WASHINGTON — The Brazilian Conference of Catholic Bishops has repudiated efforts to use public alarm over the Zika virus epidemic to advance abortion rights in South America’s most populous nation.
In a Feb.4 statement, the conference made clear that reports of a causal link between the mosquito-borne Zika virus outbreak in Brazil and a surge in cases of microcephaly, a type of birth defect with potentially serious consequences for the child, did not justify a stepped-up campaign to loosen legal restrictions to abortion.
The Brazilian bishops strongly opposed the new push to promote abortion, particularly, “in the cases of microcephaly, as, unfortunately, some groups are proposing to the Supreme Federal Court, in a total lack of respect to the gift of life.”
Abortion is illegal in Brazil, except in cases of risk to the life of the mother and incest. But several women’s rights groups have petitioned the Supreme Federal Court in Brazil to legalize abortion in cases of “malformation of the fetus.”
On Feb. 1, the World Health Organization (WHO) announced that a reported increase in cases of microcephaly in parts of Brazil appeared to be connected to the spread of the Zika virus in the region, and declared a global “emergency” to address the looming public health crisis.
The organization’s statement stirred fears that Latin American countries battling the virus could face an unprecedented number of infants born with microcephaly, a condition that can leave children with much smaller heads and a range of mild to severe neurological problems.
“The evidence is growing and it’s getting strong,” said Dr. Margaret Chan, the director general of the WHO, during a Feb. 1 press conference that announced her agency’s increased focus on the Zika virus and the health risks it posed.
Chan emphasized that specialists had yet to confirm their suspicion that the Zika virus was responsible for the spike in microcephaly cases in Brazil. But she argued that health officials should urge the public to take immediate precautions.
Thus far, the Zika virus has spread to 20 countries in Latin America and the Caribbean, and five governments have reacted to the news by advising women to avoid pregnancy until the epidemic has been controlled, perhaps for several years. Brazil’s ministry of health announced on Thursday that it is investigating 3,670 reported cases of microcephaly. Thus far, it has confirmed the condition in 404 infants — with just 17 of these cases linked to the Zika virus — and found that 709 infants do not have the condition.
But many expectant mothers are still anxious about the virus, and activists who seek to expand access to contraception and abortion contend that women have no other effective solutions for dealing with the increased risk of birth defects. Some blame this predicament on Catholic moral teaching, and they have targeted Church doctrine that prohibits direct abortion and the use of artificial contraception.
“The fears over the Zika virus are giving us a rare opening to challenge the religious fundamentalists who put the lives of thousands of women at risk in Brazil each year to maintain laws belonging in the Dark Ages,” Silvia Camurça, a director of SOS Corpo, a feminist group in Recife, Brazil, told The New York Times this week.
That message has found a ready forum in mainstream U.S. media coverage of the epidemic.
“Zika tests Catholic position on birth control,” read one CNN headline. Meanwhile, The New York Times published this headline: “Surge of Zika Virus Has Brazilians Re-examining Strict Abortion Laws.”
In the wake of the WHO’s report, organizations that seek to expand access to medical or surgical abortions announced plans to develop outreach programs.
“Free medical abortions for pregnant women with Zika offered by Women on Web,” read one online report.
Brazilian Bishops’ Statement
The statement from the Brazilian bishops’ conference was the first formal response to the moral debate provoked by the epidemic from church leaders in the region.
The conference statement did not question the WHO’s public health concerns.
“The connection between the Zika virus and microcephaly deserves special attention, even though it has not been scientifically proven,” the bishops said.
They urged “all Catholics in Brazil to continue cooperating in the fight against the Aedes Aegypti mosquito,” which transmits the Zika viruses, and directed politicians to “secure medical assistance to the persons affected by the disease, especially babies with microcephaly and their families.”
Sressed the bishops, “Health is a right that must be guaranteed. Without a comprehensive and effective national health policy, all efforts to fight the disease will be compromised.”
The conference statement will likely set the tone for a comprehensive response by Catholic leaders, Church-affiliated institutions and pro-life physicians and activists, even as abortion rights groups look to promote their own coordinated response to the epidemic.
“A lot of people are using this crisis as an argument or an opportunity” to promote abortion and attack Catholic sexual ethics, said Dr. Timothy Flanigan, an infectious disease expert at Brown University’s Brown’s Warren Alpert Medical School, who has been involved in the public health response to the HIV/AIDS crisis and the recent Ebola outbreak in Liberia.
“Shame on them for blaming the pain of the Zika epidemic on the Catholic Church’s care for the unborn.
“The Church, as it has always done, has campaigned to protect those who are the weakest and most vulnerable, and that includes the unborn,” said Flanigan, who also serves as a deacon in the Diocese of Providence, R.I.
A Serious Threat
However, while public health experts have yet to confirm the link between transmission of the virus and birth defects, he stressed that the WHO’s warning should be taken seriously. Pregnant women in affected areas must take precautions to prevent mosquito bites, and couples in high-risk areas who want to start a family should consider delaying that step until the outbreak is controlled.
The Center for Disease Control, which has advised pregnant women to avoid travel to affected areas, said it issued the notice following “reports in Brazil of microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant.
“However, additional studies are needed to further characterize this relationship. More studies are planned to learn more about the risks of Zika virus infection during pregnancy.”
The public health warnings could pose a moral conundrum for pregnant women who are already infected with the virus, or fear they could be infected, as the virus can be present without symptoms.
In the wake of the WHO’s announcement, they will likely face an agonizing wait before they know whether their child has suffered neurological damage. And while news reports have suggested that ultrasound screenings could be administered at about five months into the pregnancy to determine whether the fetus’ head has developed normally, experts note that the evaluation can only indicate — but cannot confirm — a potential neurological damage.
Yet, even as Flanigan described the epidemic as a potential “calamity” for pregnant women, he stressed that “many children carried by infected mothers will be healthy.
“Those who do have birth defects should be embraced with love and given the medical care that Church-affiliated providers excel at providing.”
Melding Medicine and Morality
That pro-life message goes to the core of Catholic moral teaching on the dignity and sanctity of each human life. But Church leaders, bioethicists, and fertility experts will have to move quickly to shape a fast-moving debate that could drive a global response to the epidemic and challenge moral norms that affirm the right to life of unborn children diagnosed with birth defects.
“A lot of the coverage of the epidemic has focused on pushing these countries to allow for abortion in these circumstances,” agreed Melissa Moschella, assistant professor of Philosophy at The Catholic University of America.
“That is like saying that for the thousands of children who are already born, the solution is to kill them, and that is not a solution.”
The Church teaches that abortion and artificial contraception are objectively evil. But it also teaches that married couples should practice “responsible parenthood” in conformity with the natural law. With the help of natural family planning, couples can space pregnancies by engaging in periodic abstinence.
“For just reasons, spouses may wish to space the births of their children. It is their duty to make certain that their desire is not motivated by selfishness but is in conformity with the generosity appropriate to responsible parenthood,” states the Catechism of the Catholic Church (2368).
Natural Family Planning and Abstinence
Meanwhile, several fertility specialists contacted by the Register challenged the negative references to natural family planning in media reports on the Zika virus, and suggested the crisis provided a fresh opportunity for women to gain a deeper knowledge of their fertility cycle and be empowered by that information.
Indeed, following a confirmed report of the transmission of the virus through sexual intercourse, one expert emphasized that fertility awareness could be the best path for avoiding transmission.
"If the virus can be sexually transmitted, and if persons infected with the Zika virus want to be sure they do not infect their female partner, they need to refrain from intercourse and genital contact," said Franciscan Sister of Christian Charity Renee Mirkes, director of the Center for NaProEthics, the ethics division of the Pope Paul VI Institute .Study of Human Reproduction.
"Only sexual abstinence will give infected persons the 100% assurance of not passing the virus on to those they love who may be pregnant or trying to achieve a pregnancy currently or in the future."
Sister Renee noted that women may decide to postpone pregnancy in areas affected by the epidemic. And she pointed out that "the FertilityCare System, a natural system of family planning, developed by Dr. Thomas W. Hilgers and his colleagues at the Pope Paul VI Institute, would provide these women a moral way to avoid a pregnancy, that is, without intentionally suppressing the procreative good.
"Its system of cyclic charting effectively helps a woman identify the fertile phase of her cycle--the only time she could conceive--so she can refrain from genital contact during those days and resume intercourse with her husband during the days of infertility," she said.
CUA’s Moschella suggested that updated information about natural family planning and fertility awareness be part of a coordinated response to the Zika virus by Catholic leaders.
The Church, at both the diocesan and parish level, “should give clear guidance and information, beginning with the … fact that every human being regardless of disability or illness has value. That needs to be reaffirmed.
“Perhaps the Church could also think about practical support groups that could form to help parents who already have children with birth defects, or for parents who believe they are likely to have children affected by the virus.”
She also proposed that pastors reaffirm Church teaching on contraception and encourage the faithful to learn about natural family planning.
“When is the last time you heard anything like that from the pulpit?” she asked.
At the same time, U.S. physicians, who have practiced medicine in impoverished areas of the Caribbean and Latin America, have suggested that Catholic institutions could help mobilize public efforts to address mosquito control and encourage preventative measures.
Recalling the lessons learned in the wake of the 2010 earthquake that devastated Haiti, Dr. Joseph Giere, a Washington, D.C.-based obstetrician and gynecologist who has volunteered over the years at Sacred Heart Hospital in Milot, Haiti, told the Register that simple precautionary measures — like targeting areas that breed mosquitoes, teaching women to use protective covering, and organizing the shipment of insect repellent to poor communities, would help enormously.
The Brazilian Bishops’ initial response to the outbreak also highlighted practical strategies, while rejecting efforts to promote abortion as a solution to the crisis. But in the weeks and months ahead, much more will be required.
Specialists acknowledge that public health crises can shake moral norms, and they point to the 1964-65 rubella outbreak in the UNited States as a case study.
At that time, an estimated 20,000 infants were born with congenital rubella syndrome, with many experiencing severe disabilities, like blindness, as well as medical complications, such as deafness, brain and heart damage.
“As a result of the national conversations, more Americans came to empathize with those mothers who had an illicit abortion,” the NPR reporter posited. “That was nearly a decade before Roe v. Wade ushered in the era of legal abortions.”
But Dr. Howard Markel, an expert on the history of medicine at the University of Michigan, also noted the difference between the government’s response to the rubella scare and the reaction of some Latin American governments to the Zika virus epidemic.
“Expectant moms were told to avoid German measles, but I don’t ever recall a government telling women not to get pregnant,” said Dr. Markel, who observed that the growth of the epidemic in a Catholic region had made local religious beliefs a part of the story.
“There is a lot of noise [about] reproductive rights, the whole pro-life pro-choice debate and religion,” he said.
As a physician, he added “my number one goal is to figure out how the virus is transmitted and how to contain it.”
Challenging the Abortion Arguments
Church leaders and bioethicists applaud those goals, but they also face a different and equally pressing mission: challenging efforts to present abortion as an antidote to an epidemic.
“The attitudes that are fostered to justify abortion” as an ethical response to this international emergency, Melissa Moschella warned, “could have an impact well beyond the crisis.”
Joan Frawley Desmond is the Register’s senior editor, The Catholic News Agency's Brazil bureau provided additional reporting.