By Carole Joffe
The Zika virus crisis, which is believed to have already caused the birth of thousands of newborns with microcephaly (which causes unusually small heads and underdeveloped brains), has created an acutely distressing situation for millions of women. Most of the affected countries, particularly in Latin America, have extremely strict policies about abortion and very inadequate provision of birth control. Most notably, in El Salvador, where the Minister of Health recently suggested that women delay pregnancy for two years because of the Zika virus, abortion is absolutely forbidden, even in cases where the pregnant women’s life is at risk. Women suspected of abortion, or even in some cases, miscarriages, now languish in El Salvador’s jails. (Other Zika-infected countries which have a similar absolute ban on abortion are Nicaragua and the Dominican Republic). But being pregnant while infected with the Zika virus is not life threatening—so even in Latin American countries which would permit abortion in such cases would not do so, under current law, because of the possibility of the serious birth defects of microcephaly.
The Zika crisis has led many observers to speculate whether this grave situation might be a game changer with respect to abortion in Latin America. There are, of course, many countries in Latin America, and they can’t all be expected to react alike. But there are grounds to hope that at least some of the affected countries might be moved to change their laws to make abortion more readily available. Actually, the history of abortion in the United States offers an interesting case of a dramatic shift in public sentiment that might be a harbinger of what’s to come in Latin America.
Two events that occurred in the 1960s were instrumental in moving much of United States toward legal abortion. The first, in 1962, involved Sherri Chessen Finkbine, a Phoenix woman pregnant with her fifth child, who learned that the thalidomide pills she had been using for sleep were strongly associated with severe birth defects. Her doctor was able to arrange a “therapeutic” (i.e. approved) abortion for her at a local hospital, but Finkbine, in an act of decency that would prove costly, went public with her story, in order to warn other women facing the same situation. Her interview with a journalist created a media sensation, and nervous hospital authorities cancelled Finkbine’s abortion. Ultimately Finkbine, unable to find an abortion anywhere in the United States, obtained one in Sweden, where she delivered a fetus with missing limbs. Finkbine’s story spread beyond Phoenix to become a national story, including a sympathetic story in Life Magazine, a highly popular journal in that period. In the eyes of many observers, this marked a turning point in support for abortion among the general public.
The second incident, which took place in 1966, had a similarly powerful effect, this time within the medical community. Nine highly-respected San Francisco doctors, affiliated with university hospitals, were abruptly threatened with the loss of their licenses because they had been performing hospital-based abortions on women infected with rubella, a practice that was increasingly common in a number of states by the 1960s, as evidence of the link between this disease and birth defects became known.
The sudden decision to prosecute these physicians apparently was instigated by one person, a strongly anti-abortion member of the California Board of Medical Examiners. But the prosecution backfired. The case drew national media attention and an unprecedented show of support across the country; more than 100 deans of medical schools protested this prosecution, and ultimately the charges were dropped. A few years later, the American Medical Association reversed its longstanding position on abortion and voted, at its annual meeting, in support of a resolution calling for legalization.
It is too soon to know whether the Zika crisis, in at least some of the affected countries, will have the same galvanizing effect as did the combination of thalidomide and rubella pregnancies in the United States in the 1960s. (Nor, for that matter, do we know yet whether Zika will come to the United States in significant numbers and impact the abortion debate here). Arguably, in the U.S. case back then, many Americans were already becoming increasingly in favor of legal abortion and these incidents simply crystallized sentiments that were already there.
Today, abortion politics are far different than they were in the 1960s, and those in Latin America pushing for abortion liberalization have to contend with powerful religious organizations both within their own countries and globally. Much will depend, of course, on the willingness of the medical and legal communities, as well as the feminist health movements in these countries to take on these formidable opponents. Some hope that the Pope will soften the Church’s opposition to abortion and contraception because of this crisis. One thing is clear, as it always is in the reproductive wars: it is the poorest women and their families, most likely to live in Zika-infested areas and least likely to have the resources to prevent tragic births, who will suffer the most.
Update: On February 18, the Pope, after a visit to Mexico, stated to reporters that women in areas affected by Zika were justified in using contraception, though he reiterated his opposition to abortion.
About the Author
Carole Joffe is a professor in the Advancing New Standards in Reproductive Health (ANSIRH) Department of Obstetrics, Gynecology & Reproductive Sciences at the University of California-San Francisco and a professor emerita of sociology at the University of California-Davis. She is the author of several other books, including Doctors of Conscience and Dispatches from the Abortion Wars. Follow her on Twitter at @carolejoffe.