Is the Trump Administration putting millions of lives in danger in the name of being “pro-life”?
Earlier this month, the London Family Planning Summit took place. This international gathering brings together advocates, policymakers, and donors working towards providing family planning resources worldwide. “Family planning” is a broad term used to describe methods that women can use to control the number of children she has as well as the time intervals between their births. Family Planning 2020, one of the leaders of the Summit and a top player in the fight for family planning access, sums up its need quite simply. “Family planning is a best-buy in global development. When women and girls have access to family planning, they are able to complete their education, create or seize better economic opportunities, and fulfill their full potential.”
With this renewed discussion surrounding the importance of family planning, it is time to revisit the ‘global gag rule’ that was reinstated by President Trump at the beginning of this year. Otherwise known as the “Mexico City Policy,” this controversial aid protocol requires NGOs to agree to not perform or actively promote abortion as a family planning method in order to receive global health assistance funds, even in countries where abortion services are legal. Before the Trump Administration, this restriction applied only to family planning NGOs receiving U.S. funds. As of May, the Administration expanded the policy to all global health NGOs receiving U.S. funds, including organizations focused on HIV/AIDS, maternal and child health, malaria, global health security, and family planning and reproductive health. Under President Trump’s global gag rule, NGOs wishing to acquire US funds have two choices:
- Accept US money and be prohibited from providing abortion counseling, referrals, or advocacy efforts, and from providing abortions outside of the three exceptions: rape, incest, or danger to the mother’s life.
- Refuse US money and look elsewhere for funding in order to keep health clinics open, continue to provide a range of sexual and reproductive health services, and continue advocating for law reforms to reduce unsafe abortion.
The global gag rule, when only applied to family planning NGOs, affected around $575 million in foreign aid. With the Trump Administration’s expansion, it now affects $8.8 billion in U.S. global health assistance. No US foreign assistance money has been used to actually perform abortions since the 1973 Helms Amendment, but when the Mexico City Policy has been enforced with past Republican presidents, there has been a proven rise in the number of abortions in countries where U.S. aid money is sent. A Stanford University study shows that between 1994 and 2008, the number of abortions in 20 sub-Saharan countries with high exposure to the global gag rule rose greatly when President Bush implemented the policy. Countries with low exposure to the policy showed no significant change in abortion rates before and after it was reinstated.
The Mexico City Policy affects far more than abortion – it will prevent access to various other medical resources. A standard global health model of integrated care has developed where numerous services are offered in one place, especially helpful in regions lacking a strong transportation infrastructure. For example, a single clinic might provide contraception resources, HIV treatment, immunizations, prenatal care, and information or referrals on safe abortion care. Trump’s global gag rule would prevent this clinic from receiving any U.S. aid because their integrated care includes resources on abortion. If this example clinic lost funding, it could very well lead to:
- Halted contraception delivery, which helps prevent the need for abortions in the first place
- Possible death from untreated HIV and/or mothers passing on HIV during childbirth
- Contraction of easily preventable diseases due to lack of vaccination
- Women giving birth with little to no prenatal care – these women are seven times more likely to give birth to premature babies and five times more likely to have infants who die
In addition to having tangible effects on international healthcare delivery, the global gag rule raises questions about free speech and medical ethics. This rule puts a limit on what NGO workers can and cannot speak about during healthcare delivery. Not only is free speech a right guaranteed by the U.S. Constitution, the very country where the aid money is coming from, Article 19 of the Universal Declaration of Human Rights protects the right to freedom of opinion and expression.
The Mexico City Policy essentially forces individuals to give up rights in order to sustain financially their aid efforts. Furthermore, the global gag rule directly contradicts widely accepted standards of medical ethics. The American Medical Association Code of Medical Ethics states, “Except in emergency situations in which a patient is incapable of making an informed decision, withholding information without the patient’s knowledge or consent is ethically unacceptable.” Informed consent is the cornerstone of medical ethics – the global gag rule compels healthcare professionals who want to continue giving care to violate their responsibility to provide patients with all pertinent information.
It is quite obvious that being ‘pro-life’ in this situation involves no true concern for actually protecting life. Secretary Tillerson’s name for the policy expansion, “Protecting Life in Global Health Assistance,” is downright laughable. The Center for Health and Gender Equity estimates that Trump’s version of the global gag rule will contribute to at least 6.5 million unintended pregnancies, 2.1 million unsafe abortions, and 21,700 maternal deaths.
Women and girls in 60 middle- and low-income countries will lose access to life-saving contraception, costing them educational and economic opportunities that would fuel growth and development. Families unable to take advantage of family planning strategies aside from abortion will contribute to the ever-present problem of virtually uncontrolled population growth. Forcibly attaching an ideology to aid money will cost the world millions of lives in addition to letting more innocent babies be born into a world where their parents cannot clothe, feed, or educate them. Being pro-life should be about providing people a dignified, high-quality life rather than just plain existence.