Silenced by a Signature: The Global Gag Rule
With the stroke of his pen, President Trump changed the game of women’s health internationally. The global gag rule (officially known as the Mexico City Policy) has dictated women’s access to family planning services internationally since its implementation under Ronald Reagan in 1984. Democratic presidents have promptly rescinded the policy, and Republicans have just as rapidly signed it back into play; thus, it was no surprise when one of the first executive orders Trump signed after entering office was the global gag rule. When family planning services are compromised, the global health of women and their families suffers.
In post-Roe v. Wade America, enforcement of the global gag rule seems to signify the beginning of an “anti-abortion” administration, yet the global ramifications of this enforcement extend far beyond preventing abortions. Indeed, within the public there are two prominent myths surrounding the global gag rule. The first is that this policy protects federal funds from being used to finance overseas abortions. This is false; it has been illegal to finance abortions globally with U.S. foreign aid since the 1973 Helms Amendment. The second myth is that the gag rule helps to reduce abortions internationally. This is also false; there is no evidence that abortions are reduced under the global gag rule. Rather, it is likely that because access to contraceptives is reduced and family planning programs are defunded by this policy, there are more unwanted pregnancies globally and thus more abortions.
The policy prohibits organizations and health service providers funded by U.S. foreign aid (United States Agency for International Development) from advising on abortion, recommending abortion, providing post-abortion care, and lobbying any government to decriminalize abortion. The global gag rule also threatens to defund organizations that use other funding sources for abortion services and organizations (including UNICEF and the WHO) that work alongside NGOs that provide abortion counselling.
Many have referred to the policy as a silencing of healthcare providers on abortion entirely. This puts organizations in a vulnerable position: they either continue to receive vital funding but risk the health of their patients or reject USAID, losing not only a crucial portion of their budget but also contraceptive supplies and technical assistance from the U.S. Under the Bush administration, the International Planned Parenthood Federation lost $18 million per year in USAID and is estimated to lose $100 million over the next four years. Trump has expanded the policy to incorporate all global health funding (not just family planning services), which includes HIV/AIDS and infant mortality prevention programs.
As the U.S. plays an incredibly powerful role in family planning services in over 50 countries, the global gag rule limits the healthcare available to millions of women. For example, one of Kenya’s leading healthcare organizations, the Family Planning Association of Kenya (FPAK), rejected USAID under the Bush administration in 2001 due to the constraints of the global gag rule. Consequently, the organization lost 58% of its annual budget, had to lay off 30% of its staff, and close eight family planning clinics across the country, leaving 28,000 patients without care. These clinics predominantly serviced the poorest and most underserviced communities, providing critical care including HIV/AIDS testing and treatment, post-abortion care, and pap smears.
Beyond the budget constraints and withholding of medical supplies, the policy also works to silence organizations. This violation of free speech has undermined many countries’ struggle to decriminalize abortion under their own governments’ healthcare providers. This is the case in Peru, where abortion is illegal yet 30% of pregnancies end in unsafe abortions, which has resulted in 65,000 women being hospitalized each year for abortion complications. Not only are organizations funded by USAID not able to help Peruvians lobby their government to legalize the practice and bring safe abortion to the country, but they are also not able to treat the many women injured by self-induced and unsafe abortions.
With one simple order, Trump has jeopardized the health of millions of women and families by limiting their basic human right to health, which includes the availability, accessibility, and quality of various health services. The effects of this policy demonstrate the far reaching power of the U.S. in the global arena as well as the Trump Administration’s willingness to deprive women of their basic right to informed healthcare choices. Many developing nations rely on USAID for their health needs, yet their opinions are not being heard. It is important to bear in mind that if the global gag rule were applied to healthcare providers in the United States, it would undoubtedly be deemed unconstitutional as a violation of the First Amendment for impeding free speech.
Under the Trump administration, the constitution appears to only apply to a select population, and global healthcare providers and women in the developing world are not party to this protection.
Natasha is a U3 Joint Honours student in International Development and Political Science with a minor in Gender, Sexuality, Feminist and Social Justice Studies. She has focused her degree on the connection between gender and international development. Particularly she is interested in studying the impact of identity politics, foreign policy, and international organizations have on gender-based violence and reproductive healthcare access.