Experts Don’t Know What To Tell Women About Getting Pregnant In the Caribbean With The Zika Virus Present
SAN JUAN — As the Zika virus bears down on the United States, federal health officials are divided over a politically and ethically charged question: Should they advise American women to delay pregnancy in areas where the virus is circulating?
Some infectious disease experts are arguing that avoiding conception is the only sure way to prevent the births of deformed babies, according to outside researchers who serve on various advisory panels.
Women’s health specialists, on the other hand, counter that the government should not tell women what to do with their bodies.
Indeed, federal health officials have never advised all the women in a region of the country to stop having children. Moreover, they say, most babies conceived during Zika epidemics in Latin America have been born healthy.
Several federal experts central to the discussion declined to be interviewed for this article. Dr. Thomas R. Frieden, the director of the Centers for Disease Control and Prevention, described the internal debate as “a very long conversation.”
For now, “we do not have a recommendation to not become pregnant,” Dr. Frieden said at a “Zika summit” held recently at disease agency headquarters in Atlanta. “We do recommend access to contraception.”
On Wednesday, the agency confirmed what many experts already believed: that the mosquito-borne virus, which is usually mild in adults, can cause severe brain damage in infants.
In view of the gathering evidence, health officials in some countries struck by Zika epidemics, including El Salvador and Colombia, have urged women to avoid pregnancy.
Dr. Marcos Espinal, who directs the Zika response of the Pan American Health Organization, an arm of the World Health Organization, said in an interview that he thought advising women to avoid conception during an epidemic’s relatively brief peak months, as Colombia did, “is sound advice.”
Yet the W.H.O. does not follow that policy. Dr. Bruce Aylward, the agency’s head of emergency response, called avoiding pregnancy “a complicated decision that is different for each individual woman.”
Currently, the question affects Americans only in Puerto Rico, the U.S. Virgin Islands and American Samoa, where the Zika virus is circulating locally. But if the virus spreads as expected this summer, women in Hawaii and many Gulf Coast states may also be faced with tough choices.
Despite the CDC’s stance, Puerto Rico’s health secretary, Dr. Ana Ríus, has been advising women to avoid pregnancy, although she has done so in public interviews, not in a large health campaign. Women on the island may be following her advice, she said; preliminary figures indicate that there are eight percent fewer pregnancies than there were at this time last year.
For women living on those islands, the disease agency’s current guidelines do not advocate delaying pregnancy, instead calling the timing of conception a “deeply personal and very complex decision” and suggesting that women consult their doctors for “pregnancy planning.”
But tourists visiting the islands receive specific advice to avoid pregnancy for eight weeks after a visit, and for six months if male partners have had symptoms of Zika infection.