Health officials recently reported the first U.S. cases of Zika traced to local mosquitoes, in Miami, and the virus is spreading rapidly in Puerto Rico. Given the link between Zika and microcephaly in some babies born to infected mothers, it renewed questions about how Americans might respond to a potential epidemic. Could it bear any resemblance to a German measles epidemic a half-century ago, which also caused birth defects? Illinois history professor Leslie Reagan wrote about that earlier epidemic in her 2010 book “Dangerous Pregnancies” and discussed the parallels with News Bureau social sciences editor Craig Chamberlain.
What makes these past and present cases so similar and so frightening?
Both Zika and German measles (rubella) appear as such mild rashes that they are often never noticed. Both the German measles epidemic of 1963-65 and the current Zika epidemic, which has already spread through much of Latin America, produced intense social anxiety about the potential birth of thousands of “damaged” babies. Pregnant women then, like those facing Zika now, faced great uncertainty about whether they had been infected and about the effects of the virus on their developing pregnancies.
In the case of German measles, some doctors told women not to worry, that the chance of disability was slim. Other doctors believed the likelihood was 50 to 100 percent and advised abortion, which was then illegal. In the case of Zika, the Centers for Disease Control and Prevention can now perform tests to confirm the mother’s exposure to the virus, and ultrasounds of the fetus can confirm microcephaly (a head much smaller than expected). None of these tests, however, can confirm the absence or significance of brain damage or the number of other birth defects. So infected women face much of the same overwhelming uncertainty regarding the health and future of their potential children.
How did German measles change the abortion discussion in the U.S.?
During the epidemic, a handful of women talked openly for the first time about their need for abortion as married mothers. And, for the first time, the media treated women who sought abortions with respect rather than as criminal deviants – the fact that they were white, middle-class, married women helped make this possible. At the same time, the medical profession accepted fetal defects as a justifiable reason for inducing a legal “therapeutic” abortion, and leading specialists in obstetrics began to argue publicly for reforming the abortion laws.
The repression of abortion in the midst of this frightening, nationwide epidemic produced the earliest abortion rights movement. These early efforts ultimately led to the decriminalization of abortion in several states and then nationwide following the U.S. Supreme Court’s 1973 Roe v. Wade decision.
You note that it also changed the discussion around disabilities and disability rights.
“Rubella parents,” as some named themselves, fought to end the discrimination that their disabled children endured. Through their individual and collective efforts in local schools, cities and states in the late 1960s and 1970s, parents put an end to the routine denial of education to children with disabilities. Parents, and especially mothers, worked for their children’s education and independence. Their efforts have often been overlooked, but they helped win the first federal law mandating public education for all children with disabilities in 1975.
Can you envision how Zika might influence these discussions today?
Epidemics tend to produce fear and panic, and an epidemic that produces frightening birth defects – especially cognitive disabilities, about which Americans are most anxious – would be especially alarming. Genetic testing is now routinely offered to pregnant women in the U.S., and we know that of those who discover genetic anomalies that will result in intellectual deficits, the vast majority will abort. There is every reason to assume that the response to Zika will be similar and that many pregnant women who have been, or suspect they have been, infected will seek abortions.
The difficulty is that Florida and the other Southern states where Zika is most likely to develop are also the states where abortion is most severely restricted and the most inaccessible. Conditions in Florida and the Gulf states are in many ways similar to those in 1965: Women and couples with money can travel out-of-state if necessary and pay for good providers, while those who are low-income, teenagers or undocumented may try to induce their own abortions with dangerous results or continue pregnancies against their will. There are already women landing in hospital emergency rooms in the U.S. as a result of illegal abortions.
In the early 1960s, a movement developed to make abortion available in precisely these types of complicated cases. Perhaps a similar movement to expand access to abortion will develop out of the Zika epidemic. But 2016 is not 1965 and Zika is not rubella, so we cannot map the past onto the future. In Brazil, where Zika first gained attention and where abortion is now illegal, a feminist movement has already brought the demand for reproductive rights to the public discussion of Zika. In contrast, there has been virtual silence on the topic in the U.S. CDC information sheets and its Zika website do not mention the word abortion.
Of equal concern is the lack of discussion about providing for the needs of children born with the neurological effects of Zika and for the needs of their parents. Public discussion focuses on Zika as a threat and the necessity of avoiding it; I have yet to read anything about how to prepare for and welcome these new babies and their families. I hope this will change, but at the moment, it appears that too little has been learned from America’s earlier experience with rubella.