Global health anthropology

Trumping women's reproductive rights

'Global gag rule' reinstated by Trump threatens girls' and women's access to reproductive health services including safe abortion

Women's March 21 January 2017
Women's March 21 January 2017
Michael Nigro/Pacific/Barcroft

Main content

On his first day in office, on Monday 23 January 2017, Donald Trump signed a memorandum reinstituting the 'global gag rule' or the Mexico City Policy from 1984 (by Reagan and reistituted by Bush Jr.), and that Obama had rescinded 23 January 2009. This policy states:

“The United Nations Declaration of the Rights of the Child (1959) calls for legal protection for children before birth as well as after birth. In keeping with this obligation, the United States does not consider abortion an acceptable element of family planning programs and will no longer contribute to those of which it is a part. Accordingly, when dealing with nations which support abortion with funds not provided by the United States Government, the United States will contribute to such nations through segregated accounts which cannot be used for abortion. Moreover, the United States will no longer contribute to separate nongovernmental organizations which perform or actively promote abortion as a method of family planning in other nations. With regard to the United Nations Fund for Population Activities (UNFPA), the U.S. will insist that no part of its contribution be used for abortion. The U.S. will also call for concrete assurances that the UNFPA is not engaged in, or does not provide funding for, abortion or coercive family planning programs; if such assurances are not forthcoming, the U.S. will redirect the amount of its contribution to other, non-UNFPA, family planning programs.”

US aid recipients during the Clinton and Obama era, when the gag rule was rescinded, could use non-US funds to engage in abortion-related activities but were required to maintain segregated accounts for US assistance. This is no longer possible with the Mexico City Policy reistituted if they wish to receive US family planning funds (see explanatory fact sheet on the Mexico City Policy).

In one of the many executive orders Trump signed his first day in office it is stated: The Committee (which will be established) shall recommend appropriate strategies (by 1 January 2018) to cease US funding that directly or indirectly supports, among a host of things, (4d) "The performance of abortion or sterilization as a method of family planning or to motivate or coerce any person to undergo abortion or sterilization". This point is however in accordance with the Helms amendment of the US Foreign Assistance Act of 1961, Section 104(f) which has prohibited the use of US funds for performing abortions and involuntary sterilisations since 1973 (see USAID's family planning guidelines and principles). So in his executive order Trump just reaffirms what has been US policy all along. However, of special concern for women’s sexual and reproductive health and rights is the fact that the United Nations Population Fund (UNFPA) again is on the list of operations and organisations that most probably will lose its funding; as it has during past republican presidents.

The United States spends about 600 million dollars a year on international assistance for family planning and reproductive health programs. In addition around 30 million dollars have gone to UNFPA for family planning and reproductive health programs during Obama's presidential period. The reintroduction of the 'global gag rule' together with the reconsidering of US funding for UNFPA might therefore have devastating effects on women's reproductive health in countires where nongovernmental reproductive health organisations have been dependent on UNFPA and/or US funding.

But will the reinstating of the 'global gag rule', and the consequent reduction in US funding to those who refuse to be gagged, have the same deadly effects on women's access to abortion this time around?

The discussion at the Africa Regional Conference on Abortion in Addis Ababa in November 2016 suggested that it might not be that straight-forward as other networks of support from other sources and partners have also been established since the last gag rule era of Georg Bush Jr. African Leaders’ passing of the Declaration on Safe, Legal Abortion as a Human Right, on 20 January 2017, is also a positive sign that the situation might be different now. The Dutch government and others (including the Norwegian foreign minister) have also challenged Trump's restrictive policy by suggesting an international fund that will fill the funding gap for information on and performance of safe abortion services where legal locally. In fact, by 3 February 2017, the Netherlands Development Minister Lilianne Ploumen said that 13 countries have signed up so far to contribute to the She Decides fund, to overturn the effects of the global gag rule on NGOs who will lose US funding if they refuse to stop informing about and performing safe abortions. An international fund-raising meeting is to be held in Belgium on 2 March 2017. The Norwegian government has signalled that Norway will give 85 million NOK to help fill the funding gap that the 'global gag rule' leaves.

Furthermore, since the link between unsafe abortion and maternal mortality is now well established, the Sustainable Development Goal of reducing maternal mortality might manage to forge a continued focus on unwanted pregnancies and unsafe abortions. One question is also whether knowledge about and access to medical abortion have created a more resistant terrain against deadly setbacks for women this time around?

These questions now form part of a new context for the SAFEZT project’s focus on fertility control and safe abortion in Ethiopia, Zambia and Tanzania.