Zika is not the only disease plaguing pregnant women in Brazil

Recently I wrote a news story for Quartz about the increasing numbers of syphilis infections among pregnant women and newborns in Brazil.

While the country’s spotlight is on the microcephaly-linked Zika virus, cases of pregnant women and newborn babies suffering from syphilis silently jumped year after year as a shortage in penicillin hits the country.

Both diseases are linked to birth defects, such as severe brain damage and deformities – but press coverage and public investment have been disproportionately targeting the mosquito-borne virus.

Syphilis is currently more deadly than Zika infection – it leads to one in every 10 infected pregnancies ending in either fetal or baby death. In 2013 alone, the disease led to 695 neonatal and infant deaths in Brazil.

“People don’t see syphilis as a serious disease as much as they see HIV and Zika, and we are seeing a comeback of the infection, which is now routinely detected in pregnant women,” says Jorge Senise, infectologist at a health center for women with STIs at Federal University of Sao Paulo.

The full story can be read at Quartz.

Despite restrictive laws, Latin America has the world’s largest unsafe abortion rate

Latin America and the Caribbean have some of the most restrictive laws against abortion in the world, but the region holds the world’s largest rate of unsafe abortions.

According to estimates from the World Health Organization, last published in 2012, 31 in every 1,000 women aged between 15-44 have had an unsafe abortion in Latin America and the Caribbean. The large number of procedures, often undertaken with no assistance of trained professionals and without post-abortion care, is responsible for 13% of all maternal deaths in the region.

When looking at South America alone, 36 in every 1,000 women aged between 15-44 have had an unsafe procedure. The number is more than double the global rate of 14 cases for every 1,000 women.

Unsafe abortion rate and abortion rights

Despite the figures, the majority of countries in the region will only allow abortion in the most extreme circumstances, such as if a woman has been raped or to save a mother’s life. Such restrictive abortion laws are in place in both Brazil and Argentina.

Out of the 34 countries in the region, only Cuba, Mexico, Guyana and Uruguay allow abortion under any circumstance.

Restrictive laws and higher cases of unsafe abortions are strongly linked, according to a study published by WHO and the Guttmacher, a U.S-based institute specialized in sexual and reproductive health and rights worldwide.

South America's unsafe abortion rate

Africa, abortion and maternal deaths

Africa has the world’s largest percentage of maternal deaths due to unsafe abortion and is one of the regions where laws are the most restrictive.

Three out of five of the continent’s countries only allow a woman to terminate a pregnancy in strict circumstances. Nations such as Congo, Mali and Somalia only allow it to save a woman’s life.

In Eastern Africa, home of countries such as Kenya and Burundi, 18% of all maternal deaths were caused by the unsafe termination of pregnancy, the world’s largest rate.

“Legal restrictions do not stop abortion; mainly, they drive it underground. Too many women are maimed or killed each year because they lack access to legal, safe abortion services,” said Susan Cohen, vice president for public policy at US-based Guttmacher Institute.

“Unrestrictive abortion laws do not predict a high incidence of abortion, and by the same token, highly restrictive abortion laws are not associated with low abortion incidence,” noted Gilda Sedgh, a research scientist responsible for WHO’s study on worldwide abortion trends.

Sedgh added: “In Africa, where abortion is highly restricted by law in nearly all countries, there are 650 deaths for every 100,000 procedures, compared with fewer than 10 per 100,000 procedures in developed regions.”  

Liberal laws are not associated with an increase in abortions as highly restrictive measures are not linked with a reduction in procedures. Between 1995 and 2008, abortion rate dropped most where laws are liberal, while it decreased least where abortion is mostly illegal.

Click on the map below for an interactive version:

Abortion rights around the world

In Europe, where the greater majority of countries have liberal laws for women seeking to end a pregnancy, the abortion rate per 1,000 women dropped by 44%. Africa saw the lowest drop of all regions, with a 12% fall.     

Abortion rate percentual change

Cohen, from the Guttmacher Institute, notes: “The evidence makes clear that if a woman is determined to avoid a birth, she will resort to an abortion if that is her only option, regardless of the law. All too often this means putting her own life at risk.

“Until unsafe abortion is embraced as a public health issue needing urgent attention, women, their families and communities will continue to suffer the consequences.”