Zika, abortion and health emergencies: a review of contemporary debates

Abstract

Background The Zika outbreak provides pertinent case study for considering the impact of health emergencies on abortion decision-making and/or for positioning abortion in global health security debates. Main body This paper provides a baseline of contemporary debates taking place in the intersection of two key health policy areas, and seeks to understand how health emergency preparedness frameworks and the broader global health security infrastructure is prepared to respond to future crises which implicate sexual and reproductive rights. Our paper suggests there are three key themes that emerge from the literature; 1) the lack of consideration of sexual and reproductive health (SRH) services in outbreak response 2) structural inequalities permeate the landscape of health emergencies, epitomised by Zika, and 3) the need for rights based approaches to health. Conclusion Global health security planning and response should specifically include programmatic activity for SRH provision during health emergencies.

COVID-19: the gendered impacts of the outbreak

“…8 For example, resources for reproductive and sexual health were diverted to the emergency response, contributing to a rise in maternal mortality in a region with one of the highest rates in the world. 9 During the Zika virus outbreak, differences in power between men and women meant that women did not have autonomy over their sexual and reproductive lives, 10 which was compounded by their inadequate access to health care and insufficient financial resources to travel to hospitals for check-ups for their children, despite women doing most of the community vector control activities. 11 Given their front-line interaction with communities, it is concerning that women have not been fully incorporated into global health security surveillance, detection, and prevention mechanisms.…”

Zika Virus Public Health Crisis and the Perpetuation of Gender Inequality in Brazil

“…Destroying mosquito breeding sites, implementing measures of individual protection, preventing pregnancy or caring for a child with microcephaly is nonetheless more troublesome for those in the low end of the socioeconomic scale (5). By ample recommending pregnant postponement without taking into account the large socioeconomic and self-determination differences of Brazilian women, campaigns not only charged women with the responsibility to avert microcephaly (5,34), but also "transforms a problem that is political, systemic, and structural into a question of individual conduct of poor, marginalized women who do not have power over their life projects" (30).…”

“…Other than providing women the toolkit to make informed reproductive health decisions, campaigns fail to address contexts of gender based violence (5,30,34) and women´s low power of negotiation to implement their reproductive plans (27,29,32). Failed attempts to alter sexual behavior and the inability to disagree with their sexual partners comprised vital aspects for understanding female sexual behavior, particularly when practices compromised health.…”

“…Essentialist beliefs legitimized traditionally gendered roles (60). Pregnancy aversion during the Zika epidemic expected women to assume the prevention burden, fomenting uneven responsibilities distribution (34).…”

“…When a public health crisis taps directly into reproductive health, typically a feminine realm, gender systems may reproduce traditionally and deeply-rooted gender norms, especially those linked to cultural beliefs and expectations playing out in different relational contexts. Despite its importance, most of the literature regarding the gender consequences of the Zika outbreak is theoretical (5,16,(27)(28)(29)(30)(31)(32)(33)(34)(35) with a dearth of empirical studies exploring how traditional gender stereotypes increase women´s vulnerability and how gender division of labor hinders arbovirus control. Exceptions have been able to explore gendered power and norms during the Zika outbreak in connection with sex and contraceptive use (24,28,36).…”