The Global Gag Rule: An Impediment To Women’s Health

Donald Trump’s recent reinstallation and expansion of the Global Gag Rule intrinsically hurts women on a global scale. Although the Global Gag Rule’s intention is to decrease abortion rates worldwide, it has historically had far vaster implications, including devastating women in impoverished nations. Without a shift in policy implementation, politicians will continue to play politics at the detriment of women in need of reproductive care.

Approximately 830 women died every day in 2015 as a result of complications during pregnancy and childbirth. The majority of these deaths took place in regions in which there was limited access to women’s healthcare. Even more striking is that the majority of these deaths were preventable, if important resources could have been provided to these women. On a global scale, 225 million women have an “unmet need” for modern contraception. This unmet need is defined as wanting to stop or delay having a child, but not having access to any method of contraception. Reproductive healthcare is in great demand worldwide, and yet, for many women, resources are scarce. Further diminishing these resources, as the Global Gag Rule intends to do, will cause further uptick in the already preventable deaths of women lacking necessary healthcare.

Under the United Nations Guidelines on Reproductive Health, such health is defined as, “a state of complete physical, mental and social well-being, and not merely the absence of reproductive disease of infirmity.” Reproductive health can deal with the reproductive processes, functions, and system at any stage of life. As a result of the International Conference on Population and Development Programme of Action, reproductive health is related to the freedom and capability of men and women to decide whether or not to reproduce, and if so, how often.

While many lack freedom to make reproductive choices, some women are set at an even further disadvantage. Reproductive health accessibility is linked to class disparity. Impoverished women disproportionately suffer from unintended pregnancies, unsafe abortion, maternal death and disability, sexually transmitted infections (STIs), gender-based violence, and other related problems. More than a million people acquire an STI every day; without access to diagnosis and treatment, some of these STIs can turn fatal.

There are huge benefits to improved reproductive health and contraceptive usage. In 2014, the Guttmacher Institute listed the benefits that would consequent if all women who want to avoid a pregnancy used modern contraceptives, and all pregnant women and their newborns received care at the standards recommended by the World Health Organization.  Unintended pregnancies would drop by 70 per cent, from 74 million to 22 million per year. Maternal deaths would drop by 67 per cent, from 290,000 to 96,000. Newborn deaths would drop by 77 per cent, from 2.9 million to 660,000. The burden of] disability related to pregnancy and delivery experienced by women and newborns would drop by two-thirds, and transmission of HIV from mothers to newborns would be nearly eliminated — achieving a 93 per cent reduction to 9,000 cases annually.

President Trump has reinstated and expanded upon President Ronald Reagan’s Mexico City policy, aka the “Global Gag Rule,” originally announced during a 1984 United Nations population conference in Mexico City. It is motivated by the belief that taxpayer money should not be used to pay for abortion or any abortion related services. After the Reagan administration, Democratic Presidents have suspended the policy, and each Republican administration has reinstated it.

Trump has greatly expanded upon the original Global Gag Rule, freezing funds to nongovernmental organizations in poor countries if they offer abortion counseling or even if they advocate the right to seek an abortion within their country. This applies even if organizations use other sources of funding for such services. It prohibits the granting of American foreign aid to health providers abroad who discuss abortion as a family planning option. In addition to all foreign NGOs who provide family planning and reproductive healthcare, any NGO providing services related to HIV/AIDS, maternal and newborn health, malaria, tuberculosis, other infectious diseases, nutrition, or any other global health program will have to certify that they do not provide abortion services, counsel or refer for abortion, or advocate for the liberalization of abortion laws, in order to continue to receive US assistance.

Despite the fact that the policy is intended to decrease abortion worldwide, health experts have concluded that the policy, in some cases, has had the opposite effect. In a Stanford study of twenty sub-Saharan African Countries, who relied heavily on the funding from the United States for reproductive health services, abortion rates rose when the Global Gag Rule was in place. This study concluded that the policy had “unrecognized-and unintended-health consequences”. The lead author of the study, Eran Bendavid, said, “When the policy comes on, fewer women get contraceptives in countries that depend on US funding for family planning.” Clearly, in these twenty countries, the Global Gag Rule caused a decrease in contraceptive usage, and a subsequent increase in the abortion rate. If Republicans want to decrease abortion rates worldwide, this rule may not achieve that goal.  

This executive order hinders the ability for women in poor countries to access reproductive health services, including family planning, by severing American funding to health clinics that offer such services. After the policies reinstatement in 2001, shipments of United States donated condoms and contraceptives to 16 countries completely ceased Most of these countries were in Africa. Family planning providers in an additional 16 countries lost access to condoms and contraceptives as a result of refusing to accept the policy’s restrictions. According to the American Congress of Obstetricians and Gynecologists, the policy’s restrictions “violate basic medical ethics by jeopardizing a healthcare provider’s ability to recommend appropriate medical care.”

Another key problem with this legislation is the way in which it was set into action- by an executive order. Executive orders allow the President to set forth a directive on a particular issue without the legislative branch deliberating on the issue. Dictating policy by executive order ensures policy accomplishments can only be temporary. In the case of the Global Gag Rule, each new party administration has reversed the policy, destroying continuity for the intended beneficiaries of the United States aid programs.

The United States government has to stop playing politics with women’s rights and global health efforts. Instead, the United States must pledge long term federal funding and foreign aid support in order to make a positive impact upon developing nations. This support must be more than just an executive order that can easily be reversed, but rather a law that promises more longevity. This cannot be done conditionally, and cannot be prohibited based on restrictive eligibility requirements with respect to the provision of assistance under part I of the Foreign Assistance Act of 1961.  With women dying as a consequence of political play, real action must be taken.


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