Maternal Stress and the ZIKV Epidemic in Puerto Rico

In the summer of 2016, we examined the impact of the ZIKV crisis on women's experiences of perinatal stress in Puerto Rico. Twenty-two pregnant or recently postpartum women engaged in qualitative interviews designed to elicit experiences of stress and pregnancy. Three key themes emerged from the interviews: 1)'Every day I think that it was invented': Skepticism of official messaging about ZIKV; 2)'I worried about mosquitoes all the time': Fear of ZIKV-related birth defects; and 3)'What am I going to do?': ZIKV as a compounding maternal stressor. Public health ZIKV education campaigns inadvertently sent the message that attempting to avoid ZIKV was futile. In response, women focused on more immediate, tangible life stressors and questioned the anti-natalist objectives of Puerto Rican and US health authorities. Any public health messaging that recommends delaying or preventing pregnancy must consider how such messaging might be received in a post-sterilization society. Prioritizing preventive measures - such as removing standing water - is essential for building trust in this colonial context.