Requests for medication abortion support in Brazil during and after the Zika epidemic

ABSTRACT

Brazil declared a public health emergency during the Zika virus epidemic, recommending avoiding pregnancy. This study analyses requests received by Women Help Women for information about and support for self-managed medication abortion (MA) in Brazil during and after the Zika epidemic to understand how Zika may have impacted requests to the service. This analysis considered 20,609 requests for MA support received between January 2016 and June 2017. Reasons for seeking an abortion were analysed alongside geographic trends in the percent and rate of requests citing Zika as a reason for seeking abortion. The average number of daily requests for MA support increased from 31 in January 2016 to 48 in June 2017. The average percent of daily requests citing Zika as a reason for seeking an abortion decreased from 15% in March 2016 to 1.5% by June 2017. The most common reason for abortion seeking during and after the Zika epidemic was not being prepared for a child or not wanting any or additional children (between 52%–59% of requests). As the Zika epidemic slowed, MA requests citing Zika as a reason decreased, while requests increased overall. Few people cited Zika alone as a reason for abortion seeking, necessitating a broad contextualisation of abortion access in people’s daily lived experiences and realities.

KEYWORDS:

• Abortion
• Zika
• Brazil
• Induced abortion
• Self-managed abortion

Acknowledgements

We would like to thank Yasmin Reyes, MPH and Isabel Muñoz, MPH for their work processing and prepping data for this study. CG and KJ led the conceptualisation of the study; AW and CG led the design; AW lead the drafting of the manuscript; and SL, CG and KJ revised and edited the manuscript. All authors approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

Due to our commitment to protect the confidentiality and anonymity of those requesting support from Women Help Women, we cannot make the data used for this study available for download. We are happy to answer any inquiries related to the data used for the manuscript and provide additional information, where possible.

Notes

1 We acknowledge that not all people who are in need of abortion care and who submitted requests for medication abortion support identify as ‘women’. However, the best approximation for the population who are able to become pregnant and may be in need of abortion care is women of reproductive age. Throughout this manuscript we use the gender-inclusive term ‘people’ where possible, and use the more specific ‘women’ when referring to the standardized rates we have created using the population of women 15–49.