The reinstatement of the “Global Gag Rule” means poor women in foreign countries will have narrower access to contraception and other health-care services.
Two days after millions of women and their allies throughout the world took to the streets to protest the bigotry and misogyny of Donald Trump, the president sat in the Oval Office, surrounded by other men, and signed an executive order that could have dire consequences for women living abroad.
The United States provides more funding for women’s health services than any other country. For health providers that receive that aid, the gag rule forces them to limit their services, or face a major budget gap. In other words, health organizations that provide a whole range of essential services besides abortion get punished. For women, it means narrower access not just to abortion but also to contraception, which in many poor countries is largely funded by foreign donors. Disruptions in aid put women at greater risk for HIV and other sexually transmitted infections, and make them more likely to resort to unsafe abortions. More than 1,327 communities in Ghana, for instance, were affected after George W. Bush reinstated the rule in 2001, forcing Planned Parenthood Association of Ghana to forgo $200,000 in USAID funding and cut its nursing staff by 44 percent, according to Population Action International. In Kenya, two leading reproductive health–care providers were forced to close a total of 17 clinics. Contraceptive shipments from the US to 16 countries—primarily in Africa—stopped completely.
Given the history of the gag rule, Trump’s rush to reinstate it is not a surprise. But that doesn’t diminish the significance of the order for millions of women and their families. The two largest recipients of family-planning funding from USAID, Marie Stopes International and the International Planned Parenthood Federation, announced Monday that they won’t comply with the reinstated policy. IPPF, which will lose $100 million as a result, promised to “work with governments and donors to bridge the funding and service gaps the Global Gag Rule creates.” But even if the money materializes from another source, it will take time, leaving women—particularly poor and rural women—at risk to disruptions in access to care. MSI (which often works in unstable and emergency settings, such as in Nepal after the deadly 2015 earthquake) will lose $30 million, or about 20 percent of its annual budget. The organization estimates the shortfall could, during Trump’s first term, lead to 6.5 million unintended pregnancies, 2.2 million abortions, 2.1 million unsafe abortions, and the deaths of 21,700 pregnant women.