Singaporean pre-school teacher Siti is determined to try for a baby even as Zika infections spread across the Southeast Asian nation. She just does all she can to avoid mosquito bites.
"I really love kids and want to have one of my own," the 37-year-old who declined to give her full name said after a procedure at the fertility clinic of KK Women's and Children's Hospital, the largest facility for women's health in Singapore. "I'm not postponing my pregnancy plans but I'm taking all precautions I can."
The mosquito-borne virus has been linked to a spike in microcephaly, a rare birth defect, in Brazil, which has so far been the hardest hit by an outbreak affecting large parts of Latin America.
Babies born with the defect have undersized heads and brains. In adults, the virus - which can also be sexually transmitted - has been linked to a rare neurological syndrome called Guillain-Barre.
Economists say concerns about the birth defect could dent the Singapore government's efforts to boost the number of babies born to its citizens. The city-state, a major financial hub, has one of the world's lowest birth rates and a rapidly aging society, while more than a third of its 5.5 million population are foreigners.
"It could lead to some delay in people who are going to get pregnant or thinking of getting pregnant," said Michael Wan, an economist at Credit Suisse. "But it's a bit too early to tell."
The low birth rate, and a drive to wean the economy off foreign labor, prompted the government last year to start giving out as much as S$10,000 ($7,400) in cash to Singaporeans who have a baby.
Singapore health authorities have urged pregnant women or those trying to conceive to avoid mosquito bites and take precautions since the first case of locally transmitted Zika was detected on Aug 27. Since then, more than 280 people have become infected, of which two were pregnant.
In their guidelines, they highlight the risks for pregnant women that are associated with Zika. They do not urge women who are otherwise healthy, and whose partners also show no symptoms of infection, to postpone pregnancy.
"Use insect repellent. Practice safe sex for the duration of your pregnancy if your partner has been exposed to Zika," reads the advice for pregnant women on the Singapore government's main online portal. "Note that a positive Zika test may not mean your unborn child is infected or harmed."
Some Expats Consider Relocating
Citing a study published in the New England Journal of Medicine, Singapore's government portal says Zika infected women have a 1 to 13 percent chance of giving birth to a child with microcephaly.
There is currently no vaccine for Zika, and Singapore has said the virus is likely to be in the country to stay, given the prevalence of the Aedes mosquitoes that carry it in this small, tropical island. Singapore has been battling dengue, another mosquito-borne virus, for decades.
The World Health Organization, which has praised Singapore's handling of the Zika outbreak, recommends people considering pregnancy get counseled about the risks in Zika-affected areas, and are told that their options include delaying pregnancy.
In Singapore, some women are not taking any chance.
"Some patients, particularly expatriates, are calling to ask if they should relocate back to their own home country," said obstetrician Kelly Loi of the Health and Fertility Center for Women.
But Aude Vazart, a French engineer who gave birth in Singapore last week, told Reuters leaving the island to avoid Zika was "too extreme."
"There are thousands of diseases I could get, even in France," the 29-year-old said.
($1 = 1.3473 Singapore dollars)