The World Health Organization estimates that every eight minutes a woman in the developing world dies from an unsafe abortion. On January 23, 2017 President Donald Trump endangered even more women’ lives by reinstating the “Mexico City policy,” more commonly known as the global gag rule. First put in place under Ronald Reagan, the global gag rule has seesawed through the last thirty-three years; each time a Democratic president has come into office he has rescinded the policy, and each time a Republican has won the presidency he has reinstated it. Trump’s reinstatement of the policy expanded its impact further than ever before, applying it for the first time to all U.S. global health spending. Today, on International Safe Abortion Day, we must all call for an end to playing political games with health and lives and demand the permanent repeal of the global gag rule.
The reinstatement of the global gag rule represents the latest and most dangerous in a decades-long history of U.S. foreign policy opposition to abortion. Since 1973, the Helms Amendment has prohibited the spending of any U.S. foreign aid dollars on any abortion-related services. The global gag rule goes further than that policy, restricting how all recipients of U.S. global health assistance can use their own non-U.S. funds. The rule includes a ban not only on providing abortion services, but also on any discussion of abortion with patients whatsoever and on any advocacy for reform of abortion laws in their own countries.
Under every Republican administration from the policy’s inception until now, the global gag rule has applied exclusively to U.S. family planning funding. Human Rights Watch reports that this newest, most severe iteration of the policy, now impacting all global health spending, has increased the affected funds from approximately $575 million to an estimated $8.8 billion – an increase of more than 1500%. The expanded rule applies to programs aiming to prevent HIV, malaria, and tuberculosis, bringing the funding of more lifesaving organizations than ever into this game of political ping-pong.
Putting this policy into the dominant language of pro-choice and pro-life that we use to discuss abortion in the U.S. obscures the fact that the global gag rule is downright homicidal. As has been widely shown in study after study, restricting access to abortion does not lower abortion rates. It does, however, increase maternal mortality. The World Health Organization reports that 47,000 women die annually as a result of lack of access to safe abortion, approximately thirteen percent of overall maternal mortality. Trump’s policy will only exacerbate this crisis. The Center for Health and Gender Equity has estimated that Trump’s global gag rule will contribute to at least 6.5 million unintended pregnancies, 2.1 million unsafe abortions, and 21,700 maternal deaths. As the Guttmacher Institute neatly summarized, the global gag rule’s “only impact on abortion has been to make the procedure more likely and unsafe.” If those impacts were not enough, the global gag rule has also been shown to impede HIV prevention and care efforts and inhibit rural communities from accessing any form of health care by shutting down clinics. Although motivated by attempts to appear “pro-life,” Trump’s Global Gag Rule directly causes nothing but reduced healthcare access and more death.
The global gag rule also represents what can only be understood as U.S. imperialism. Telling others how to spend their own money is plain paternalism and disrespect for the right to self-determination. The restrictions on what NGOs can and cannot say constitute a basic infringement on free speech rights, such that this policy would be thoroughly unconstitutional if applied to U.S. subjects. For countries in need of international aid though, overwhelming located in the Global South, a disregard for free speech is apparently perfectly acceptable. The rule also ignores countries’s own laws surrounding abortion, applying the same standard regardless of if abortion is actually legal in an impacted country. As women and girls are put at risk around the world, imperialism prospers; what else can you call holding funding hostage to circumvent sovereign nations’ own laws, restricting free speech globally, and dictating what countries and NGOs can spend their own money on?
In both the House of Representatives and the Senate, the Global Health, Empowerment, and Rights (HER) Act has been introduced to permanently eliminate the global gag rule and end the cycle of executive orders repealing and reinstating the policy. The Global HER Act represents an opportunity to end decades of deadly policies and stop playing politics with people’s lives. If you care about access to safe and legal abortion, you should support repealing the global gag rule. If you care about promoting health incomes and lowering maternal mortality worldwide, you should support repealing the global gag rule. If you just think that telling others how to spend their own money is wrong, you should support repealing the global gag rule. Take advantage of International Safe Abortion Day to tell your representatives why they should too.