Zika Virus Forcing Brazil to Consider Exceptions to Its Strict Abortion Law

Ny Times (Feb. 3, 2016): Surge in Zika Virus Has Brazilians Re-examining Strict Abortion Laws, by Simon Romero:

RECIFE, Brazil — The surging medical reports of babies being born with unusually small heads during the Zika epidemic in Brazil are igniting a fierce debate over the country’s abortion laws, which make the procedure illegal under most circumstances.

In Brazil, abortions are only allowed in cases of rape, where the mother's life is in danger or when the the fetus suffers from anencephaly, a birth defect that causes part of the brain or skull to be missing.  Concern that pregnant women's exposure to the Zika virus may cause microcephaly in their fetuses has spurred debate over whether access to abortion should be broadened. 

The abortion debate is further complicated because severe cases of microcephaly aren't detected until around 24 weeks.  While anencephaly is almost always fatal, microcephaly outcomes are less predictable.  

“Some children with severe-appearing brain malformations seem to be relatively unaffected,” said Dr. Hannah M. Tully, a neurologist at Seattle Children’s Hospital specializing in brain malformations. “Yet others with relatively minor structural problems may have profound disabilities.”

At least 10 percent of babies with microcephaly have no mental deficits. These children end up “intellectually and developmentally normal,” said Dr. Constantine A. Stratakis, a pediatric geneticist and a scientific director at the National Institute of Child Health and Human Development in Bethesda, Md. But any child whose head measures “three or four standard deviations below the mean, then it’s very unlikely that you will be dealing with normal intelligence.”

Because of Brazil's restrictive abortion laws, an estimated 850,000 women obtain illegal abortions.  These procedures are unregulated and create unnecessary health risks - hospital records show that 150,000 women seek attention for complications from illegal abortions each year.  They also pose the risk that women will be arrested.  The NY Times reported that one Brazilian woman was "handcuffed to a bed and arrested after she sought medical attention for a botched abortion."

The anencephaly exception was recognized in 2012 by a ruling from Supreme Federal Tribunal of Brazil following ten years of activism and litigation. Abortion rights groups are planning to file a similar lawsuit seeking to legalize abortion in cases of microcephaly.