The messages from the expectant mothers in Brazil resonate with desperation.
“I'm thinking of doing the worst,” one woman wrote when her order for abortion medication failed to arrive. “I really need help. I can no longer eat, and I cry all the time.”
The messages were sent to an international advocacy group that had been providing abortion-inducing drugs free of charge to expectant mothers who fear that the Zika virus could cause severe birth defects.
Now, however, the group has temporarily suspended its operations in the country because Brazilian authorities have confiscated the drugs in the mail. Abortion is prohibited in most instances in Brazil, and the drugs are illegal.
“It's not fair to tell women they are going to get a package, and it will not arrive to them,” said Leticia Zenevich, a spokeswoman for the advocacy group, Women on Web. “It's very tragic.”
Even in the face of the Zika virus, providing pregnancy-ending alternatives to women in a country where abortion is in most cases illegal is proving to be nearly impossible, Zenevich said.
Women on Web, a Canadian group that is based in the Netherlands and operates worldwide, said in February that it had sent “dozens of packages” to women in Brazil but only two packages had arrived. The rest were apparently seized. The packages provided by Women on Web contained misoprostol and mifepristone, which can end a pregnancy.
Authorities acknowledge that they are confiscating abortion drugs sent in the mail because the medicines are banned in Brazil.
The Brazilian Health Surveillance Agency said it was illegal for individuals to receive misoprostol — an abortive substance best known in Brazil by the brand name Cytotec — in the mail.
“Packages are checked when they arrive at the post office, and if medications are discovered they are forwarded to us,” said Carlos Dias Lopes, an agency press officer.
Lopes, whose bureau is responsible for approving and supervising pharmaceuticals, told The Times: “We have a duty to send any illegal substances for destruction.”
Since Feb. 1, Women on Web has been providing misoprostol together with mifepristone, a combination that increases the efficacy of the procedure, free of charge to women in countries affected by the Zika virus.
In Brazil, 95% of the packages have been seized, the group said in a statement.
Lopes said his agency was not familiar with the origin of the packages because that was not part of the government body's work.
The World Health Organization lists misoprostol and mifepristone on its Model List of Essential Medicines that “satisfy the priority healthcare needs of the population,” but includes the annotation “where permitted under national law and where culturally acceptable.” It also notes that usage of these drugs requires “close medical supervision.”
Brazil is among several nations in Latin America and the Caribbean that prohibit abortion in most circumstances.
In Brazil, it is only permitted when necessary to save a woman's life, in rape cases or in cases of a birth defect known as anencephaly. Calls to relax the country's abortion laws in the face of the Zika outbreak have run up against fierce opposition from clergy and some politicians.
According to Women on Web, nearly a third of the women who ordered abortion medication from them did so out of a fear of Zika. Scientists suspect that the mosquito-borne virus is linked to an increase in cases of microcephaly, a rare condition in which babies are born with unusually small heads.
Zenevich said the organization received 9,500 emails last year from women largely in Brazil inquiring about abortion medication, and an additional 10,400 emails from women in the Spanish-speaking Americas.
The fear of facing motherhood in the era of Zika had increased demand for the drugs, Zenevich said.
Reproductive rights advocates fear the lack of access to abortion pills might push women to pursue unsafe options to terminate a pregnancy.
“We have a situation here in Brazil in which women are having clandestine abortions, and in which women are dying,” said Sonia Coelho, a spokeswoman for the National Campaign for the Legalization of Abortion. “This brings consequences ... principally for poorer women and black women, who lack the means to have an abortion in a safer
Though illegal, relatively safe clandestine abortions are available in Brazil to those able to pay around $800 or more, almost four times the monthly minimum wage.
The flood of emails from women who ordered the drugs from Women on Web but didn't receive them has been frantic.
One woman, whose medication was confiscated twice, wrote to the group saying she had run out of options: “Here in my town there's nothing else to do, it's either your service or nothing.”
Some who ordered the confiscated drugs feared they might be “hunted down” and face criminal prosecution, as one women put it.
The group is advising women with the means to find a post office box in another South American country, such as neighboring Argentina, where the packages could be sent. But for many of the low-income women seeking help, the option is simply unrealistic.
Even before the Zika crisis, a booming business in fake abortion pills had sprung up, said Coelho. Many women resort to buying drugs from traffickers only to discover they are bogus and sometimes dangerous, she said.
“We have had cases of women calling us for advice, saying they bought Cytotec but that it did not work,” Coelho said. “What can we say? There's nothing she
can do. Who is she going to complain to given that the medicine is prohibited in Brazil?”
Special correspondent Rigby reported from São Paulo and Times staff writer Simmons reported from Los Angeles.
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