Zika FAQ for Pregnant Women: Here's Everything I Know About Zika (So Far)

Google Zika. The first thing you'll find is a “reassuring” reminder that there's not much to worry about if you're not pregnant. But what if you are?

Welcome to the world of useless advice. Mainstream pregnancy sites are filled with hollow information. “Zika might cause birth defects in babies,” they tell us, “so take reasonable precautions.” What precautions? What birth defects?

More clinical sites such as the CDC and Mayo Clinic don't offer much help, either. “We don't yet know whether Zika will come to the U.S.” “We don't know how many pregnant women will be affected,” they say.

And then there are the “natural living” sites. They tell us that Zika is a government conspiracy, or that it doesn't cause birth defects and that, in any case, bug sprays don't work and pesticides will kill your baby.

So pick your poison: Confident paranoia that leaves you comfortably able to do nothing. Uncertainty about what to do and when to do it. Or maybe just a hefty dose of confusion.

At first glance, Zika might not seem like a weird issue to cover on a blog about pregnancy and feminism. But the dearth of reliable medical advice, the condescending and judgmental advice so many "green" websites are willing to dish out, and the intense paranoia so many pregnant women feel absolutely matter. The challenge of finding good medical advice that blends what's good about natural healing with the best of modern science is a recurring theme in feminism.

Moreover, women deserve to spend their pregnancies happy, not in a state of terror or locked in a basement afraid of going outside. I've spent endless days researching Zika statistics. It's hard to find specific and clear information. I think my readers should benefit from my obsessive research tendencies. Here's everything I know so far.

A Word About Bias

If you've decided to trust me without learning about my biases, that's great (but maybe not a wonderful idea). You can skip this section to get right to the facts, if you want.

Never trust anyone who tells you they are unbiased. Our experiences and values color the way we see the world, and scientific studies repeatedly back up this claim. I am biased. So is your doctor, your best friend, and the CDC. You should not believe anything you read online without doing your own research, but you should also know that some sources are more reliable than others. Peer-reviewed scientific studies in mainstream journals are always among the best sources for information. No matter where your information comes from, though, you need to demand evidence.

You should also apply the same lens to all evidence. Don't believe the study that says Zika causes birth defects? Then that means you definitely shouldn't believe a claim about Zika that is not supported by any study! This is one of the simplest ways to prevent your feelings from interfering with the facts.

So here are my biases:

• I do not blindly trust any authority. The fact that a doctor, a foundation, or a public health source said it does not make it credible. The EPA, for example, has a history of approving pesticides that subsequently prove highly damaging to the environment. The CDC has been accused of making sexist recommendations to pregnant women. Yet some authorities are more trustworthy than others. Those include peer-reviewed medical journals, public health organizations with no commercial ties (including the imperfect CDC), and researchers who are not funded by pharmaceutical companies, political groups, or other special interests. Here's a shortcut: if a source always comes down on a single side of an issue (such as by always insisting on "natural" remedies, no matter what), it's probably not reliable.

• I believe that natural approaches are often safer. If you can avoid putting potentially harmful chemicals into your body, you should. But the cause of avoiding "chemicals" is not the most important cause. If the choice is between increasing your risk of cancer by a minuscule probability and greatly endangering your child, you need to use the chemical. Greenwashing--the tendency to believe that nature only has our best interests at heart, and that what is "natural" is always safer--is very real. Just post about Zika on Facebook and watch the conspiracy theories begin if you have any doubt. 

• I endeavor to avoid strategies that harm the environment wherever possible. After all, it doesn't matter if you avoid Zika if you also kill all the bees, since doing so might mean we go extinct. 

• I believe in science, which means I believe in evidence. The more evidence, the better. Claims should be tested and re-tested, and no single study can be the final word on anything. The more frequently a claim is tested, the more credible it becomes.

So let's get to it.

Is Zika in the U.S. Yet?

Zika is indeed in the United States, with about 200 cases so far reported to the CDC. None of those cases came from local mosquitoes. This means that Zika has not spread to mosquitoes in the U.S. yet, so you can't get Zika from a mosquito bite--yet. So far, all American cases have been either among people who traveled to other countries, or those who had sex with people already infected.

There's an important catch here: It's not mosquito season yet. This could be the sole reason Zika hasn't made its way to the United States. For southerners like me, mosquito season begins in April. Other areas of the country might not have mosquitoes until May. No matter where you are, we won't know whether local mosquitoes are infected until they come out for the season.

Will Zika Come to the U.S.?

The short answer is that we don't know. Zika is already in the U.S. thanks to travel cases, and it's possible that local cases will begin occurring. But even the best epidemiologists cannot be sure.

Zika is only carried by Aedes species mosquitoes, which is prevalent primarily in South America and the southernmost tip of the United States--including Puerto Rico, where an outbreak has already begun. Eradication efforts have made this mosquito less common than some others, but alarming research suggests the species may be experiencing a resurgence. What does this mean? You can no longer count on being protected just because you live in, say, Missouri or Pennsylvania. Moreover, some epidemiologists are concerned that the virus could spread to other mosquitoes. If that happens, an outbreak could rapidly reach epidemic levels.

If Zika does make its way to the U.S., it's likely that the Deep South and Eastern coast will be most heavily hit. Check out this guide to the areas where Zika could pose the biggest threat for more details.

How Quickly Will We Know if Zika Comes to the U.S.?

The incubation period for Zika virus--that's the time between a bite and when symptoms appear--is short, at a mere 3-12 days. Theoretically, this means we'll know pretty quickly when and if the virus appears here. The problem? Not everyone who gets Zika develops symptoms, and fewer still will seek medical care. It's possible that the first, second, or even tenth patient might not even know they have the virus. Moreover, there has to be a first patient. That means the fact that Zika is not yet apparent does not conclusively demonstrate that it's not here. Your neighbor, your friend, or you could have just been bitten by a Zika-carrying mosquito, but you won't know it for a week or so.

I say this not to scare my readers, since fear does little to prevent outbreaks, but to emphasize the need for pregnant women to be proactive. Do not embrace false assurances. Zika could be here, or you could be the first to get it, particularly if you live in a region with an early mosquito season, like Florida or South Georgia.

How Likely Is It That I Will Get Zika?

Every panic-prone person--especially if she's pregnant--loves statistics. It's a lot easier to, say, manage to leave your house if you believe the odds of getting Zika from a bug bite are 1 in 10,000. The South American outbreak is new enough that reliable research simply isn't available. We do know that mosquito-borne viruses tend to spread rapidly, since a single mosquito can bite lots of people and most people get at least a few mosquito bites each season.

Still dying to know your odds of getting Zika? One retrospective study sifted through medical records after a 2013-2015 outbreak in French Polynesia. The results don't inspire much confidence. 66% of the population contracted Zika.

Retrospective studies often produce misleading results, and might not apply to other areas or places. There could, for example, be fewer mosquitoes in the U.S., or Americans might take more mosquito precautions than Polynesians. If all other factors are equal and there is a Zika outbreak in the U.S., though, this study suggests that you have a more than 6 in 10 chance of contracting the virus.

Does Zika Cause Birth Defects? How Likely is Zika to Cause Birth Defects?

This is another unkonwn. Scientists don't like to state that something is fact until they're absolutely certain; that's one of the hallmarks of good science (as opposed to Internet conspiracy theories). So far, every study I have read finds a clear correlation between Zika and birth defects.

That Polynesian study that looked at medical records argues that pregnant women who contract the virus have a 1% risk of giving birth to a child with microcephaly. Other studies have produced even more troubling results:

• One study, which infected cells in a petri dish with the virus, found that it directly attacked brain cells, infecting 85% of studied cortical cells. Kidney and other cells were also affected, but to a much lesser extent, suggesting that Zika works by attacking the brain's cortex. If these laboratory results are similar to what happens in the brain and body, babies exposed to Zika could be expected to have a very high rate of birth defects.

• A second study, which followed 88 women--80% of whom were infected with Zika--found that 29% of babies born to women with the virus had birth defects. That's a significantly higher rate of birth defects than you might expect with even the worst lifestyle choices, such as drinking or using drugs during pregnancy, suggesting that Zika could pose a more significant threat to babies in utero than just about anything else.

• In that same study of 88 women, two babies died during the third trimester. This is virtually unheard of, even among very unhealthy women. Women who make it to the 20 weeks (which is still the second trimester) have a less than .5% chance of losing their babies. The study was small, so it must be repeated, but if the results hold, this is compelling evidence that Zika directly attacks fetuses, even right before birth.

In Which Trimester Does Zika Cause Birth Defects?

The first trimester is a notoriously dangerous time during pregnancy, so most experts originally thought this was the most threatening time to contract the virus. Not so, according to the research I mentioned above.

Researchers in that study looked at women at eight, 22, 25, and 35 weeks. They were all more likely to give birth to babies with serious birth defects. Again, the study was small, so we can't be certain. When you're pregnant, though, it's better to be safe than sorry. After all, the cost of believing that Zika is "safe" at a certain point in pregnancy could be the loss of your baby. For now, it looks like there is no safe time to contract Zika.

I Heard That a Pesticide Caused the Birth Defects Associated With Zika. Is That True?

You don't need to consult a natural news or alternative medicine website to learn that pesticides are linked to birth defects. Research on what level of exposure is safe is mixed, and studies suggest as many as 3 in 4 women are exposed to pesticides at some point during their pregnancies. Obviously many babies turn out just fine, but this by no means indicates pesticides are safe. Even mainstream organizations such as the American Pregnancy Association warn that pesticide exposure, particularly during the first trimester, can be dangerous.

In February, a report circulated suggesting that a pesticide used to eradicate mosquitoes caused microcephaly. Government regulators and even mainstream public health agencies are often slow to decry the use of dangerous chemicals. So to those of us who don't fully trust such agencies, the claim made intuitive sense.

It was also a wonderful thing to believe, since it meant that the key to not getting Zika was to live a "natural" life. A scared pregnant woman, if the report were true, didn't need to douse herself in bug spray and stay inside! She could smugly comfort herself with the knowledge that her superior natural lifestyle would protect her.

The problem is that there is absolutely no scientific evidence to support the study's claim. No studies showing that women exposed to pesticides birthed children with microcephaly, no research showing that women with Zika in areas without pesticides did not. When we're talking about something as serious as Zika, paranoia is not enough. With numerous peer-reviewed studies showing a clear correlation to Zika, there is no reason to believe Zika does not harm babies. Moreover, continuing to advocate this position puts women and their babies in danger.

If you do not believe the studies demonstrating a clear connection between Zika and microcephaly, then you certainly should not believe a claim that has no evidence whatsoever to support it.

Are Mosquito Sprays Safe for Pregnant Women?

Meh. The CDC and most other organizations say yes. Most bug sprays contain DEET, which has been around for a long time. That's a good argument in favor of its safety. Animal studies suggest that there is not an increased risk of birth defects among pregnant animals who use DEET, either. Of course, animal studies can be wrong.

I'm not wild about the idea of covering yourself in DEET for the entirety of your pregnancy. But even if DEET does cause birth defects, the risk is markedly lower than Zika, so the intelligent choice is to take the risk and use the spray. One thing to know: products with higher concentrations of DEET do not offer more protection. They just last longer. So if you're concerned about the risks of bug spray, pick a product with a relatively low concentration and re-apply it often, especially if you're spending time outside.

How Can I Protect Myself Against Zika?
If a Zika outbreak comes to the United States, every pregnant woman is in serious trouble. Mosquitoes are ubiquitous, and if a significant portion of them become infected with the virus, the single best option for staying safe is avoiding mosquito bites.

Easier said than done, particularly when you consider that Zika-carrying mosquitoes bite during the day, not in the early mornings and evenings like other mosquitoes.

Consider the following options for protecting yourself, and know that the more strategies you try, the safer you will be:

• Use a bug spray containing DEET every time you spend more than a minute or two outside. Thoroughly cover your body and your clothes. The spray is worthless if you've left half of your flesh exposed. 
• Light citronella candles when you go outside, and keep them nearby. Citronella's record for preventing mosquito bites is spotty, but the candles are safe so the extra protection can't hurt. 
• Consider wearing one of those mosquito bracelets or fans. Alone, they probably won't keep the mosquitoes completely away. Paired with a strong bug repellent, they are more effective and serve as a backup to your bug spray. 
• Remove all standing water in your yard, including in gutters. Realize that this is easier said than done, and is an ongoing effort which you will have to complete at least a couple of times a week. 
• Keep your home doors closed, and if you leave any windows open, ensure they have screens on them. 
• Wear as much clothing as you can. In the deep South in the midst of the summer, this might be impossible. Elsewhere, long and loose sleeves can help. 
• Consider having your yard sprayed for mosquitoes. The mosquito life cycle is 21 days, so you will need to repeat the process every three weeks. Pyrethrin-based sprays are controversial, and some research links them to honeybee colony collapse disorder. Most research suggests they are safe, and bees remained in my yard after I had it sprayed. This one's really a cost-benefit issue. If your yard is overrun with mosquitoes, the risks of not spraying might be greater than your concerns about mosquito treatments. 
• Ask your partner to take the same precautions you do, including liberal use of bug spray. If he or she does not, use a condom every time you have sex; Zika is sexually transmitted. 

Is There a Natural Alternative to Bug Spray That Can Still Protect Me From Zika? 

Natural is not always safe. Indeed, some of the world's most dangerous substances--including arsenic and heroin--are totally natural. Indeed, the most popular mosquito insecticide, pyrethrin, derives from chrysanthemum flowers.

What you probably want is not a natural alternative, but a less environmentally destructive and non-toxic option. There's bad news here. Essential oils can be toxic at high doses, and the body readily absorbs many into the blood stream.

There are no 100% effective "natural" bug sprays, and homemade recipes for killing mosquitoes are unlikely to work. Moreover, many products marketing themselves as natural are just as dangerous as those that don't make this misleading, manipulative claim.

So what's an eco-friendly pregnant mama to do? The simplest solution is to stay indoors. If you stop to think about this, it becomes impossible. No one can be a total shut-in. You must go to the doctor and to work, after all. Your next best bet is to wear long sleeves all summer. Barring this, if you're committed to protecting your baby, ditch the natural schtick for a summer and suck it up. I'm not thrilled about it, either, but a mother's most important role is to protect her child. And there's not much out there right now that's more dangerous than a Zika infection.