The Global Gag Rule Is Back: The Human Cost

Do you remember last year’s reports of undecided voters who vowed not to cast ballots in the 2016 presidential election because they just couldn’t see the difference between electing a Republican or a Democratic candidate?

Try convincing women’s health organizations and providers in developing countries around the world of the veracity of that empty argument. You can bet they’d set those non-voters straight without a moment’s hesitation. That’s because as dedicated health professionals they know from first-hand experience that poor women’s reproductive choices, their health, the health of their babies and children, their economic independence, and their very lives often depend on which party’s candidate occupies the White House.

The American president holds sway over women’s health worldwide as a result of policies and priorities concerning the use of foreign-aid funds that fall within the purview of the executive branch. One of those policy decisions concerns the Mexico City Policy or, as it’s more commonly called, the Global Gag Rule. The Global Gag Rule determines how life-saving foreign-aid dollars are spent on women’s health services in developing countries. The decision to enforce the rule or nullify it comes straight out of the Oval Office. On this issue, the difference between Republicans and Democrats could not be more profound.

What is the Global Gag Rule?

The Global Gag Rule was first introduced by President Reagan in 1984. The rule requires that NGOs (foreign non-governmental organizations) certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including privately donated funds or funds from countries other than the U.S.). When the Global Gag Rule is in force, that certification is a pre-condition for receiving funds for family-planning and health-screening assistance from the American government.

Let’s unpack what this means.  What’s not at issue is how overseas organizations spend American aid dollars for abortion services. They don’t. That’s because since 1973 the Helms Amendment has disallowed the use of federal funds for abortion or for providing information about abortion in the U.S. or abroad. What the gag rule seeks specifically to accomplish is to dictate how foreign clinics spend their own private funds in order to be eligible for receiving American aid.

The Global Gag Rule’s history has been depressingly predictable. Democratic presidents, like Clinton and Obama, rescind it. Republican presidents, like the Bushes, reinstate it. The policy has been in effect for seventeen of the past thirty-two years. What happens to the health and well-being of poor women and their newborns and children whose fates fall into the off years seems to have been of no concern to past Republican presidents.

Where does Trump stand in this historical continuum of Republican versus Democratic presidents and their approaches to women’s health issues globally? In January—on January 23 to be exact, just forty-eight hours after the massive Women’s March in Washington—Trump decided to bolster his conservative bona fides with his base by bringing back the gag rule. Perhaps under the influence of Vice-President Mike Pence, who throughout his political career has consistently espoused far-outside-of-the-mainstream views on issues of reproductive health, rape, and choice, Trump signed a presidential memorandum that didn’t just reinstate the gag rule but expanded it. In yet another poorly considered and destructive decision, Trump’s radical expansion means that the gag rule will now apply not just to family-planning assistance but also to “global health assistance furnished by all U.S. government departments or agencies.” What that means is that the Global Gag Rule now applies to American aid to health organizations working to prevent, treat, contain, and eradicate some of the most devastating diseases and epidemics around the world.

What’s the human cost of bringing back the gag rule?

We’ve been here before, so it’s not hard to predict. Health providers in the developing world will lose desperately needed American assistance. The gag rule will make it more difficult for poor women in developing nations to access family-planning services and make informed decisions about their health and the health of their families. There will be more unintended pregnancies, more unsafe abortions, and more maternal and newborn deaths.

According to the Guttmacher Institute, a research and policy organization committed to advancing sexual and reproductive health and rights in the United States and globally, funding provided in 2016 by the U.S. government for contraception (not abortion) prevented 6 million unintended pregnancies, 2.3 million abortions, and 11,000 maternal deaths worldwide.

On Trump’s expansion of the rule, we’ll just have to wait and see how deeply the expansion will impact the effectiveness of the global medical community to prevent and treat disease among the world’s poor.

Simply said, the human cost of the Global Gag Rule will be devastating. For more on how women will be affected, take a look at the International Planned Parenthood Federation video below.