A Duty to Protect

The Zika outbreak threatens dire consequences in countries that have failed to prioritize women’s health and human rights.

Katia lives in El Salvador, one of several Latin American countries where the government has advised women to avoid pregnancy due to the spread of Zika virus. Mosquito-borne and sometimes sexually transmitted, the disease has been linked to an increase in the birth of infants with microcephaly, which can lead to severe developmental problems. It also increases the risk of developing an autoimmune disorder known as Guillaine-Barre syndrome, and researchers are investigating possible links between Zika and various neurological conditions, as well as a heightened risk of miscarriage and other pregnancy complications.

“They’ve said we shouldn’t get pregnant from now until 2018, but what they haven’t said is ‘use this contraceptive or birth control or have these tests,’” says Katia, who is 36 years old and contracted Zika this past year. “And they haven’t given contraception to women with low economic resources either.”

When Katia fell ill with Zika, she developed chills and a fever, pain in her joints, and a severe allergic reaction—all of which are common symptoms of the virus. Months later, she still deals with residual joint pain. Katia is currently unable to get pregnant due to a spinal injury, but she maintains hope of having a family sometime in the future. El Salvador’s policy toward pregnant woman—particularly as highlighted by Zika—makes that prospect less desirable.

“I would like to live in a country that supports you—where you can receive sexual health education—and that doesn’t harm you, like what happens here,” she says.

El Salvador’s long-standing failure to prioritize women’s reproductive rights has left women in the country—particularly poor women—needlessly vulnerable to the impact of a public health problem like Zika. In Latin America, approximately 55 percent of pregnancies are unintentional, and 22 percent of women of reproductive age have an unmet need for effective birth control.

“The call from the Salvadoran government for women to avoid pregnancy during the Zika crisis lacks legitimacy when the government has done nothing to help women get access to the full range of reproductive care options,” says Catalina Martínez Coral, regional director for Latin America and the Caribbean at the Center for Reproductive Rights. “It shifts the burden of responding to the situation onto individual women—which is especially harmful to those with fewer resources.”

The situation becomes all the more dire when women face a pregnancy they wish—or need—to end. In a number of Latin and Caribbean countries, including Katia’s home country of El Salvador, abortion is completely banned—with no exceptions, even in cases of rape, incest, severe fetal anomalies, or when a woman's life is in danger. Generally only women of means are able to travel elsewhere to obtain safe abortion services, while low-income women—for whom having an unexpected pregnancy is often most untenable—are forced to carry their unwanted pregnancies to term or seek clandestine, unsafe abortions.

In El Salvador, the political climate is so hostile to abortion that hundreds of women have been criminalized and prosecuted as a result of the ban, including 17 women who were charged with homicide and sentenced to 30 or more years in prison after experiencing miscarriages or other obstetric emergencies.

The Center and our local partner, Agrupación Ciudadana, have been relentlessly working to expose the harms of the extreme ban and to advocate for the release of Las 17. Just this month, one of the wrongfully imprisoned women was freed after her 40-year sentence was overturned due to serious judicial error in the original trial. Nevertheless, the Salvadoran government refuses to consider a pardon for the other women who remain imprisoned and has taken no real steps to liberalize the country’s destructive and inhumane policies in light of the Zika crisis.

This past week, El Salvador confirmed its first case of a baby born with microcephaly linked to Zika. In Brazil, where Zika-linked microcephaly was first identified, there have been more than 1,400 cases since last fall.

“At this point, the governments of El Salvador and other Latin America countries have plenty of resources and support from global bodies like the World Health Organization to address the crisis in a meaningful way—before the epidemic escalates further—and to implement policies that fulfill their duty to protect women’s basic rights to health and personal autonomy,” says the Center’s Martínez Coral. “Our goal is to raise awareness about the consequences of inaction and hold governments accountable to developing policies that protect women’s health in light of the Zika virus.”

Along with our partners both domestically and in Latin America, the Center has urged governments to place reproductive rights at the center of their response to the Zika outbreak.

In the United States, we are working with disability rights advocates and state lawmakers to craft policies that would expand access to information and reproductive health services, and provide adequate social and economic support to people with disabilities—allowing women to make meaningful, autonomous reproductive health decisions should Zika become a significant threat in this country.  

We’re also working with our allies in Congress to ensure that any government response to Zika would include provisions for a range of contraceptive options, safe and legal abortion care, and quality maternal health care.

The region of the United States most likely to first face the virus—the South—is also the region that has been most ravaged by the recent ideological assault on women’s reproductive rights and is least prepared to deal with the outcomes of a possible epidemic, due to high rates of poverty, lack of insurance, and unintended pregnancy.

The threat of Zika underscores why, for millions of women like Katia—in Latin America, the Unites States, or elsewhere in the world—full access to reproductive health services is essential.