Initially known as the “Mexico City Policy,” the Global Gag Rule was reinstated and expanded just days after President Trump was sworn into office. This rule, a favorite executive move for modern Republican presidents, restricts access to all healthcare worldwide, especially family planning resources and abortion.

The Global Gag Rule prohibits the United States from providing funding to nongovernmental organizations (NGO) abroad that provide abortion services, provide education about abortions, or advise women about where they can receive abortions, even if abortion services are completely legal in those countries. The only exception to the Global Gag Rule involves abortions in the case of incest, rape, and direct threats to the mother’s life.

During previous Republican administrations, the Global Gag Rule has only restricted funding to organizations receiving family planning assistance, not all global health funding like Trump’s. First implemented in 1984 by President Ronald Reagan, it had detrimental impacts on communities abroad, reducing assistance for nutrition, malaria, HIV/AIDS testing, children’s health care and more.

After the George W. Bush administration implemented the less expansive version of Global Gag, Engender Health carried out impact studies in 2006 in Nepal, Kenya, and Zambia. All of these countries experienced a decrease in access to clinics and health care, including, but not limited to contraception and abortion. But the challenges created by prior versions of the Global Gag Rule are only exacerbated under President Trump.

Under Trump’s expanded Global Gag Rule, every organization that receives any global health assistance from the United States, some $9.5 billion a year, whether they work to combat Zika or diabetes, is not allowed to even mention the word abortion. Organizations are either forced to deny patients complete information of their legal medical options or stop taking all funding from the single largest donor to global health initiatives in the world, closing clinics and ending health care initiatives in vulnerable communities.

For example, the U.S. previously provided family planning aid to International Planned Parenthood Federation (IPPF), which would then provide funding to a number of clinics in Kenya and other countries that were treating HIV/AIDS, curing cervical cancer, and yes, providing abortion services. However, since the Global Gag Rule was implemented, the available funding to IPPF is expected to be reduced by approximately $100 million over the next two to three years, forcing clinics to either close or discontinue important programs. A representative from IPPF stated, “This blocks access to sexual and reproductive health services in the poorest and hardest to reach communities where we are currently changing lives.”

The Trump administration’s Global Gag Rule has far reaching implications, with the risk of unplanned pregnancies, maternal deaths, and dangerous abortions likely to grow.

Criminalizing abortion, or otherwise denying access, does not have an impact on the number of people who seek out abortions. In fact, research shows that the abortions rates in countries that go from legal to illegal remain constant, but the abortion practices become more dangerous. A representative from Marie Stopes stated, “Restrictions make it more likely that women will turn to unsafe practitioners, whose methods range from counterfeit drugs to industrial poisons or wire coat hangers. Every 11 minutes, a woman dies from complications related to unsafe abortion.”

Unsafe abortion procedures are one of the leading causes of maternal death around the world. In Peru, a country that receives US aid, an estimated 13% of maternal deaths are caused by unsafe abortion practices that women were forced to seek out due to lack of access to a safe, legal, medically supervised method.

Not only does Trump’s Global Gag threaten the lives of women seeking out abortion, but by closing clinics and limiting health initiatives, they are also threatening the lives of women and girls who intend to carry their pregnancies to term. The Human Rights Watch reports that “complications from pregnancy and childbirth are the second leading cause of death for adolescents ages 15 to 19 globally.” In addition, “More than 800 women and girls die globally from preventable causes related to pregnancy and childbirth every day, including unsafe abortions.”

As Fred Gbagbo, the Director of Medical Development with Marie Stopes in Ghana, stated, “Murder does not mean just picking a gun or a knife and killing people. Denying someone their legitimate, rightful access to a service, as a health worker, is equally as murderous as killing someone.”

In addition to increasing risk of maternal death, the Global Gag Rule limits access to much needed contraception. When contraception access is limited, families grow at a faster rate and women and girls often find themselves with fewer educational and economic opportunities. Time that they would have previously devoted to education has shifted towards caring for children and their growing families. This lack of access to education limits women’s abilities to find work that would adequately support them and their loved ones, and is shown to contribute to high rates of violence against women.

According to Melvine Ouyo, the Director of the Kibera Clinic in Kenya, many women she knows turn to prostitution in order to support their families. In discussing the experiences of a woman in Kenya who was working to support her family, Ouyo stated, “She could not just avoid having to have sex for money, because she has to survive.”

When asked about her concerns for the future, Ouyo continued, “If we cannot intervene in the right time, we are going to see a suffering country… We cannot just let them die.”

The Global Health, Empowerment and Rights (HER) Act has the potential to end the Global Gag Rule. This Act was introduced in the House and Senate last January by Senator Jeanne Shaheen and Representative Nita Lowey. According to the Center for Health and Gender Equity, the HER Act would essentially, “guarantee that U.S. foreign aid promotes health care that is free from stigma and discrimination, prioritizes women’s health, and is consistent with the fundamental principles of the United States, including the right to free speech.”

The consequences of the Global Gag Rule are becoming clear on a global level. Increased maternal deaths, higher numbers of unwanted pregnancies, and spread of disease due to a lack of access to contraception are only a few of the ways in which women are suffering as a result of the Trump Administration’s current restrictions to global health funding. It’s time we put women’s lives first, not outdated ideological grandstanding.

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