January 28, 2017; Business Insider (Associated Press)

While his first full week in office was an interesting one in foreign policy terms for the newly minted 45th president, for advocates of global access to health care for women, it was also oddly productive. On January 23rd, President Donald Trump reinstated the Mexico City policy using a presidential memorandum. International healthcare advocates cried foul, stating that the move would lead to the need for more abortions and cause more maternal deaths in regions of the globe where advances in women’s healthcare have been hard won over the last decade.

While international aid for to fund abortions was long ago prohibited under the 1973 Helms amendment, the Mexico City policy takes Helms a step further and applies to nonprofits that would even discuss abortion. The gag rule goes so far as to prevent health workers in foreign countries from even testifying about the impacts of illegal abortion, from which 47,000 women die from complications from each year, according to World Health Organization estimates. When in effect, the Mexico City policy has required foreign NGOs to certify that they will not “perform or promote abortion as a method of family planning” with non-U.S. funds as a condition for receiving U.S. global family planning assistance—and, as of January 23, 2017, any other U.S. global health assistance, including U.S. global HIV (under PEPFAR) and maternal and child health assistance.

The operative phrase, of course, is “when in effect.” The Kaiser Family Foundation notes that the policy was first announced by the Reagan administration at the second International Conference on Population, held in Mexico City in August of 1984. Since then, the global gag order has become a proverbial political football, jostling between U.S. administrations. After first being enacted by President Reagan, President Clinton rescinded the gag rule in 1993. President Bush reinstated it in 2001 and President Obama lifted it again in 2009. Even during the 17 years of the last 34 that it has been active, the gag rule has never enjoyed uniform support; as the Guardian reports, in 2015, when Sen. Jeanne Shaheen (D-NH) introduced legislation that would have made the gag rule impossible to reinstate by executive order, it attracted support from several moderate Republicans.

Weary of what they see as critical advances in women’s health care access being at the whim of the changing winds of politics, the Dutch government made a move this week to form an international fund to finance access to birth control and abortion in developing countries in order to fill the gap left after President Trump’s gag order. Dutch Trade and Development Minister Lilianne Ploumen announced the launch of a global fundraising initiative called She Decides to assist the “225 million women and girls would like to avoid pregnancy but they have no access to contraceptives.” The Dutch government has committed $10 million to the initiative, and Canada has also pledged to participate.

The facts are staggering: With over 830 women and girls dying of pregnancy complications every day and community access to basic health care services from doctors and nurses hanging in the balance, the supporters of the fund feel there is no time to waste over playing politics in Washington.

“I think that restricting the access to abortion does not reduce abortion. It only increases the number of unsafe abortions and it endangers the lives of women,” Canada’s Minister of International Development Marie-Claude Bibeau told the CBC.

Donations for She Decides will be made available to organizations affected by the Mexico City policy as coordinated by The Rutgers Foundation, an international operating NGO on sexual and reproductive health and rights based in the Netherlands.—Carrie Collins-Fadell