Requests for medication abortion support in Brazil during and after the Zika epidemic.

Brazil declared a public health emergency during the Zika virus epidemic, recommending avoiding pregnancy. This study analyses requests received by Women Help Women for information about and support for self-managed medication abortion (MA) in Brazil during and after the Zika epidemic to understand how Zika may have impacted requests to the service. This analysis considered 20,609 requests for MA support received between January 2016 and June 2017. Reasons for seeking an abortion were analysed alongside geographic trends in the percent and rate of requests citing Zika as a reason for seeking abortion. The average number of daily requests for MA support increased from 31 in January 2016 to 48 in June 2017. The average percent of daily requests citing Zika as a reason for seeking an abortion decreased from 15% in March 2016 to 1.5% by June 2017. The most common reason for abortion seeking during and after the Zika epidemic was not being prepared for a child or not wanting any or additional children (between 52%-59% of requests). As the Zika epidemic slowed, MA requests citing Zika as a reason decreased, while requests increased overall. Few people cited Zika alone as a reason for abortion seeking, necessitating a broad contextualisation of abortion access in people's daily lived experiences and realities.