On his flight home from Mexico last week, Pope Francis declared that contraception could be permissible in areas afflicted with the Zika virus because of the growing evidence linking it to serious birth defects. Contraception is currently banned by the Catholic Church and the Pope's comment made big waves in the worldwide Catholic community. In fact, Rev. Federico Lombardi, a spokesman for the Vatican, said shortly after the Pope's interview went public that the Pope was speaking only of exceptional circumstances. The pope, he said, was simply saying that in, "situations of grave urgency, a well-formed conscience can see if there is the possibility or necessity of recourse [to] contraception or condoms."
The Pope's directive may seem like a big, benevolent step for the Catholic Church and it may be globally, but it will have little effect on U.S.-based Catholics. According to a poll by the Pew Research Center published last fall, 66% of self-identified American Catholics said they don't believe it is a sin to use contraceptives and they actually reject the prohibition on contraception.
Personally, I do think the Pope's message was progressive, even for an American audience. As a result, he deserves any accolades he receives and none of the internal criticism because for the first time, the Catholic Church is actually respecting a woman's right to make broader decisions about her own body. That, in itself, is an unfortunate revelation. It is a shame, however, that the church would take this progressive step in response to Zika, but still reject a woman's right to abortion in extreme circumstances.
The current Zika outbreak emerged in Brazil and is now exploding across Latin America and the Caribbean. The virus is reportedly responsible for a huge increase in microcephaly, a congenital condition that causes devastating birth defects in which babies' brains do not develop normally. Severe microcephaly causes children to be born with very small heads and brains and can cause a range of other health problems depending on the severity of the microcephaly. Problems these children face can include seizures, developmental delays, intellectual disabilities, feeding problems, hearing loss, and vision problems.
The spread of the virus has been blamed on mosquitos, similarly to other prominent diseases in the region such as Dengue Fever and Malaria. The only difference in the case of Zika is that it can also be spread through human sexual contact.
In fact, a case emerged in Texas last week that pointed towards the virus' spread through sexual contact, which may have prompted the Pope's immediate response to remove the ban on contraception worldwide. The main evidence in the Zika investigation, however, points to the mosquito as the culprit, and is starting to show that the virus is progressing (along with Dengue and Yellow Fever) in areas where there are large amounts of standing water, largely a result of a recent El Nino event that brought massive downpours to Brazil. This trend, of course, disproportionately affects the poor who may sleep with open windows because they don't have air-conditioning and whose neighborhoods might have more standing water due to inadequate sanitation.
What if Zika Takes Hold in the United States?
Will the current discussion about defunding family planning die down? Will we suddenly subsidize contraception for the poor, as Brazil has done, to prevent the spread of microcephaly cases? In the United States, access to contraception is often dictated by financial status and as a result the poor are often the most directly affected. In addition, certain studies show that access to contraception can dramatically improve women's lives.
A recent Guttmacher Institute study showed that a majority of women claimed birth control enabled them to better support themselves financially (56 percent), complete their education (51 percent), take better care of themselves and their families (63 percent), and get or keep a job (50 percent). Among women with incomes under $75,000, 44 percent stated that they want to limit or delay their childbearing because of economic hardship.
It's a common misconception that birth control is easy to come by and affordable. It is, in fact, just the opposite -- especially for those without health insurance. The ACA was intended to make insurance available to all U.S. citizens but only when combined with expanded Medicaid, the health care insurer for those with the lowest income in the US. Traditionally Medicaid has provided health care to people in the United States only under certain circumstances. These are often referred to as "low income and" meaning that in order to qualify for Medicaid, subscribers had to meet not only an income threshold, but also another indicator. Most often this meant low income and pregnant, or low income and a minor, or low income and disabled. Medicaid expansion was meant to provide Medicaid to those who need it based solely on income.
Currently 19 states have elected not to expand Medicaid and this has left a gap in coverage for those who cannot meet one of the additional requirements for Medicaid coverage and cannot afford to buy insurance through the exchanges. Ironically, this means in order to qualify for birth control coverage, women in this circumstance must choose to get pregnant in order to obtain health insurance.
In 2012, the Center for American Progress found that for uninsured Americans, the potential annual cost of oral contraceptives alone was $1,210, an impossibly large sum for those living under the poverty line. If Zika were to take hold in the US, it is the poor who would be most at risk of being affected by the virus and in many cases would be left with few to no resources to combat it.
The U.S. already has one of the highest infant mortality rates among the 14 wealthiest countries in the world. This trend is largely a result economic inequality -- often associated with poor housing developments and toxic environments. Add Zika to the mix in the US and suddenly that trend expands to include increased rates of microcephaly and physical deformities for those babies that do survive. It seems increased access to contraception provides the simplest solution to the complicated problems presented by Zika, and something we can all agree will make the biggest difference in preventing illnesses and improving quality of life.
*image credit: Tânia Rêgo/ABr (Agência Brasil) [CC BY 3.0 br (http://creativecommons.org/licenses/by/3.0/br/deed.en)], via Wikimedia Commons