Repeated Exposure to Epidemics and Desire to Limit Fertility: The Case of Zika and Covid-19

Sneha Kumar, Northwestern University
Leticia Marteleto, University of Pennsylvania

This paper examines how young women’s exposure to back-to-back health shocks: Zika in 2015-17 and Covid-19 in 2020 – informed their desire to limit fertility via sterilization (tubal ligation). We focus on sterilization desire as it reflects preference for surgical, irreversible contraception to bring an almost definitive end to childbearing, highlighting women’s risk aversion during successive novel infectious disease crises. Our data come from population-based surveys with 3,489 women, ages 18-34, in 2020 in Pernambuco, Brazil – one of the hardest-hit states in a country that was the epicenter of Zika in 2015-17 and Covid-19 in 2020. Using logit regressions, we find that women who had Zika were almost twice as likely to want sterilization, net of socioeconomic and demographic characteristics, during Covid-19. We also find that Zika infection likely motivates sterilization desire by generating worry about pregnancy/fetal Covid-19 complications. For next steps, we will examine how women’s own contraction of Covid-19 infection interacts with their Zika infection history to inform sterilization desires. We aim to highlight how successive epidemics, distinctly and jointly, impact women’s reproductive lives.

Keywords: Fertility, Population, Shocks and Pandemics, Family Planning and Contraception

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