As one of his first acts as president, Trump reinstated a Reagan-era policy that prohibits United States funding for global health providers who perform or discuss abortion as a family-planning option.
The global gag rule, formally known as the Mexico City Policy, was first enforced under the Reagan administration in 1984 and has since been reinstated by every Republican president.
This time, however, the policy extends to “to global health assistance furnished by all departments or agencies,” as stated in a Presidential Memorandum released on Jan. 23.
Activists fear that this far-reaching policy could affect various nongovernment organizations (NGO) that provide lifesaving treatments outside of family planning, such as those that distribute bed nets for malaria, provide childhood vaccines, combat ebola and Zika, etc.
According to analysis from PAI, a global health NGO, the gag rule impacts over $9 billion of U.S. funds, compared to $575 million when George W. Bush reinstated the policy in 2001.
The U.S. funding of abortions in foreign countries as a method of family planning has been outlawed since 1973 by the Helms Amendment.
This means that, in reality, the global gag rule prevents women from accessing basic sexual and reproductive services, like gynecological exams, H.I.V. prevention and contraception. Instead of curtailing the rate of abortion, research has shown that when the policy is in place the rate for unsafe abortions actually increases, especially in rural areas.
After Bush reinstated the policy in 2001, a study conducted by Stanford University found that there was a surge in abortion rates in 20 sub-Saharan African countries. In developed countries, the rate remained relatively unchanged.
The study stated that, “If women consider abortion as a way to prevent unwanted births, then policies curtailing the activities of organizations that provide modern contraceptives may inadvertently lead to an increase in the abortion rate.”
With the World Health Organization (WHO) estimating yearly that 21.6 million women experience an unsafe abortion and 47,000 die from related complications across the globe, it is evidenced by research that the rates will only increase due to the reinstatement of the gag rule.
Director of Women’s and Gender Studies Dr. Ina Seethaler expressed her discontentment about the policy’s repercussions.
“…The global gag rule is clearly attempting to prohibit women to become informed about all their reproductive choices,” said Seethaler. “As the numbers of deaths that will likely result from this policy show, this decision was not made with women’s and children’s health in mind but to take away women’s bodily autonomy. It’s a political and ideological decision that condones putting women’s lives at risk.”
Because the U.S. is the world’s largest bilateral family planning donor, when the rule is instated organizations like the International Planned Parenthood Federation and Marie Stopes International (MSI) suffer greatly.
In a statement released by MSI, the director Marjorie Newman-Williams explained that the gag rule is counteractive.
“Attempts to stop abortion through restrictive laws—or by withholding family planning aid—will never work, because they do not eliminate women’s need for abortion,” said Williams. “This policy only exacerbates the already significant challenge of ensuring that people in the developing world who want to time and space their children can obtain the contraception they need to do so.”
Seethaler echoed this statement, stating that “the only way to prevent unsafe, ‘back-alley’ abortions is to legalize abortion.”
“Legal abortion, provided in a medical environment like at a Planned Parenthood, is safe, in fact, in many cases safer than carrying a pregnancy to term, especially in countries with high maternal mortality rates,” said Seethaler.
MSI also estimated that there will be “2.1 million unsafe abortions and 21,700 maternal deaths under Trump’s first term that could have been preventable.”
MSI typically receives $30 million per year in U.S. Agency for International Development (USAID) funding, which provides 1.5 million women in over 12 countries with family planning services.
But if they are unable to find donors, the organization will be forced to cut these programs.
“Abortion is a fundamental right for women and also very necessary public health intervention,” Maaike van Min, MSI’s London-based strategy director, told Reuters. “Aid is under pressure everywhere in the world and so finding donors who have the ability to fund this gap is going to be challenging.”
A decline in family planning programs can also lead to an increase in the risk of the spread of sexually transmitted diseases.
According to a policy review conducted by the Guttmacher Institute, in 2001, the Lesotho Planned Parenthood Association went from receiving 426,000 condoms to becoming ineligible for shipments, even though the organization does not provide abortion counseling. At the time, one in four women in the country were H.I.V. positive.
Recently, the Executive Director of the association Lerotholi Pheko told The New York Times that he was fearful of “a hit to his operating budget.”
“If we are not able to increase the income we get locally, it would mean that we would have to downsize,” said Pheko.
Another program that could face serious losses is The Family Life Association in Swaziland, an area that has one of the world’s highest H.I.V. infection rates.
The association, which receives a quarter of its funding from the U.S., provides abortion information to women infected with H.I.V. when necessary, even though the land-locked country only allows abortion in cases of rape and incest. If and when this occurs, patients are typically referred to adjoining South Africa, where abortion is legal.
Executive Director of the Family Life Association Zelda Nhlabatsi also expressed her concern to The New York Times about the possible negative outcomes that could arise from the newly reinstated policy.
“Our organization could definitely be affected, including our H.I.V. services, and you can imagine how detrimental that could be for a small country like Swaziland that’s been heavily affected by H.I.V.,” said Nhlabatsi.
Although the policy is in effect, Seethaler explained that there are various ways that any concerned citizen can aid in supporting the cause.
“If you want to support reproductive justice globally, including in the U.S., you can call your political representatives and voice your concerns,” said Seethaler. “You might also consider volunteering at organizations in the U.S., like Planned Parenthood, who are collaborating with other organizations overseas. Keep educating yourself about this topic. Women’s and Gender Studies courses are great ways to learn more about reproductive justice, why it is so important, and what we can do to support human rights.”