The connection between infection with the Zika virus (ZKV) and congenital anomalies such as microcephaly has been generally accepted. Although efforts are underway to develop preventive interventions such as vaccines, these are not yet available. Family planning is an effective preventive approach that has been underemphasized in many lists of research priorities. In addition to acquisition of ZKV from mosquitoes, sexual transmission from males to females has been documented. Women at risk of ZKV need access to effective contraception if they want to avoid or postpone pregnancy, as well as access to safe abortion. There is often overlap between areas where risk of ZKV acquisition is highest, and areas where access to reproductive health services may be more limited. Data on the impact of ZKV on contraceptive use and abortion are sparse, but a few studies have begun to address these questions. ZKV highlights the need to provide at-risk women and couples with effective means to prevent or postpone childbearing. Contraception, prenatal care, and safe abortion should be available to all women.