Pope Francis did not just change the church's stance on contraception — here's what he really said

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They were only brief remarks, but Pope Francis's response to a question about the use of contraception in the midst of the Zika outbreak has already prompted debate about its implications for public health.

Zika, of course, is suspected of causing some pregnant women who contract the virus to give birth to babies with abnormally small heads, a condition called microcephaly.

Several countries in Latin America have asked women to avoid pregnancies for anywhere from six months to two years, and Catholic leaders throughout the region refuted suggestions that they should reconsider their opposition to contraception in light of the epidemic.

On Thursday, Francis did not endorse a change in official Church opposition. But what the pope said on the issue, as with all issues, will matter.

Let's explain.

What exactly did Francis say?

While aboard his plane, Francis was asked if, given the Zika outbreak, abortion or contraception could be considered permissible under the Catholic principle of the "lesser evil." "Avoiding pregnancy is not an absolute evil," Francis told reporters. Abortion, on the other hand, "is never the lesser evil."

Has a pope ever suggested something similar before?

Pope Benedict XVI told journalist Peter Seewald for a 2010 book that condom use by male prostitutes to stop HIV transmission might be OK as a "a first step in the direction of moralization, a first assumption of responsibility, on the way toward recovering an awareness that not everything is allowed and that one cannot do whatever one wants." But condoms would not provide "a real or moral solution" to ending AIDS, the pontiff said. Some observers saw Benedict's remarks as a sign of new openness to contraception, but the Vatican never changed its position on contraception.

Are there any specific cases in which the church has made an exception?

Yes, and Francis pointed to it Thursday. The Vatican made an exception for nuns in the former Belgian Congo to use contraception in the 1960s during a time of mass rapes.

The Vatican did not make any exception during the Bosnian genocide in the 1990s, saying that any children of the thousands of Muslim women who were raped by Serbs should be adopted. The Vatican also opposed the United Nations's distribution of emergency contraception — sometimes known as Plan B or morning-after pills — to rape victims. A Vatican official told Newsweek in 1999 that the Congo exception amounted to "a defense against the very real possibility of rape," whereas giving the morning-after pill "is not a defense — it is an afterthought."

Global health officials view the morning-after pill as a contraceptive because it blocks a pregnancy before a fertilized egg is implanted into the uterus, but the Vatican sees it as a form of abortion.

Do women have access to contraception in Latin America?

Buda Mendes / GettySome. Use of modern contraceptive methods in these countries ranges from 33.6 percent in Haiti to 75.7 percent in Costa Rica, according to data compiled by the Kaiser Family Foundation. But it's important to note that women who are poor and lack education are the least likely to have access to contraception; they also tend to be particularly vulnerable to the mosquitoes that transmit the Zika virus, in part because they rely on open windows instead of air-conditioning.

How will the pope's remarks be received?

Time will tell, of course. On Thursday, Maria Clara Bingemer, a professor of theology at the Pontifical Catholic University of Rio de Janeiro, noted that the only means of birth control allowed by the Catholic Church involves natural family planning, also known as the rhythm method, and abstinence.

She said contraception could be seen as a "lesser evil" if it is proved that Zika is transmitted through sexual relationships — a method of transmission that researchers say is rare, but possible.

Bingemer said the pope may have opened the door to the possibility that contraceptives could be a lesser evil in the case of Zika. But, she added, he stopped short of offering a firm endorsement.

"The Church is prudent," she said. "It needs all the data before making decisions."

Stephen Pope, professor of theology at Boston College, characterized Francis's statement as "a bombshell."

Church teaching has long held that artificial contraception "is intrinsically evil," Pope said, "meaning there is absolutely nothing that would justify its use."

"Here he is saying maybe it can be used" to prevent the birth of babies with a serious medical condition, Pope said.

The closest other Church officials have come to such a position is the "pastoral judgment" by some African bishops that the use of condoms to prevent the transmission of HIV/AIDS is morally acceptable.

Sharon Begley and Patrick Skerrett contributed reporting.

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