With the Zika virus quickly spreading across the Americas, the World Health Organization will announce next week whether the disease is a global emergency, according to NBC News. In the next 12 months, there may be three to four million infected by Aedes aegypti mosquitoes. 80 percent won’t even be aware they have Zika, but 20 percent may end up with rashes, fever, or pinkeye, CNN reports.

Though Zika is mostly seen as harmless, it is very dangerous for pregnant women and their children. Zika has been tied to microcephaly, which causes babies to be born with small heads and underdeveloped brains. The BBC reports that “the brain condition can be deadly or cause intellectual disability and developmental delays.” Women affected with  Zika have already given birth to thousands of babies with microcephaly.

Earlier this week, scientists from the United States said a Zika vaccine was still 10 years away, but because of the severity of the illness to pregnant women, a Canadian scientist may have one ready to go by the end of the year, according to Reuters. Brazil’s Butantan Institute planned to have a vaccine “in record time,” which would mean about three to five years.

In the meantime, government officials in Brazil, Colombia, Ecuador and El Salvador are advising women to avoid getting pregnant – a response has been widely panned by human rights organizations, which note the unfair burden on women to assume this public health responsibility when their access to contraception, family planning information, and abortion is limited (or outright forbidden).  Not to mention the rampant sexual violence against women in Central America, which can result in unwanted pregnancies.

Currently, abortion is only fully legal in three countries in all of Central and South America: Uruguay, Guyana, and French Guiana. Everywhere else in the region, abortion is only allowed in cases of rape or incest or if the life of the mother is at risk – and in some countries it is illegal no matter the circumstance, according to Time. Only Mexico, Colombia, and Panama accept fetal impairment as a reason to terminate a pregnancy.

“You’re asking women to make a choice that sounds logical from a health perspective, but it’s not a real choice,” Tarah Demant, senior director of the Identity an Discrimination Unit at Amnesty International, told Time. “It’s putting women in an impossible place, by asking them to put the sole responsibility of public health on their shoulders by not getting pregnant, when over half don’t have that choice.”

Here’s a look at how three countries with strict abortion rules are handling Zika virus:

El Salvador

EFE/Archivo

Recently, El Salvador told women to avoid getting pregnant until 2018. “We’d like to suggest to all the women of fertile age that they take steps to plan their pregnancies, and avoid getting pregnant between this year and next,” El Salvador’s Deputy Health Minister Eduardo Espinoza told Reuters.

Vocativ says that El Salvador does not allow abortion in any cases – not even if the mother’s life is in danger. And women who have had miscarriages have faced long jail sentences after being accused of purposely terminating the pregnancy.

Birth control and condoms are legal, but they are not easily accesible to everyone. The pill is only sold in some places via prescription, and condoms are not affordable for low-income families because there are limited subsidies.

The International Planned Parenthood Federation says that Asociación Demográfica Salvadoreña “is the main supplier of condoms in the country and is El Salvador’s second most important source of voluntary surgical contraception.”

Many young women choose sterilization.

Brazil

Tasso Marcelo/AFP/Getty Images

270 cases of microcephaly have been confirmed in Brazil since October 2015, and there are 3,500 pending cases. Currently, abortions are only allowed if they save the mother’s life, in cases of rape, and as of 2012, anencephaly – when a part of a baby’s brain, skull, or scalp is missing, according to PRI.

Women seeking abortions in Brazil have turned to dangerous methods. In early 2015, Jandyra Magdalena dos Santos Cruz’s body was found mutilated after she went to a clinic run by a gang to get an abortion.

“The press said they cut off her hands,” said her sister Joyce, according to The Guardian. “It wasn’t just her hands. They took off her arms, legs, teeth. A woman so beautiful. OK, she committed a crime, but she was committing a crime against herself, against her own life. It didn’t hurt anyone.”

Wealthy women in Brazil, on the other hand, can go to private clinics to “arrange a clandestine, safe abortion,” or they may hire lawyers to persuade a legal tribunal to let them have abortions. The discussion about abortion becomes more about inequalities.

A judge in Goias said that pregnant women whose babies have microcephaly should be evaluated on a “case-by-case” basis, but this doesn’t mean that all judges will rule this way.

In 2007, after Pope Benedict XVI said he was against government-backed contraception, former President Luiz Inacio Lula da Silva announced that the government would be subsidizing birth control pills.

Elective sterilization is another option women have, which is only available to women who are either 25 or older or have two children. Women must have their husband’s consent.

A petition, which will be delivered to the Brazilian Supreme Court in two months, are looking to get the country to loosen its rules on abortion. And it places the blame on Brazil for not having gotten rid of the Aedes aegypti mosquito, the BBC learned.

Colombia

More than 500 pregnant women are infected with Zika in Colombia, but there have been no cases of newborn babies with microcephaly so far. This may change, as the illness is expected to affect a total of 700,000 people. The government is advising women not to get pregnant in the next six to eight months, the Huffington Post reports.

Mónica Roa of Women’s Link Worldwide told El Mundo that this is an unreasonable request. “I was puzzled when I heard that the Ministerio de Salud recommended that women put off getting pregnant for six to eight months,” she said. “In what country do they think they are? They are empty words, nothing realistic. They’re not taking into consideration that 50 percent of pregnancies in Latin America are not planned or the high rates of sexual violence reported in Colombia.”

Abortion is only allowed if the women is a victim of rape or incest, if the fetus’ life will be negatively affected, and if it puts the mother at risk. There is not enough information on how microcephaly will affect a child. And Fernando Ruiz Gómez, the vice minister of public health, did not make it clear if microcephaly will allow women to get abortions. Ruiz said that this is something that women have to figure out with their doctors.

“The ministry of health needed to take a position,” Roa said. “I’m not saying they should tell all women with Zika to have an abortion, but they do need to let them know what their options are.”

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