January 22, 2017; Politico
One day after the 44th anniversary of the Supreme Court’s Roe v. Wade decision and two days after the massive international Women’s March, Donald Trump, in one of his first acts in office, reinstated the Mexico City Policy, which requires that organizations receiving U.S. federal aid “neither perform nor actively promote abortion as a method of family planning in other nations.”
Specifically, organizations receiving funds from USAID cannot:
- Provide abortion-related information to their patients and clients
- Provide referrals to other health care providers who perform safe abortions
- Provide legal abortions or legal abortion-related services
- Advocate for the legalization of abortion in their country
This policy, known as the “global gag rule,” has been a political football since Ronald Reagan introduced it in 1984. Democratic presidents rescinded it, claiming that it was too broad, and Republican presidents reintroduced it, insisting that no American dollars support abortions. This is the policy’s fourth reversal; NPQ discussed this possibility back in December.
The policy is problematic in a number of ways, not least of which is that it presumes the United States government has the right to make decisions for women in other countries about their bodies and their families. But even for those who oppose abortion rights, there are reasons to oppose the Mexico City policy.
In the U.S., an organization like Planned Parenthood can separate its funding streams, so federal dollars pay for cancer screenings and mammograms, but private funding pays for abortion, and they get to keep both. (At least for now.) The Mexico City policy does not permit foreign NGOs to make that distinction; any organization that even counsels on abortion loses all of its USAID funding. This forces healthcare providers to make a choice between losing a large part of their budgets and providing what they consider sub-optimal care. Organizations like Marie Stopes International and the International Planned Parenthood Federation, which persist in providing abortion and counseling, will lose up to $100 million of their funding.
“Marie Stopes International knows that safe abortion is a vital component of women’s reproductive healthcare, and therefore we cannot agree to these conditions,” Marie Stopes International stated. Population Action International director of advocacy Jonathan Rucks said that with the gag rule back in effect, large geographic areas may simply lose services, including birth control, when organizations like Marie Stopes are forced to pare down services due to funding cuts.
This leads to another flaw in the Mexico City Policy: It doesn’t stop abortions, or even reduce them. In fact, according to a study by the World Health Organization (WHO), when the “gag rule” is in place, women in developing countries are more likely to get an abortion, and it is more likely to be an unsafe one that could lead to infertility or death.
Another study cited by the World Bank found that “the policy was associated with a 12 percent increase in pregnancies amongst rural women in Ghana, increasing both abortions and unintended births. The unintended births were concentrated among the poorest and least educated women, and those children had significantly lower height-for-age relative to their siblings.” When USAID is prevented from funding women’s health organizations in developing countries, contraception and reproductive health become less available. Poor, uneducated women become more likely to have children, and scarce resources are divided among more mouths.
The rule also creates ripple effects in the U.S. In 2008, when the Mexico City Policy was active under George W. Bush, USAID employees made the search term “abortion” invisible on POPLINE, a database of population and reproductive health and development literature. Elizabeth Pisani, a prominent health researcher and former WHO official, explained that “POPLINE staff restrict abortion as a search word because they fear they will lose USAID funding…they’re trying to make the very word invisible, even in a [database] used only by academics and other nerds.” After research librarians raised a fuss, the search term was reinstated.
The gag rule does not apply to domestic organizations, following a 1988 court case ruling that it “violated the First Amendment free speech rights of domestic [family planning organizations], but not the rights of foreign organizations.”
Republican lawmakers applauded President Trump’s move. Senator James Lankford of Ohio tweeted, “For yrs, U.S. has debated abortion. At least we can agree no taxpayer should be forced to pay for it.” Of course, taxpayers were never directly paying for abortion, with or without the gag rule, since the passing of the Helms amendment in 1973, but this detail has consistently escaped Republican lawmakers, who instead focus on the fungible nature of federal support.
Democratic lawmakers and women’s health groups immediately took issue with the policy. Senator Jeanne Shaheen of New Hampshire said Trump’s move puts “ideological politics over women and families’ futures.” She promised to introduce legislation to fight the policy. Senator Elizabeth Warren of Massachusetts tweeted, “I’ve been a cosponsor of a bill to repeal the global gag rule. I’ll be 1st in line to cosponsor again when @SenatorShaheen reintroduces it.”
The Mexico City Policy force nonprofits abroad to make a nearly impossible choice, with health repercussions falling on the poorest and most vulnerable people. The global gag rule’s reinstatement is seen by many as a warning sign that further cuts to health services are coming, even when the evidence shows that services are sorely needed.— Erin Rubin