Pregnant Women in Brazil Are Scared of Zika and Unsure What to Do About It

Amanda Ferreria is young, newlywed, and happy to be 13 weeks pregnant. She is also frightened.

"I only heard about the disease after I was already pregnant," Ferreria said of the mosquito-borne Zika virus that scientists believe is linked to a hike in cases of Brazilian babies born with abnormally small heads. "There is no way not to be scared. My husband and I are afraid."

The 17-year-old lives in a sprawling outlying community in the west of Rio de Janeiro, and says that pretty much all she knows about the virus and its possible consequences comes from what she has seen on TV.

She goes to her prenatal appointments at a state-run family clinic where she says the doctors provide little in the way of information about the Zika scare that was first made public in November. What's worse, the place has many mosquitos.

Ferreria said her family is taking precautions against mosquitoes in their home, and she has gone to a private hospital for ultrasounds.

"They give me more details and information there," she said. "I have more confidence because I see all of my baby, and that's important to me."

Related: Brazil Steps Up Its War Against Zika

But even for those with full private healthcare plans and access to better hospitals, being pregnant in Brazil has turned into a nerve-racking experience made worse by the number of unanswered questions still swirling around the disease.

Scientists have yet to fully establish a link between Zika and the increase of children born with microcephaly, in which the small heads are the most obvious symptom of a whole range of developmental problems that can be life threatening.

Researchers are also not fully clear on how the disease — which is normally mild in healthy adults and often goes undetected by those who get infected — can be transmitted.

The Aedes aegypti mosquito has received most of the blame for the current epidemic that now affects at least 24 countries in the Americas since it was first detected in Brazil last May, though the numbers of cases in some of these countries remains small. But there is also evidence that Zika can be passed along by the more common Culex mosquito.

Meanwhile, experts at the Fiocruz Institute in Rio are currently investigating whether Zika can spread through everyday person-to-person contact, after they found the active virus in saliva and urine samples.

The Center for Disease Control and Prevention has also confirmed one case in the US where the virus was apparently transmitted through sex.

Related: 'Sexually Transmitted' Case of Zika Reported in Texas

"In the newspapers, on the internet, some people are saying one thing, others are saying another," says Tainá Barros, who is 39 weeks pregnant and lives in the middle class neighborhood of Tijuca. "No one is sure yet so you listen and you try to protect yourself but there's no real guidance."

Barros said her husband Julio had Zika-like symptoms in the first month of her pregnancy last year before any alarm was raised or any form of diagnosis was available.

Doctors have since given her reassurances that their baby does not have microcephaly, even though the most dangerous time for pregnant women is said to be in the first trimester.

"Even so, I have used repellent," Barros said. "I started to take extra care because of this."

Some are now telling pregnant women to avoid sharing utensils and going to large gatherings of people.

Many changed plans to protect themselves from crowds during last weekend's Carnival celebrations, particularly in the northeast of the country where the Zika outbreak has been most active.

The lack of readily available tests to distinguish between Zika and other similar diseases carried by the Aedes aegypti mosquito, such as Dengue and Chikungunya, also adds to the fears.

The National Health Surveillance Agency (Anvisa) authorized five new Zika tests earlier this month, but the kits have yet to become available in public hospitals.

Meanwhile, with some officials in Brazil and other countries urging women to postpone getting pregnant during the epidemic, critics say that too much of the responsibility for halting the spread of the virus and limiting its potential risks is being placed on women.

Sex education in Brazilian schools typically includes little discussion of sexual and reproductive rights.

"The Ministry of Health has thrown the responsibility for reproduction-related issues onto women once again," said Carla Batista, a gender and feminism expert at the Federal University of Bahia. "We know what that means. We know the problems they have to plan their pregnancies."

For those who are already pregnant, the sense of their own vulnerability is unavoidable.

Renata Lira Vidal recently spent time in the city of Salvador, which has been far more affected by Zika than Rio. She is now 16 weeks pregnant and careful to avoid areas where mosquitoes congregate and particularly alert to keeping up her stock of repellent.

"It's obvious that the greatest risk is mine, because I'm going to have a baby," she says. "But I don't think it's okay for people to get any disease because of a general problem [of widespread mosquito infestations] that could have been avoided."

Related: Latin America Responds to the Zika Virus with Soldiers, Repellent, and Pregnancy Warnings

Follow Donna Bowater on Twitter: @donnabow