In a nation where Abortion is illegal and has been the hardest hit by the Zika virus epidemic, Brazil has seen a precipitous drop in pregnancies. According to a letter published in the BMJ Journal of Family Planning and Reproductive Health Care, 56% of women surveyed said that they avoided getting pregnant because of Zika

Brazil leads the world in confirmed cases of infection with nearly 110,000 cases, according to the Pan American Health Organization. As a result of the infections, there have been over 2,200 cases of congenital Zika syndrome in babies (microcephaly) born to women infected with the virus.

The report revealed some detailed insights. More black and non-white women said they didn’t want to get pregnant as did women in the northeastern part of the country, the area most hit by the virus. The latest report from a Brazilian scientist studying the impact that the epidemic is having on reproductive choices shows that the consequences of the Zika outbreak may be long lasting. In a brief . More women in the hardest hit areas of Brazil, in the northeastern part of the country, said they didn’t want to get pregnant, as well as more black and non–white women.

The report says that the findings should alert government officials to the urgent need to address reproductive health options for women. Better access and more options for birth control should also be a priority to give women longer term control over their reproductive health, the report says.

h/t Time