Abortion – Page 7 – Population Matters-USA

Image courtesy of the CDC

“The Zika virus provides a glimpse into a future we should do everything possible to avoid, a terrifying reminder why the fight for a stable physical planet is the fight of our time.” Bill McKibben

â€œDonâ€™t get pregnant until 2018â€ is the advice given women in El Salvador. Yet only two thirds of married women there are using modern contraception.

The Zika virus, declared â€œpublic health emergency of international concernâ€, is the cause of the Salvadorian governmentâ€™s warning against pregnancy. â€œWeâ€™d like to suggest to all the women of fertile age that they take steps to plan their pregnancies, and avoid getting pregnant between this year and nextâ€¦.â€ This quote from Deputy Health Minister Eduardo Espinoza is frightening.

Although it hasnâ€™t caused an epidemic in Africa where it was first identified, it is raising havoc in the Americas. Zika virus symptoms are usually mild: eye inflammation, fever, rash and joint irritationâ€”but the majority of infected people have no symptoms at all. There is no treatment for Zika disease. Mosquitoes of the Aedes genus spread Zika, dengue and other diseases, and it may also be spread by sex.

The best way to avoid getting Zika is to avoid being bitten by mosquitoesâ€”insect repellant, dress appropriately and avoid areas where mosquitoes live. So far Colorado is safe from Aedes.

Climate change has recently increased the range of Aedes mosquitoes. Air travel has allowed the virus to spread like lightning. Humans have destabilized the planet, as McKibben states.

The Zika story in the Americas is still being written, but began last year. Brazilian doctors noticed a huge increase in the incidence of babies born with small headsâ€”microcephaly. They found an association with the mothers having had Zika virus infection early in pregnancy.

I am terrified that brain scans of affected babies show other serious abnormalities usually associated with profoundly impairment. There are dozens of causes of microcephaly, but most of them are associated with cognitive and other problems.

The CDC recommends avoiding Zika when a woman is, or could become, pregnant. If the mother could have been exposed to the virus during pregnancy, it recommends ultrasounds to monitor fetal head growth.

What is so concerning is that where Zika is found, family planning services may be spotty. Fortunately El Salvador, where women are supposed to abstain from pregnancy for the next 2 years, has had a pretty successful reproductive health program. It is regrettable, however, that El Salvador is one of only 6 countries worldwide that outlaw abortion for any reason.

Beloved Pope Francis recently gave Catholic women who are at risk of Zika virus permission to use â€œartificialâ€ contraception. This is great news for the millions of women where Zika is a threat, and will hopefully encourage governments in those areas to make contraception easily available.

One of the reasons that the U.S.A. liberalized of our abortion laws was that we had a viral epidemic that caused severe fetal damage. Fortunately, immunization has made rubella a disease of the past.

What happens if a woman is infected with Zika in pregnancy and ultrasound shows that her fetus has microcephaly? The Salvadorian punishment for having an abortion is 2 to 8 years in prison for the woman and up to 12 years for the doctor. Nevertheless hundreds of women risk having an illegal abortion. Often they cause their own abortions by thrusting a knitting needle or piece of wood into their uterus. Tragically, suicide is not uncommon among pregnant women in El Salvador.

Here is a hypothetical situation. Luisa, a Salvadoran campesina, has two healthy children. She was taking birth control pills, but her clinic ran out. Shortly after conceiving her third pregnancy she had what she thought was a cold with a mild red rash. During a routine ultrasound at 5 months the doctor said everything was ok except the fetusâ€™s head seemed small, and she could see calcifications in the brain. What can Luisa do? If this babyâ€™s brain was severely damaged she couldnâ€™t afford to take care of it, and her other two children would suffer because of the familyâ€™s very limited resources.

What is wrong with a society that puts women in such a difficult bind? Rape is common in El Salvador, yet a woman who has been raped or is carrying a terribly compromised fetus has no legal recourse. Climate change and international travel make it more important that women everywhere have access to family planning and safe abortion services.

Â© Richard Grossman MD, 2016

Lament over Unplanned Pregnancy

The prevention of unwanted pregnancy is more important than ever for the well-being of the family.

Antero Myhrman, Born Unwanted

One of my strongest memories from medical school was a delivery I assisted with. This was the motherâ€™s fifth child and a quick birth. I proudly held up the newborn boy to show him to his mother. She turned her head away and cried.

I donâ€™t remember the names of the mother or baby, who would be about 44 years old now. How his life has gone is only conjecture, but the likelihood is that his path has not been an easy one.

We generally assume that all adults are cut out to be parents, but that is not true. Forced parenthood can have unhappy consequences for the adults, and especially for the children. This column examines the outcomes of children of unwilling parents. Next monthâ€™s column will include the words written by a person who, herself, was born unwanted.

The biggest and best analysis of children born unwanted was done in Czechoslovakia at a time when women had limited access to legal abortion. An American psychologist, Dr. Henry David, collaborated with Czech counterparts. Czech women had two chances to request an abortion in the 1960s. The first chance was at a local clinic. If the woman were turned down, she could apply again at a regional level, the last resort for a legal abortion. Unfortunately, the many advantages of adoption were not considered in this study.

One of the Czech psychologists had a list of women who had been twice denied for the same pregnancy. Because of the excellent record keeping of that country, the children born to these women with unwanted pregnancies could be followed for many years. They were carefully matched to children who were desiredâ€”same age, same socioeconomic class, same school etc. All the families lived in Prague, the countryâ€™s capital.

These people, both those who were unwanted before birth and the â€œnormalâ€ controls, were examined and tested at age 9, in adolescence and again in their early 20s. The investigators also looked at records, interviewed parents and spoke with teachers.
The two groups of people ended up significantly different despite growing up in very similar circumstances. Compared to the people who resulted from pregnancies that were planned (or at least accepted), those born unwanted did not fare so well in life.
Specifically, the babies who had been unwanted were not breastfed as long, and did not achieve as well in school even though their intelligence tests were as good as the more desired children. They were more likely to be less social and more disruptive and hyperactive, and were more likely to have criminal records. When asked as adolescents, the children who had been unwanted believed their mothers showed less maternal interest than did the control group.

The young adults in their 20s were asked how they felt about their lives. Again there was a significant difference, with the people who were unplanned being less satisfied with their lives, with their love relationships, with their own mental health and with their jobs. It is interesting that their sexual debut was at an earlier age and they had more sexual partners than control people. Thus, these people were more likely to beget another generation of unwanted pregnancies.

There are exceptions to the general rule, fortunately. Dr. Davidâ€™s research found three groups of women who requested abortions but were denied. Some had temporary motivation for wanting to abort, such as financial reasons. These women usually accepted the pregnancy and both mother and child did well. For other women the pregnancy resulted from a poor relationship, and they did not do so well with childrearing. The third group of women apparently realized from the beginning that they would not be good parents, and the study, unfortunately, bore this out. Both the women and their children did not fare well.

The Czech study was of women who were denied legal abortion. Those who were allowed to have abortion must have had even more compelling reasons to not parent. If they had been forced to bear their unwanted kids, presumably these children would have had even more severe problems.

What does this mean? A person resulting from an unplanned, unwanted pregnancy starts off life with a handicap, like the baby I delivered in medical school. This can have consequences for society, too. There is a controversial theory, popularized in Freakonomics, that the downturn in serious crime in the USA noted in the early 1990s was due to the decrease in unwanted pregnancies after the legalization of abortion in 1973.

An unwanted pregnancy can be devastating. Sometimes things work out well, but delivering and raising an unwanted baby may be traumatic for the parent(s), and scar the child.