"Despite repeated calls from public health officials, and a request from the White House for $1.9 billion to fund mosquito control and increased access to contraception, Congress is nowhere near approving a Zika appropriations bill," write Abigail Aiken, an assistant professor of public affairs at the University of Texas-Austin, and James Trussell, a professor emeritus of economics and public affairs at Princeton University, in an opinion piece for Time.
Aiken and Trussell condemn the "staggeringly irresponsible" delay on Zika funding legislation, noting that "Congress has had seven months to take decisive action" in anticipation of mosquito season in the United States. "Yet here we are in July -- with 287 pregnant women having confirmed or suspected Zika infection, and seven babies born with serious neurological anomalies -- and we are still waiting for Congress to act," the authors write.
The authors note that as of last week, "one of the final opportunities to pass such a bill before the seven-week summer recess ended in stalemate: [Conservative lawmakers] attached a poison-pill amendment barring Planned Parenthood from receiving funds to provide contraception, and [liberal lawmakers] abandoned the bill." Citing "similar efforts to de-fund Planned Parenthood in state legislatures across the country," Aiken and Trussell write, "Once again, a critical effort to protect public health and ensure reproductive autonomy has been sacrificed in favor of a political agenda. As a result, millions of women and their families have been failed."
According to the authors, "Without funding to provide timely access to contraception, advisories from the World Health Organization (WHO) and [CDC] to delay or carefully plan pregnancy are meaningless" and could "have the unintended consequence of harming women rather than helping them." Aiken and Trussell cite a study they published last week that found women in Latin America "who were already pregnant or unable to avoid pregnancy ... experienced heart-breaking fear and anxiety due to their inability [to] follow" official guidance released by their countries advising against pregnancy. The authors write that as a result of these countries' strict abortion laws, "these women were left with no means of preventing pregnancy, no means of avoiding mosquitoes, and no means of safely ending their pregnancies through their own healthcare systems."
"The situation for women in the U.S. may not be much different," Aiken and Trussell continue, noting that given the lack of funding for contraception and mosquito control, "many fewer women at risk of Zika infection will be able to avoid pregnancy" or Zika exposure after becoming pregnant. Moreover, the authors note that for women "unwilling to take the risk of Zika-related fetal anomaly, current clinical guidance recommending serial ultrasound scanning and fetal monitoring is not sufficient." Nonetheless, "neither the CDC nor the WHO has issued any guidance on the reproductive options that should be available to women who are already pregnant or who cannot avoid becoming pregnant while Zika transmission remains a risk," the authors write.
Noting that the "very personal" decisions about abortion "become issues of public policy when the ability to choose a particular option is foreclosed," the authors write, "In the United States, while women have a legally protected right to choose abortion, the practice of that right depends on socioeconomic circumstances and geographical location."
Aiken and Trussell note, "In many of the states expected to be hardest hit by Zika, including Alabama, Arizona, Florida, Louisiana, Mississippi, and Texas, a surge of laws restricting access to abortion has forced clinics to close and women to travel long distances and negotiate waiting periods." As a result, they explain that "many women are effectively unable to choose abortion, and low-income women and women of color are disproportionately affected." Further, according to the authors, "recent convergence of the politics of abortion and contraception has meant that contraceptive access in many of these states has also been devastated by budget cuts, diversion of funds away from dedicated family-planning providers, and refusal to participate in Medicaid expansion."
Aiken and Trussell note that while "[t]he risk of Zika exposure is clearly not the only reason why women in the United States require access to abortion," it "brings the issue of reproductive rights sharply into focus." The authors write, "At the heart of Congress' failure to ensure equitable access to contraception and abortion is a craven political choice: that reproductive autonomy and individual liberty matter less than ideological pandering. This posturing must stop." The authors conclude, "With such high stakes, those with the power to make public policy that places women in control of their own reproductive decisions must ensure safe, legal, and accessible reproductive choices" (Aiken/Trussell, Time, 7/5).
