Pope Francis told reporters Thursday that using artificial contraception may be morally acceptable in fighting the Zika virus, but called abortion another situation entirely, akin to “what the Mafia does.”

Francis’s comment came on the plane ride back to Rome from Mexico. During the week-long trip, the pope had not addressed the virus, which has hit Latin American countries hardest.

His remark immediately set off debate about his intentions — as has become common during the news-making pope’s tenure — and whether Francis had offered a more open tone about the use of artificial contraception than that of his recent predecessors.

The impact of the pope’s remarks in Zika-hit areas, if any, wasn’t immediately clear. The Colombian bishops’ conference said it was still studying them. A top bishop in El Salvador said officials there needed more context and that it is still “under debate” whether women can use contraceptives for any reason.

Before Thursday, when asked about Catholic teaching and Zika, some top church officials in Latin America and in the United States have emphasized that artificial contraception is immoral.

Francis made the comment in response to a question. He was asked whether abortion or birth control could be considered a “lesser evil” when faced with the Zika-linked cases of rare birth defects such those in Brazil, where babies have been born with abnormally small heads, the AP reported.

“Abortion isn’t a lesser evil, it’s a crime,” he told reporters. “Taking one life to save another, that’s what the Mafia does. It’s a crime. It’s an absolute evil.”

Francis cited the decision taken by Pope Paul VI in the 1960s, according to a transcript, approving nuns in Belgian Congo using artificial contraception to prevent pregnancies because they were being systematically raped.

Abortion “is an evil in and of itself, but it is not a religious evil at its root, no? It’s a human evil,” Francis said. “On the other hand, avoiding pregnancy is not an absolute evil. In certain cases, as in this one [Zika], such as the one I mentioned of Blessed Paul VI, it was clear.”

Cathleen Kaveny, a moral theologian at Boston College, noted that previous popes had spoken of exceptions when contraception use was acceptable. However, she said, Francis was addressing the issue in an accessible way in the midst of a crisis, not speaking of a policy proposal. “He wasn’t talking about it as an incentive to change behavior,” the way, for example, Pope Benedict did in 2010 about male prostitutes using condoms to avoid spreading AIDS. Benedict had said such use might be possible as a first step towards helping a person become more moral.

“So much of what is going on here isn’t new. It would be a bad mistake to think of this as liberal pope changing Catholicism again,” said Charles Camosy, a moral theologian from Fordham University. “[Pope Benedict] asked the same kind of questions and responded in a similarly vague, and open-to-multiple-interpretations kind of way.”

Because the question asked about “avoiding pregnancy,” it wasn’t explicitly clear what kind of contraception Francis meant — and Catholics immediately debated that point. Some felt he was speaking of artificial contraception, since he mentioned a case of nuns using hormones. Some suggested he could have been encouraging Catholic women to abstain or use natural family planning.

Some said the pope was not giving women any kind of permission, just answering a hypothetical.

“I think what he is saying is that a woman who uses contraception is doing something wrong but it’s much less wrong than choosing to abort,” said John Grabowski, a moral theologian at Catholic University. “I think [some Catholic groups] are reading too much into it and not quite understanding that he’s reflecting things the church already does. I don’t see this as any way a game changer. It’s just Pope Francis being Pope Francis. I think he likes to stir the pot a little bit. He wants people to lean in and listen more closely.”

The spread of the Zika virus has accelerated debates over contraception and abortion in Latin American countries, including Mexico, where Francis just spent a week.

Mexico’s Health Department said Tuesday it has confirmed that six pregnant women are infected with the virus, a statement that came as the pope was about to leave the region after his six-day visit to Mexico.

The virus is now tied to discussions about abortion and birth control because of its potential impact on pregnant women and babies. The Vatican, however, released a statement Tuesday saying that it was concerned by the call from international leaders to increase access to abortion.

“Not only is increased access to abortion and abortifacients an illegitimate response to this crisis, but since it terminates the life of a child it is fundamentally not preventative,” the Vatican said. Church officials have argued that certain contraceptives, including IUDs (intrauterine devices) and drugs Plan B and Ella are abortion-inducing drugs.

Church teaching has come up against some public health advocates who want women to have greater access to abortion and contraception. Health officials in some Latin American countries have advised women not to get pregnant, because some believe the Zika virus is linked to a spike in cases of babies born with abnormally small heads and impaired brains, a condition called microcephaly.

“It must be emphasized that a diagnosis of microcephaly in a child should not warrant a death sentence,” said Archbishop Bernardito Auza, the Vatican’s representative to the United Nations.

“Regardless of the connection to the Zika virus … these children deserve to be protected and cared for throughout their lives, in accordance with our obligation to safeguard all human life, healthy and disabled, with equal commitment, leaving no one behind,” Auza said.

The pope said in a 2013 interview with America magazine that it is not necessary to talk about abortion, gay marriage and contraception all the time.

If women in heavily Catholic Latin America do get pregnant, abortion is illegal in most countries in the region, though some have exceptions in cases of rape, fetal impairment or danger to the life of the mother. Earlier this month, the U.N. Office of the High Commissioner for Human Rights called on Latin American countries to repeal their policies restricting contraception and abortion rights.

Francis has called for a less centralized church in which local bishops have greater decision-making authority, which could mean that each region could handle the virus differently, rather than wait for a directive from Rome, said Christopher Hale, executive director of Catholics in Alliance for the Common Good, who attended the pope’s Mass on Wednesday in Ciudad Juarez, just across the U.S. border from El Paso, Tex.

“How the church in the U.S. deals with this can be different from Latin America,” Hale said. “This is going to be a great test of whether Francis’s call for a more decentralized church will bear fruit.”

The Catholic Church teaches that the use of artificial contraception and abortion is intrinsically immoral. The church does not object to the prescription of certain oral pharmaceuticals that are designated for medical purposes, and may have the foreseen but unintended consequence of impeding pregnancy, but current Catholic teaching does not permit women to take oral contraceptives for the purpose of preventing pregnancy.

The church teaches that women who want to avoid pregnancy may use “natural family planning,” which involves a woman monitoring her body temperature and vaginal secretions to avoid having sex when she is fertile.

Calls for relaxing church teaching on abortion and contraception in light of the Zika virus outbreak met with varying responses from Latin American church leaders, who spoke before Francis’s comments.

Contraceptives are not a solution, Bishop Leonardo Ulrich Steiner, secretary general of the National Council of Bishops of Brazil, said in an interview Wednesday.

In Peru, Cardinal Juan Luis Cipriani of Lima described those who want to legalize abortion as “Herods with a tie and the budget of a public office,” a reference to the biblical story about the king of Judea, who ordered the execution of all young male children in the vicinity of Bethlehem at the time of Jesus’s birth.

Cardinal Oscar Rodriguez Maradiaga of Honduras denounced the idea of “therapeutic abortions,” telling the newspaper La Tribuna, “Therapeutic means curative, and an abortion doesn’t cure anything; it takes innocent lives away.”

Cardinal Odilo Scherer of Sao Paulo said the use of condoms was a “personal choice” that is different from abortion because it doesn’t “involve a formed life.”

On Thursday, Catholic leaders in Latin America were still sorting out what he had said.

Monsignor Gregorio Rosa Chávez, the auxiliary bishop of San Salvador, declined to comment on Francis, saying he needed more context. Asked if women fearing Zika could use contraceptives, or if there were any health situations when women could use contraceptives, he said “it’s a question that’s still under debate.”

The Colombian bishops conference said they were studying Francis’ remarks.

Some advocates for reproductive choice said the pope’s comments didn’t go far enough.

“Though it might be a rupture in religious discourse, it’s nothing new for the reality of Salvadoran women. It doesn’t change the scarcity of access to birth control, the lack of sexual education, or the penalization of abortion. The pope made his comments in the context of an epidemic, not in recognition that reproductive decisions are a basic human right,” said Silvia Juarez, coordinator of the A Life Without Violence program for Salvadoran Women for Peace in El Salvador.

In the United States, Jon O’Brien of Catholics for Choice said Francis’s comments showed his “blind spot when it comes to women..Sadly, it’s an inadequate response and one that doesn’t differ greatly from his predecessor.”

See the people and places the pope visited in Mexico

Pope Francis blesses a young boy, after his arrival at Benito Juarez International Airport in Ciudad Juarez, Mexico, Wednesday, Feb. 17, 2016. The pontiff is scheduled to wrap up his trip to Mexico on Wednesday with a visit in a Ciudad Juarez prison, just days after a riot in another lockup killed 49 inmates, and a stop at the Texas border when immigration is a hot issue for the U.S. presidential campaign. (AP Photo/Ivan Pierre Aguirre)

Post reporters Sarah Pulliam Bailey in New York, D. Ashley Campbell in Washington and Nick Miroff in Bogota, and Gabriela Martinez in Mexico City and Sarah Esther Maslin in San Salvador contributed to this report.

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