The Global Gag Rule is one of the most odious policies ever enacted on foreign assistance funding. It penalizes foreign health care providers that provide a full range of information and services that are legal within their own countries. It stifles democratic participation by prohibiting assistance to organizations that speak out about the impact of unsafe abortion in their own countries—and to be clear, it’s simply impossible to have a serious discussion about women’s health and maternal mortality in the developing world without discussing the role of illegal, unsafe abortion. And finally, it’s utterly counterproductive to the stated goals of its promoters: In 2011, independent researchers at Stanford University found that the imposition of the Global Gag Rule caused abortion rates in the African countries most affected to double between 2001 and 2008, when the policy was being enforced.
Here are just some of the effects that Trump’s Global Gag Rule are having now:
Family Health Options Kenya (FHOK) provided some 3 million services to women and young people in some of the poorest and most vulnerable parts of the country in 2016 alone. Since 2009, the more than 12 million services they provided helped reduce unmet need for contraceptives in the country from 26 percent to 18 percent. As a result, the nation’s maternal mortality rate fell too. Abortion was recently made legal in more situations in Kenya, and FHOK is unwilling to deny accurate and complete information to the people they serve.
As a result of Trump’s Global Gag Rule, the organization will lose more than half its overall budget and will have to close more than half of its clinics, cutting off a lifeline for millions of poor women and girls.
Another organization in Kenya, the Kisumu Medical and Education Trust, provides health care and education to poor women in the country’s third largest city. It expected to receive about $2 million in grants between 2017 and 2021 (more than half its total budget). Now it will receive nothing.
The organization was founded by a nurse after she discovered that half of the women in her gynecological ward were there “because of the damage done by backstreet abortions.” Providing counsel on safe, legal abortion is a critical part of the Trust’s mission to improve women’s health and lives.
In order to stay open, the Trust will now likely have to charge for contraceptives that were previously free—a cost that many of Kenya’s poor families are unable to bear. The result is as predictable as it is appalling: reduced contraceptive access, and increased unintended pregnancy, unsafe abortion, and maternal mortality.
Profamilia in Colombia has provided millions of vulnerable people with medical checkups, critical reproductive health services, affordable contraceptives, health education, and programs to address gender-based violence since 1964.
Colombia still faces numerous reproductive health challenges: Nearly 20 percent of girls ages 15–19 are either pregnant or already have children; rural girls are 26.7 times more likely to become adolescent parents; and illegal abortion remains stunningly prevalent with at least 400,000 procedures performed each year.
Trump’s Global Gag Rule will end funding for Profamilia’s outreach to conflict-afflicted communities, a program to reduce maternal mortality and Zika transmission. Young people in rural areas stand to lose their only access to information and care, undermining the progress made in recent years.
Niger has one of the most rapidly growing populations in the world. Between 1960 and today, it has grown from 3.5 million people to 20 million, and is likely to double in just 17 years. Half the population is under 15 years old, and 80 percent of its people live in poverty. Access to contraceptives is poor, and women have a 1-in-23 chance of dying of pregnancy-related causes. By any measure, Niger is teetering on the edge of catastrophe.
Marie Stopes International (MSI) began providing contraceptives and reproductive health care through mobile outreach in 2014, and opened its first clinic in 2016 with support from the U.S. government. It served some 30,000 clients and provided contraceptives to more than 16,000 women and girls, preventing nearly 2,000 unsafe abortions. But, because MSI provides safe abortion in other countries, where it’s legal, Trump’s Global Gag Rule will disqualify the agency from further support for its crucial work.
In Nepal, the maternal mortality rate used to be the highest in the world and the abortion law was, until recently, the most restrictive in the world. Women who had abortions—and survived—were routinely sentenced to long prison terms. In one infamous case, a thirteen-year-old girl was raped by a relative and made pregnant. Another relative took her for an illegal abortion. Yet another relative reported her to the authorities, and she was sentenced to twenty years in prison.
When Nepal changed its abortion law in 2002, the Family Planning Association of Nepal (FPAN)—unwilling to deny women information about safe, legal abortion—immediately lost American funding for family planning services and contraceptive supplies. As a result, 60 health workers were laid off, mobile reproductive health clinics were eliminated, and the agency’s ability to provide access to a regular supply of birth control withered.
Since President Obama lifted the Global Gag Rule in 2009 and FPAN funding was restored, Nepal’s maternal mortality rate has fallen by a third. Trump’s action threatens to reverse that remarkable progress.