http://nyti.

ms/1R2BfPj

AMERICAS

SurgeofZikaVirusHasBrazilians
ReexaminingStrictAbortionLaws
BySIMONROMERO

FEB.3,2016

RECIFE,BrazilThesurgingmedicalreportsofbabiesbeingbornwith
unusuallysmallheadsduringtheZikaepidemicinBrazilareignitinga
fiercedebateoverthecountrysabortionlaws,whichmaketheprocedure
illegalundermostcircumstances.
ProminentlegalscholarsinBraslia,thecapital,arepreparingacaseto
gobeforeBrazilshighestcourt,arguingthatpregnantwomenshouldbe
permittedtohaveabortionswhentheirfetusesarefoundtohave
abnormallysmallheads,aconditionknownasmicrocephalythatBrazilian
researcherssayislinkedtothevirus.
AjudgeincentralBrazilhastakentherarestepofpubliclyproclaiming
thathewillallowwomentohavelegalabortionsincasesofmicrocephaly,
preparingthewayforafightovertheissueinpartsofthecountrys
labyrinthinelegalsystem.
AndhereinRecife,theBraziliancityhithardestbytheincreasein
microcephalyandthebraindamagethatoftencomeswithit,abortion
rightsactivistsareseizingonthecrisistocounterconservativelawmakers
whohavelongwantedtomakeBrazilsabortionlawsalreadyamongthe
moststringentinLatinAmericamorerestrictive.
ThescientificlinkbetweenZikaandinfantbraindamagehasnotyet

beenproven.ButtherisingreportsofmicrocephalyinpartsofBrazil
strickenbyZikahavecausedenoughalarmthattheWorldHealth
Organizationdeclaredaninternationalpublichealthemergencyon
Monday,notingthatitsexpertsagreedthatacausalrelationshipbetween
Zikainfectionduringpregnancyandmicrocephalyisstronglysuspected.
SomeBraziliandoctorsarealreadyencounteringpregnantwomen
seekingabortionsbecauseofthespikeinmicrocephalycases.Dr.Artur
Timerman,aninfectiousdiseasespecialistinSoPaulo,saidthattwo
patientshadspokenwithhiminrecentweeksaboutendingtheir
pregnanciesbecausetheytestedpositivefortheZikavirus.
Theycometomyofficeandask,Isthereachanceformybabytohave
microcephaly?Dr.Timermansaid.Weneedtoinformthemthereis.
Theyaskifthechanceisbigorsmall.Irespond,Idontknow.Theyask
whatIwoulddointheirposition.Itellthemitsapersonaldecision,only
thatthechanceisarealone.
Later,Dr.Timermansaid,bothpatientstoldmetheyhad
abortions.
Thedebateoverwhetherwomenshouldbeallowedtohaveabortions
inmicrocephalycasescouldreverberateacrosstheregion.Theoutbreakin
theWesternHemisphereisbelievedtohavebeguninBrazil,thecountry
withthemostZikainfectionsbyfar.Buttheepidemichasspreadtomore
than25countriesandterritoriesintheAmericas,someofwhichhave
abortionlawsthatareasrestrictiveasBrazils,ifnotmoreso.
ThepushtorelaxabortionrestrictionsinBrazilraisesdifficultissues
onmanysidesoftheargument.Themostseverecasesofmicrocephalycan
usuallybedetectedwithultrasoundscansaroundtheendofthesecond
trimester,orroughly24weeks.SupportersofBrazilsexistingabortionlaws
contendthatsuchlatetermabortionsintensifyanalreadywrenching
decision.
Withmicrocephaly,thechildisalreadyverymuchformedandthe

parentsareconsciousofthis,saidDr.LeniseGarcia,abiologyprofessorat
theUniversityofBrasliaandthepresidentofBrazilWithoutAbortion,an
organizationagainsteasingtheabortionlaws.Gettinganabortioncreates
guiltthatwillstaywiththewomanfortherestofherlife.
JudgeJesseirCoelhodeAlcntara,whohaspubliclystatedthat
abortionshouldbeallowedinmicrocephalycases,acknowledgedthatthe
issueiscomplex.
Iknowthisisverydifficultbecausethesubjectisnew,requires
thoroughdiscussionandagreatdealofreligiousinfluencespersists,said
Mr.CoelhodeAlcntara,ajudgeinGoisState.Butmypositionisthat
abortionformicrocephalyshouldbeallowed.
Proponentsofchangingtheabortionlawcitea2012rulingbythe
SupremeFederalTribunalofBrazilallowingabortionswhenthefetushas
anencephaly,aseriousbirthdefectinwhichpartsofthebrainorskullare
missing.Almostallbabieswithanencephalydieshortlyafterbirth,the
CentersforDiseaseControlandPreventionsays.
Butmicrocephalyisfarlesspredictable.Evenwhenitisdetected
beforebirth,doctorsoftencannotsaywhattheeffectswillbe,potentially
makingdecisionsaboutabortionalotmorecomplicated.
Somechildrenwithsevereappearingbrainmalformationsseemtobe
relativelyunaffected,saidDr.HannahM.Tully,aneurologistatSeattle
ChildrensHospitalwhospecializesinbrainmalformations.Yetothers
withrelativelyminorstructuralproblemsmayhaveprofounddisabilities.
Atleast10percentofbabieswithmicrocephalyhavenomental
deficits.Indeed,thesechildrenendupintellectuallyanddevelopmentally
normal,saidDr.ConstantineA.Stratakis,apediatricgeneticistanda
scientificdirectorattheNationalInstituteofChildHealthandHuman
DevelopmentinBethesda,Md.Butanychildwhoseheadmeasuresthree
orfourstandarddeviationsbelowthemean,thenitsveryunlikelythatyou
willbedealingwithnormalintelligence.

InBrazil,abortionsareallowedonlyincasesofrape,anencephalyor
whenthemotherslifeisindanger.Untilrecently,conservativelawmakers
hadbeenseekingtomakelegalabortionshardertoget,reflectingthe
influenceofRomanCatholicleadersandtheincreasinglypowerful
preachersatthehelmofagrowingevangelicalChristianmovement.
LedbyEduardoCunha,theconservativespeakerofBrazilslower
house,aninfluentialblocofevangelicalChristianlawmakersintroduced
legislationin2015tomakeitharderforrapevictimstogetabortionsby
requiringthemtoundergoapolicereportandforensicmedicalexam.
Anotherpartofthebillseekstomakeitacrimeforpeopletoassistinan
abortionorencourageapregnantwomantohaveone.
ButnowsomeactivistsherearedrawingcomparisonsbetweentheZika
epidemicandthedebateoverabortionintheUnitedStatesinthe1960s,
whenanoutbreakofrubella,avirusthatcanalsocausemicrocephaly,
resultedinthousandsofbabiesbornwithbirthdefects.Theconcernsover
rubella,alsocalledGermanmeasles,pavedthewayforstateslikeCalifornia
toallowabortionwhenafetusissubstantiallydamaged.
PregnantwomenacrossBrazilarenowinapanic,saidSilvia
Camura,adirectorofSOSCorpo,afeministgroupinRecife.Thefears
overtheZikavirusaregivingusarareopeningtochallengethereligious
fundamentalistswhoputthelivesofthousandsofwomenatriskinBrazil
eachyeartomaintainlawsbelonginginthedarkages.
AsintheUnitedStatesbeforetheSupremeCourtslegalizationof
abortionin1973,aclandestineabortionindustrythrivesthroughoutBrazil.
Someillegalproviderschargethousandsofdollarstodotheprocedures,
riskingarrestandtheclosingoftheirclinics.
EstimatesonthenumberofillegalabortionsinBrazilvarywidely.
Drawingonhospitalrecordsshowingthatabout150,000womenseek
medicalattentioneachyearforcomplicationsfromillegalabortions,
Brazilianscholarsestimatethatasmanyas850,000abortionsare
performedillegallyinthecountryonanannualbasis.

WhileBrazilsabortionlawsarelessstringentthanthoseinsomeother
LatinAmericancountriesinElSalvador,forinstance,abortionisnot
allowedunderanycircumstancesillegalproceduresarenottreated
lightly.
OneBrazilianwomanwashandcuffedtoahospitalbedandarrested
aftershesoughtmedicalattentionforabotchedabortion.Ajudge
sentencedotherwomeninthecityofCampoGrandewhohadundergone
illegalabortionstodocommunityserviceindaycarecenters,arguingthat
itwouldteachthemtolovechildren.A9yearoldgirlwhosaidshehad
beenrapedbyherstepfatherwasallowedtohaveanabortioninRecife,but
onlyafteraheatednationalbattleinwhichofficialsovercameobjections
fromreligiousleaders.
DeboraDiniz,ananthropologistandresearcheratAnis,anabortion
rightsgroupplanningtofilealawsuitseekingtolegalizeabortionincases
ofmicrocephaly,likenedtheZikacrisistothelongstruggletoallow
abortionincasesofanencephaly,whichlastedaboutadecade.
Wehaveanepidemic,anemergency,andthepublichealthsectoris
notproperlycaringforwomensrights,shesaid.Wehaveconstitutional
rightsatrisk,therighttohealthcareandhumandignity.
ReligiousleadersarevowingtoresistanyefforttoeaseBrazils
abortionlawsbecauseofZika.
Nothingjustifiesanabortion,theRev.LucianoBrito,aspokesman
fortheRomanCatholicArchdioceseofOlindaandRecife,toldreporters.
Justbecauseafetushasmicrocephalywontmakeusfavorableto
changingthelaw.

CatherineSaintLouiscontributedfromNewYork.AnnaJean
KaisercontributedreportingfromRiodeJaneiro,andPaula
MourafromSoPaulo.

2016TheNewYorkTimesCompany