Online requests for abortion pills spiked this year in Brazil, Ecuador and some other Latin American countries that ban abortions, as those countries continue to face an outbreak of the Zika virus, which can cause severe birth defects.
Researchers reported the trend after trying to understand how pregnant women are responding to the threat of Zika-related birth defects in countries where abortion is banned but the government is warning women to avoid pregnancy because of Zika outbreaks.
The study, which was published Wednesday by The New England Journal of Medicine, has some limitations. Researchers analyzed requests for abortion pills from just one online service, which is not believed to be representative of all the women in any of the nations studied. And the research does not answer how many abortions actually occurred in those countries.
In the U.S., the states where Zika outbreaks are considered most likely -- like Florida and Texas -- are places where abortion restrictions have been increasing and the number of abortion providers shrinking.
"If Zika does begin to transmit locally, you're looking at situations for [U.S.] women that may not be that different from countries like Brazil or Ecuador," said the study's lead author, Dr. Abigail Aiken of the University of Texas.
The Zika virus, which is spread mainly by a tropical mosquito, causes only a mild illness in most people. But during recent Zika outbreaks in Latin America, scientists determined that infection during pregnancy has led to severe brain-related birth defects.
For every 100 pregnancies involving women infected early in their pregnancy, an estimated one to 15 will result in severe birth defects, according to the U.S. Centers for Disease Control and Prevention.
The researchers approached Women on Web, an international online service that tries to help women access abortion services.
The nonprofit organization, which gets 1 million visits a month, provides online consultations. In some situations, Women on Web can arrange for a shipment of pills that will induce an abortion.
In other situations -- like Brazil, where authorities have been confiscating medicines sent through the mail -- Women on Web gives advice on where women might travel for an abortion, said Dr. Rebecca Gomperts, a Dutch physician who founded the online service.
That's why the study reflects requests for services, and not pills provided or actual abortions, said Gomperts, who is a co-author of the study.
It looked at requests to Women on Web from 19 countries from 2010 through early this year, including eight where Zika outbreaks, government warnings and abortion bans all were occurring at the same time.
The researchers determined how many requests are made, and compared the average to how many requests came in between last November and early this March -- when Zika outbreaks and government warnings were occurring in much of Latin America.
They found twice as many requests from Brazil and Ecuador as normally occur, and nearly double in Venezuela and Honduras.
The overall number of requests to the abortion service, while far higher than expected, is tiny compared with the number of abortions thought to be performed. The number of requests from Brazil was about 1,200. Yet an estimated 1.4 million abortions are performed there every year, even though it is illegal.
Some experts said the women who use this service may not be representative of women across the region because they have access to computers, they know about entities like Women on Web, and they may even have the resources to travel to get abortions.
It's not clear whether poor women in rural areas -- who tend to be more exposed to mosquitoes and are at a higher risk of infection -- would be as likely to pursue abortions, said Paula Avila-Guillen, a program specialist at the New York-based Center for Reproductive Rights.
A Section on 06/23/2016