As the Zika virus bears down on the United States, federal health officials are divided over a politically and ethically charged question: Should they advise American women to delay pregnancy in areas where the virus is circulating?
Some infectious disease experts are arguing that avoiding conception is the only sure way to prevent the births of deformed babies, according to outside researchers who serve on various advisory panels.
Women’s health specialists counter that the government should not tell women what to do with their bodies. Indeed, federal health officials have never advised all the women in a region to stop having children. Moreover, they say, most babies conceived during Zika epidemics in Latin America have been born healthy.
Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, described the internal debate among federal experts as “a very long conversation.”
For now, “we do not have a recommendation to not become pregnant,” Frieden said at a “Zika summit” held recently in Atlanta. “We do recommend access to contraception.”
But officials in some countries struck by Zika epidemics have urged women to avoid pregnancy.
Dr. Marcos Espinal, who directs the Zika response of the Pan American Health Organization, an arm of the World Health Organization, said he thought advising women to avoid conception during an epidemic’s relatively brief peak months, as Colombia did, “is sound advice.”
Yet the WHO does not follow that policy. Dr. Bruce Aylward, the agency’s head of emergency response, called avoiding pregnancy “a complicated decision that is different for each individual woman.”
Currently, the question affects Americans only in Puerto Rico, the U.S. Virgin Islands and American Samoa, where Zika is circulating locally. But if it spreads as expected this summer, women in Hawaii and many Gulf Coast states may also be faced with tough choices.
Frieden said he was “guided by the perspective” of Dr. Denise J. Jamieson, a medical officer in the CDC’s division of reproductive health.
She said that even during an epidemic, “most women will have healthy babies.”
Advice from government doctors on such personal decisions, she added, “is not likely to be effective.”