More than half a century before the Zika virus grabbed international headlines and photos of newborns with abnormally small heads were splashed across our screens, a different outbreak that affected pregnancies fueled change in the United States.
It was an epidemic that predated the birth of Florida Sen. Marco Rubio, who made waves this weekend when he said pregnant women infected with the Zika virus should not have the right to an abortion, even if there’s a significant chance their babies will be born with microcephaly.
It was an epidemic that helped legalize abortion, the very right Rubio fights against.
Rubella, or German measles, hit American soil with a vengeance between 1963 and 1965. An estimated 12.5 million people were infected, according to the Centers for Disease Control and Prevention. Though symptoms were generally minor — a fever and rash — pregnant women who contracted the virus faced a harsh reality. If their babies survived, there was a chance they would be born with profound birth defects, including blindness, deafness, heart abnormalities and serious intellectual disabilities.
Previous scares from infectious diseases in the United States had been largely relegated to the poor and those living in tenements, historian Leslie J. Reagan wrote in her 2010 book, “Dangerous Pregnancies.” But this epidemic respected no boundaries and threw white middle-class married mothers into the frightening fray.
As a result, “the politics of disease took an unusual turn,” Reagan wrote. “Instead of looking for and fingering a nonwhite or other stigmatized group as the source of this contagious disease and aiming control measures at its members … a new politics of civil rights and protection of mothers and children developed.”
Fear and a fresh demand for rights
A reported 20,000 surviving babies were born with defects resulting from congenital rubella syndrome during the epidemic. Those who needed 24/7 care faced the possibility of a lifetime of institutionalization.
At the time, abortion was illegal in the United States, but that didn’t stop women from seeking the procedure, from reputable doctors or otherwise. This was true even before the German measles epidemic; the new fears attached to the virus only turned up the volume of those demanding reproductive rights and access.
About 11,250 women had therapeutic abortions or miscarriages during the epidemic, and rubella resulted in 2,100 neonatal deaths, according to the CDC.
Dr. Norman Gregg, the Australian ophthalmologist who years earlier discovered the link between rubella and congenital defects, was even quoted as saying in 1955 that he “would not allow the pregnancy to continue if the circumstances arose in my own family,” Reagan referenced in her book.
At the time, the leading medical school textbook, “Williams Obstetrics,” also “endorsed therapeutic abortion for maternal rubella in the first trimester when the risk of ‘defects’ was high ‘if the mother and her husband [did] not want to assume the obvious risks involved,’ ” Reagan wrote.
There were doctors who honored such recommendations and requests from patients. Women of means also had the option of flying to Mexico or England for the procedure. But not all women could count on or afford equal treatment. This was especially true for women living in states where abortion was criminalized and where, up until a US Supreme Court ruling in 1965, even birth control was illegal.
Conversations about reproductive rights took center stage as the women’s movement gained momentum. Mainstream media in 1965, including Life magazine, Parents magazine and CBS News, featured stories about abortion amid the German measles epidemic. Some mothers who were denied therapeutic abortions and had profoundly impaired babies joined hands with their husbands and took their cases to court. Abortion reform bills began to float through state legislatures.
These political and social shifts played out as scientists scrambled to develop the rubella vaccine, which was first licensed in 1969.
The response to the rubella virus, and what it was doing to pregnancies, helped pave the way for the 1973 US Supreme Court decision that made abortion a constitutional right.
Zika and abortion
Even so, abortion has remained a hot-button issue in the US — which is why the question of abortion gets raised in Zika-related conversations with staunch conservatives like Rubio.
“I understand a lot of people disagree with my view, but I believe that all human life is worthy of protection of our laws. And when you present it in the context of Zika or any prenatal condition, it’s a difficult question and a hard one,” Rubio told Politico. “But if I’m going to err, I’m going to err on the side of life.”
His response outraged advocates in the abortion-rights community.
“Rubio is the sitting Senator of the state that is ground zero for Zika in the [continental] U.S. and instead of helping women, Rubio has decided to play politics with the issue,” Sasha Bruce, senior vice president of campaigns and strategy for NARAL Pro-Choice America, said in a written statement.
His “statements are shameful, dangerous, and way out of the mainstream,” she continued. “Health decisions should be made between women and their doctors, not politicians.”
A recent STAT-Harvard poll (PDF), in fact, indicates that Rubio and his peers may be out of touch with public sentiment. Even among those who generally oppose late-term abortions, there’s significant wiggle room when it comes to Zika.
The CDC suggests that microcephaly diagnosis during pregnancy is possible with an ultrasound late in the second trimester or early in the third trimester. But it might not be detected until after birth.
Only 23% of Americans favor access to abortions after 24 weeks in general, the STAT-Harvard poll showed. But that rate jumps to 59% when a pregnant woman is infected with the Zika virus and there’s a serious risk her baby will born with microcephaly.
At the same time, however, a number of states in United States make late-term abortions next to impossible, according to the Guttmacher Institute.
The Florida senator, of course, is not alone in believing that pregnant women infected with Zika must see their pregnancies through.
Carol Tobias, the National Right to Life president, made her feelings clear Monday.
“You don’t kill someone because they have a disability, including unborn children,” she said. “Kill the mosquito. Kill the virus. Don’t kill the baby.”
A political quagmire and painful reality
Microcephaly, depending on its severity, can have devastating effects that last a lifetime.
As of July 28, the CDC reported that there were 479 pregnant women in the United States showing evidence of the Zika virus, 15 births in which the newborns had Zika-related birth defects and six pregnancy losses attributed to the virus. Since that report, at least one more infant has died. A newborn who had microcephaly linked to Zika died in Texas, according to a release issued Tuesday by the Texas Department of State Health Services.
The STAT-Harvard poll also revealed that only 44% of the American public is aware that no legislation has been passed to provide emergency funding in response to the Zika virus.
Squabbling in Congress began months ago, after President Barack Obama requested approximately $1.9 billion in emergency funding in February. In late June, Democrats blocked a measure put forth by Republicans in large part because it prevented funding for Planned Parenthood.
“They restrict funding for birth control provided by Planned Parenthood. Can you believe that?” Senate Minority Leader Harry Reid, a Democrat, said at the time. “And the Zika problem, who does it affect? Women, and especially pregnant women.”
The Republicans, however, say that Planned Parenthood funds would be redirected to community health centers and other organizations under their plan and that women would still be served. They also say that if babies are born with microcephaly, Democrats will be the ones to blame.
It’s this sort of political quagmire that incenses Dawn Laguens, executive vice president of the Planned Parenthood Action Fund.
“Despite the growing Zika crisis in Florida, [Rubio] continues to push an agenda to ban abortion with no exceptions for rape and incest, cut insurance coverage of birth control, and eliminate access to care at Planned Parenthood,” she said in a written statement. “This is not what the American people want.”
What they want, she said, is “full access to comprehensive sexual and reproductive health education, services, and rights, including safe and legal abortion.”
It’s what many Americans want now, and it’s what many demanded decades ago, when the rubella virus woke them up to the painful realities and decisions associated with risky and life-altering pregnancies.