Live Births and Fertility Amid the Zika Epidemic in Brazil

Marteleto, Letícia J.; Guedes, Gilvan Ramalho; Coutinho, Raquel Zanatta; Weitzman, Abigail

doi:10.1007/s13524-020-00871-x

Cited by 60 publications

(52 citation statements)

References 53 publications

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Section: Introductionmentioning

confidence: 99%

“…Historically, economic and health crises have never been preferred periods for a couple to decide to have a baby (e.g., Marteleto et al 2020;Trinitapoli and Yeatman 2011;Sobotka, Skirbekk, and Philipov 2011;Vrachnis et al 2014). Regarding health crises, the evidence shows that during and after major epidemics fertility declines strongly (Stone 2020; see e.g., Yu 2015a, 2015b;Chandra et al 2018 for the Spanish flu, and Marteleto et al 2020 for the Zika epidemic). As for economic crises, an overall economic downturn and the loss of jobs create a climate of great uncertainty, which depresses family projects (Adsera 2011;Goldstein et al 2013;Matysiak, Vignoli, and Sobotka 2018;Vignoli et al 2020).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of COVID-19 on fertility plans in Italy, Germany, France, Spain, and the United Kingdom

Luppi¹,

Arpino²,

Rosina³

2020

DemRes

129

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This study offers a descriptive overview of changes in fertility plans during the COVID-19 crisis in a sample of the young population (18-34) in Italy, Germany, France, Spain, and the United Kingdom. The data were collected between 27 March and 7 April 2020. RESULTS Our results show that fertility plans have been negatively revised in all countries, but not in the same way. In Germany and France fertility plans changed moderately, with many people still planning or postponing their decision to have a child. In Italy, however, the proportion of abandoners is much higher than in the other countries, and the proportion of those deciding to postpone their plans is lower. Moreover, across countries the demographic characteristics of individuals appear to be associated with fertility plans in different ways. In Italy, abandoners are common among individuals younger than 30 and those without a tertiary education. In Germany, abandoners are slightly more prevalent in the regions most affected by COVID-19. In the United Kingdom, the individuals that most frequently abandoned their fertility plans are those who expect the crisis to have a dramatic negative effect on their future income. Finally, in France and Spain we do not observe a clear pattern of revision of fertility plans. CONTRIBUTION These results suggest that different mechanisms are at work, possibly due to the different economic, demographic, and policy pre-crisis background and post-crisis prospects. Low-fertility contexts in particular appear to be more at risk of a fertility loss due to the crisis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of COVID-19 on fertility plans in Italy, Germany, France, Spain, and the United Kingdom

Luppi¹,

Arpino²,

Rosina³

2020

DemRes

129

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“…Given that regulation of abortion is governed at a national level, regulated by executive and legislative branches of government, our analyses demonstrate a disconnect between current policy and what women are doing in practice. Even where regulation doesn't permit termination, we know that fertility dropped ( Marteleto et al, 2019 ), and our data validate that some women sought clandestine abortions on account of Zika, or their perceived risk of CZS, and many were unable to do so safely. Official statistics either not exist (eg: El Salvador), or where they do exist (eg: Colombia) are rendered useless because they combine spontaneous and induced abortions, with no possibility of disaggregation.…”

Section: Discursive Conclusionmentioning

confidence: 66%

“…This concern had meaningful effects on reproductive decision making. Marteleto et al show a 10% decline in live birth rates in Brazil between 2015 and 2016, stratified by social class ( Marteleto et al, 2019 ) ( Marteleto et al, 2020 ). Clearly this could have been because of multiple factors, but the suggestion is that one of those might have been women seeking to terminate a pregnancy.…”

Section: The Zika Outbreakmentioning

confidence: 99%

Analysing the intersection between health emergencies and abortion during Zika in Brazil, El Salvador and Colombia

Wenham

Abagaro

Arévalo³

et al. 2021

Social Science & Medicine

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The Zika outbreak of 2015-7 is a lens to analyse the positioning of abortion within in global health security. The sequelae of the virus almost exclusively affected newborn children, manifested through Congenital Zika Syndrome (CZS), and a focus on women at risk of, planning or being pregnant. At the global level, debate considered whether Zika would provide impetus for regulatory change for reproductive rights in Latin America, a region with some of the most restrictive abortion regulation in the world. However, regulatory change for abortion did not occur. We analyse why the Zika health emergency did not lead to any changes in abortion regulation through multi-method analysis of the intersection between Zika, health emergencies and abortion in Brazil, Colombia and El Salvador. These case study countries were purposefully selected; each had Zika infected women (albeit with differing incidence) yet represent diverse regulatory environments for abortion. Our comparative research is multi-method: framework analysis of key informant interviews (n = 49); content analysis of women's enquiries to a medical abortion telemedicine provider; and, policy analysis of (inter)national-level Zika response and abortion policies. We consider this within literature on global health security, and the prioritisation of a particular approach to epidemic control. Within this securitized landscape, despite increased public debate about abortion regulatory change, no meaningful change occurred, due to a dominant epidemiological approach to the Zika health emergency in all three countries and prominent conservative forces in government and within anti-abortion rights movements. Simultaneously, we demonstrate that regulation did not deter all women from seeking such service clandestinely.

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“…By November 2020, 3,563 cases of microcephaly were con rmed in Brazil (7), disproportionately affecting poor, black, rural women (8,9). The Zika epidemic impacted birth rates and fertility (10), and fertility rates declined more steeply among young and highly educated women, which means that the informal recommendation to delay pregnancy was not followed by the group most affected by microcephaly (11).…”

Section: Introductionmentioning

confidence: 99%

Zika virus public health crisis and the perpetuation of gender inequality in Brazil

Coutinho

Montalvo

Weitzman

et al. 2021

Preprint

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Background: In 2015-2017, the Americas experienced a highly consequential epidemics for pregnancy and childbearing. Mainly transmitted by the mosquito Aedes aegypti, but also through sexual intercourse, the Zika virus poses the risk of congenital Zika syndrome to fetus, which includes microcephaly and other child development complications. When a public health crisis taps directly into reproductive health, typically a feminine realm, responses to the emergency may exacerbate deeply-rooted gender norms. This paper investigates the role of gender in two relational contexts: a) the government-led response to the pandemic in terms of communication campaigns aimed at preventing Zika infections; and b) an individual level of response to the emergency, concerning women’s negotiation with their sexual partners with regard to the prevention of Zika as well as pregnancies. Methods: We conducted content analysis of 94 unique pieces from public health communication campaigns produced by governmental agencies with the goal of promoting Zika awareness. Print and online materials were collected for one year (May 2016-May 2017), and included TV ads, Internet Pop-ups, and pamphlets. We also analyzed transcripts from 16 focus groups conducted with reproductive-aged women (18-40) in Belo Horizonte and Recife, two large cities differently affected by the Zika outbreak. Women answered open-ended questions connected to the epidemic, in areas such as personal knowledge and experiences with the Zika virus, experiences of their friends and acquaintances, their primary information sources, their perceptions of public health efforts toward containing the outbreak, as well as women’s contraceptive use. Results: Campaign pieces handling pregnancy and microcephaly were largely gendered. Pieces targeted women, placing on their shoulders the responsibility for protecting a potential fetus from the disease. Importantly, campaigns neglected addressing male´s participation on Zika prevention and contraceptive management, while failing to take into account Brazil´s large proportion of unplanned pregnancies. Women were placed in a double bind by being expected to prevent both pregnancy and Zika, in a context where gendered power imbalances often translate in women having little power/means for condom negotiation /avoiding unprotected sexual intercourse. Conclusion: Government and individual responses to the epidemics reinforced gender roles, situating pregnant women as responsible for averting mosquito bites and microcephaly. Further, prevention campaigns largely excluded men. Since low-socioeconomic status women possessed fewer resources to preclude infection, we also found that beyond the gender divide, this subgroup faced more pronounced Zika prevention challenges as they found it harder to negotiate condom use with their sexual partners and often could not access other types of contraceptives resulting in unplanned pregnancies.

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Live Births and Fertility Amid the Zika Epidemic in Brazil

Cited by 60 publications

References 53 publications

The impact of COVID-19 on fertility plans in Italy, Germany, France, Spain, and the United Kingdom

The impact of COVID-19 on fertility plans in Italy, Germany, France, Spain, and the United Kingdom

Analysing the intersection between health emergencies and abortion during Zika in Brazil, El Salvador and Colombia

Zika virus public health crisis and the perpetuation of gender inequality in Brazil

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