Zika virus outbreak: reproductive health and rights in Latin America.

In mid-January, 2016, health ministers from diff erent Latin American countries made public recommendations to women and couples to postpone pregnancy for 6 months to 2 years in the face of the Zika virus outbreak. These recommendations seemed out of place in view of the fact that 56% of pregnancies in the region are unintended. Poor quality of sex education, poor access to contraception, high prevalence of rape, and cultural barriers that make it diffi cult for women to negotiate the use of contraception with their partners, result in large groups of women who do not have control over their sexual and reproductive lives. No reliable information is currently being offered to women who are already pregnant and their families about the confi rmed or potential risks of Zika virus infection, the diff erent types of microcephaly that the virus might cause and the consequences of each type depending on its severity, and how to safely carry the pregnancy to term or access an abortion when allowed by law. The countries most affected by Zika virus have widely varying laws on women’s sexual and reproductive rights. In El Salvador, for example, abortion is completely outlawed, and many women who have had miscarriages are serving prison sentences of up to 40 years on abortion charges. Even in countries with more progressive laws that allow termination of pregnancy when there is a risk to the woman’s health, such as Colombia, many women are unaware of this right because of a scarcity of information. The Colombian Ministry of Health has been clear that women do have the right to have an abortion, and that although the physician is the person who determines whether a risk to the physical, mental, or social wellbeing of the woman is present, the decision remains in the woman’s hands. However, local health authorities at municipal levels, who are closer to women at risk, are not providing enough information to these women about the risks and the choices available according to the law. The Zika virus outbreak is exposing the tragic failures of reproductive health and rights policies in Latin America. Too many women, particularly those living with social inequality and vulnerability, face two risk factors in relation to Zika virus infection during pregnancy. These women and girls often have poor access to reproductive health and rights information and services, and their housing and local environments disproportionately expose them to areas that are breeding grounds for mosquitoes. The Zika virus crisis off ers a belated opportunity for governments to begin to close gaps in sex education and access to contraceptives, safe motherhood, safe abortion, and programmes to prevent discrimination and exclusion of people living with disabilities. If governments do not take this opportunity, the Zika virus will not only be a public health issue, but also exacerbate existing gender inequalities and social injustice.