Zika is back in the headlines recently based on a recent report by CDC which found a twentyfold increase in birth defects among pregnant women in the US with laboratory evidence of possible Zika virus infection and a thirtyfold increase in brain abnormalities in this population. In 2016 alone, there were nearly 1300 pregnancies in women with possible Zika virus infection reported to the CDC from 44 states.
Puerto Rico bears the greatest burden of Zika infections of all the US states and territories.
There have been over 35,000 cases reported in Puerto Rico from 2015 to date.
I recently traveled to Puerto Rico to speak with those leading the charge in the fight against it virus. It was clear the amount of information unknown or uncertain about Zika is startling. This makes decisions about when or if to become pregnant — or whether to continue a pregnancy — even more difficult for women.
During my time in Puerto Rico, I heard about the three main pillars in the fight to prevent Zika infection and its sequelae. The first is control of the vector of the disease, the Aedes Egyptii mosquito through eradication and prevention efforts. The other two pillars, prevention of unintended pregnancy and protection of pregnant women from Zika, reveal the critical importance of access to reproductive health care.
Unfortunately, in Puerto Rico as in many countries impacted by Zika, access to a full range of contraceptive options before the outbreak was limited. At the start of the outbreak, an
estimated 138,000 women of reproductive age lacked access to contraception and 65% of
pregnancies every year were unintended. This unmet need for reproductive health care access became even more urgent in light of the Zika epidemic. At the height of the outbreak in Puerto Rico, over 100 pregnant women per week were being infected with the virus.
To address women’s lack of access to contraception in Puerto Rico and thereby reduce the
number of pregnancies impacted by Zika, the Zika Contraception Access Network (ZCAN) was established in 2016 by the CDC in partnership with the Puerto Rico Department of Public Health and local implementing organizations in the private sector. The main objective of the ZCAN project is to build a network of healthcare providers and clinics which will provide a full range of contraception options same-day and free of charge which has been shown in other settings to increase the number of women who initiate and continue contraception.
Local organizations in Puerto Rico such as PROGyn and Profamilias are valuable players in
instilling a sense of urgency and importance for family planning and contraception availability not only for the public, but for the government officials as well.
However, this crisis sheds light on an important point: public health emergencies like Zika
should not be the only catalyst for a strong, dedicated public effort to increase access to
contraception, but rather a reminder that reproductive health is a fundamental aspect of a
healthy society.
For more information and to check out my interviews with experts in Puerto Rico, go to the videos section.