Over half the women in Brazil are avoiding pregnancy due to the Zika epidemic, reveals a study published online in the Journal of Family Planning and Reproductive Health Care.
There is an urgent need to reconsider abortion criminalisation, and also to improve reproductive health policies to ensure women have access to safe and effective contraceptives, say the authors of the study.
Since the outbreak of Zika in Brazil, there have been 1,845 confirmed cases of congenital Zika syndrome in babies.
A team of doctors, led by Professor Debora Diniz from University of Brasília, wanted to understand how the epidemic has impacted reproductive health practices.
A national survey conducted in June 2016 used face-to-face questionnaires to collect data about reproductive health and pregnancy, and a secret ballot box to obtain information related to abortion experiences.
Data was collected from 2,002 urban and literate Brazilian women aged 18-39 years, corresponding to 83 per cent of the total female population.
Over half (56 per cent) the women reported that they had avoided, or tried to avoid pregnancy because of the Zika epidemic.
Conversely, 27 per cent of women reported that they had not tried to avoid pregnancy because of the epidemic and 16 per cent had not been planning to get pregnant, regardless of the epidemic.
A higher proportion of northeastern women (66 per cent) than southern women (46 per cent) reported avoiding pregnancy, and the authors say this is most likely due to the epidemic being more concentrated in northeastern Brazil.
Black (64 per cent) and brown (56 per cent) women were more likely to report avoiding pregnancy than white women (51 per cent), most probably reflecting the disproportionate impact of the epidemic on vulnerable racial groups, they add.
There were no significant differences among the main religious groups: 58 per cent of Catholic women and 55 per cent of Evangelic women reported having avoided pregnancy because of the Zika epidemic.
"The results provide an important first glimpse into how the Zika epidemic has shaped pregnancy intentions among women in Brazil," explain the authors.
"Brazil must urgently re-evaluate its reproductive health policies to ensure better access to contraception information and methods" they argue.
This includes making available a wider range of contraceptive methods, including long-acting reversible contraception, which are either scarce, such as the copper intrauterine device, or not available, such as hormonal implants, through public health services.
"As indicated by the high proportion of women who avoided pregnancy because of Zika, the Brazilian government must place reproductive health concerns at the centre of its response, including reviewing its continued criminalisation of abortion," the authors conclude.