Some health experts worry that the expected spread of Zika in the United States this summer, combined with tough new restrictions on abortion, could put pregnant women in a ethical quandary.
While the disease caused by the Zika virus doesn't do much more than feel like a killer case of the flu, pregnant women are at risk for microcephaly, a birth defect that causes babies to be born with smaller heads and cognitive difficulties. Brazil has reported more than 2,500 such births linked to Zika already.
Pregnant women who have been bitten by a Zika-carrying mosquito test positive for the virus in their second trimester of their pregnancy. But microcephaly only becomes evident in the third trimester of pregnancy. Many states now prohibit abortions during this later time frame, while others make it extremely difficult at all.
In fact, the states with the strictest laws are also those in the "Zika belt" where the disease-carrying mosquito Aedes aegypti is plentiful.
"Were going to have a summer that is full of strife over abortion," said Arthur Caplan, professor of bioethics at the New York University School of Law. "Zika may bring the issue of fetal late detection of abnormality back into the debate."
The Supreme Court recently heard a challenge to a Texas law requiring doctors performing abortions to have privileges in nearby hospitals. If the court holds the law, it could leave Texas women with a single abortion clinic. Similar laws are on the books in Alabama and Mississippi, and awaiting signatures by governors in Indiana, Florida and South Carolina.
Those states are the same ones where the Aedes mosquitoes that carry Zika are expected to be most common this summer, according to a recent study in PLOS Currents by meteorologists at the National Center for Atmospheric Research The scientists used weather predictions to plot the spread of Aedes and found cities like Miami, New Orleans, Mobile and Houston have the greatest risk of Zika. This year's strong El Nino weather system could also mean a warmer summer, the kind that mosquitoes thrive in.
"There's no question that as soon as we see people being bitten by mosquitos and worrying that they are infected, they will realize that there options have been restricted," said Alta Charo, professor of law and bioethics at the University of Wisconsin. "Poor women in the south are going to be in a terrible position."
In February, the Centers for Disease Control reported on the cases of nine pregnant women who have tested positive for the Zika virus.
Two of them had abortions in recent months, while two others have suffered miscarriages. One woman gave birth to an infant with serious birth defects, while two others delivered healthy infants. Two are still pregnant.
In some Latin American countries where Zika is rapidly spreading and which completely outlaw abortions, women are turning to abortion pills available from online pharmacies, according to the Washington Post.
In the United States, Caplan said that women who find themselves infected with Zika will likely keep quiet about it in states where abortions are restricted or difficult to obtain.
"There will women who say I'm pregnant, I've got Zika and I'm going to end this pregnancy," Caplan said. "There may be some public discussion, but they won't make an issue out of it. They will be driving further, while some may be in places where they can't get to where they want to go."