-related birth defects, and urge women to avoid pregnancies.

*Group A included countries with local Zika transmission, legally restricted abortion, and national public advisories to pregnant women.

The researchers behind today’s study, published in The New England Journal of Medicine, wanted to see whether those government advisories were actually affecting women’s behavior — and prompting them to seek more abortions. So, they compared the number of requests coming in to what they’d normally expect to see in these countries. They found that in countries like Brazil, Colombia, and Ecuador, where Zika is locally transmitted, abortion is restricted, and government officials have issued health advisories, requests for abortion increased by 36 to 108 percent since November 2015.

"That suggests to us that there is an unmet demand for abortion in those countries, because those women would not have been able to simply go to the healthcare system to exercise their reproductive options," says study co-author Abigail Aiken, a public affairs researcher at the University of Texas. "They could not have gone to get an abortion for the most part within their own healthcare systems."

*Group B included countries with no local Zika transmission and legally restricted abortion.

The researchers analyzed the requests for abortion medications submitted to Women on Web (WoW), a nonprofit organization that provides abortion medications like mifepristone and misoprostol to women in countries where safe abortion is not universally available. When they analyzed the emails and online consultation forms filled up by the women requesting the medication, the researchers also found that many women felt anxious about getting access to abortion in countries that restricted it. "They felt they were being advised to do something that they then could not implement," Aiken says. "They had no options to avoid pregnancy."

Overall, the only countries that experienced a significant increase in abortion requests were those where the government issued a health advisory. In countries like Mexico, Bolivia, and the Dominican Republic, where Zika is locally transmitted and abortion is restricted, but where government officials did not issue health advisories, there was no significant change. "It seems from our results ... that it was not just the emergency Zika virus, but also the way that countries responded to it that has impacted women’s behavior," Aiken says.

*Group C included countries with local Zika transmission, legally restricted abortion, and no national public advisories to pregnant women.

In today’s study, the researchers analyzed WoW data from 19 Latin American countries, recorded between January 2010 and March 2016. The study also included three control countries, including Poland, where no local Zika transmission existS. The analysis showed that Brazil experienced the biggest increase in requests after the PAHO alert in 2015. The nonprofit organization received 1,210 requests for abortion medication in four months, instead of the 582 requests they expected. That’s a 108 percent increase. Ecuador, Venezuela, and Honduras also experienced steep increases. Finally, there was no significant increase in the three control countries.

The point of the study, Aiken says, was to understand how the Zika emergency is affecting women. "There’s been quite a lot of research and attention paid to how Zika virus affects pregnancies, what its medical effects are," she says, "but there really hasn’t been much attention paid to the impact on women themselves and how it might affect their behaviors and options."