Talkin’ About a Revolution: The Real Impact of Global Gag Rule

The Global Gag Rule or The Mexico City Policy first took effect under Ronald Reagan in 1985 and stated the following:

“[T]he 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. …[T]he 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.”

The Mexico City Policy expanded existing restrictions that prohibited U.S. funding for abortion internationally. However, before the policy was reinstated under President Trump as the Global Gag Rule, foreign NGOs could use non-U.S. funds for voluntary abortions and abortion counseling. However, “The Trump administration’s presidential memorandum states that the policy will apply to all U.S. global health assistance (to the extent allowable by law), including but not limited to family planning assistance, and extends prior policy to include all agencies and departments. Currently, the agencies and departments that receive direct appropriations for global health include:

  • USAID, the Department of State, including the Office of the Global AIDS Coordinator, which oversees and coordinates U.S. global HIV funding under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)
  • Two operating divisions of the Department of Health and Human Services: the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH); and the Department of Defense (DOD).”

According to “Access Denied: The Impact of the Global Gag Rule in Nepal,” the Global Gag Rule will effect Nepal in these ways:

  • A loss of $100,000 USD per year in funding has forced Nepal’s leading family planning organization to lay off 60 clinic staff members, including doctors and nurses.
  • Mobile clinics providing reproductive health care to rural regions have been discontinued, leaving clients without access to services.
  • NGOs that supported the government’s legalization of abortion have been silenced.
  • U.S. restrictions have infringed upon Nepalese sovereignty by creating barriers to its efforts to deal with the public health crisis of unsafe abortion.

In the UPI article “Health-clinics-already-hit-by-catastrophic-global-gag-rule-on-abortion” by Hannah McNeish, the effects on Kenya are equally as devastating. Although Dr. Nduhia, an obstetrician and gynecologist who performs abortions for MSI Eastleigh Clinic in Kenya says, “within the context of Kenyan law, which allows for the procedure if the woman’s life or health is at risk…but because of the gag rule, MSI operations in Kenya will lose out on a $3 million deal the organization was about to sign with USAID to provide contraceptives to around 75,000 more women in rural areas and to train public healthcare workers on how to provide longer-term family planning methods.”

And while these facts and statistics speak for themselves, unfortunately it loses the face of the people involved. Dr. Nduhia sees the real life results of botched abortions including: “Perforations to the uterus and the accidental extraction of intestines are not uncommon occurrences with abortions performed by untrained personnel…and doctors often see women with severe bleeding, trauma and infections after botched attempts to terminate a pregnancy. Unsafe abortion is a leading cause of maternal death in Kenya.”

And sadly, while we already understand the health ramifications to women, there are so many other things this ruling exposes women to–like the extortion of young desperate women. In Tanzania, where abortion is illegal and punishable by up to 14 years imprisonment, A young spoke to DW in the article “Illegal Abortion In Tanzania The Scariest Moment of My Life” A young woman who, when seeking Medical help, was instead extorted by the physician: “I told him I wanted to have an abortion because I did not want to be expelled from school and that I count on him to help me,” she said. After a brief discussion, the ‘doctor’ told her that the procedure was illegal but that he could do the job for 25,000 Tanzanian shillings ($12).” The hospital data suggests that hundreds of women still undergo abortions in secret.

According to the article: “There are no exact figures on illegal abortions in Tanzania but studies suggest that almost 60 percent of the women admitted to public hospitals with a suspected miscarriage, have in fact undergone an abortion. The actual number of women who have unsafe abortions may be higher, given that not all women seek medical care…a report by the US-based Center for Reproductive Rights indicates that Tanzania’s law and policies on abortion remain unclear and are often inconsistent. The country actually ratified the African Charter on Human and People’s Rights protocol on the Rights of Women in Africa in 2007. It allows medical abortions in cases of “sexual assault, rape, incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the foetus.” But Tanzania has not yet adopted these provisions into its laws.

This could all change with the introduction of The Global Health, Empowerment, and Rights (HER) Act, which was introduced in the House of Representatives by Congresswoman Nita M. Lowey, a Democrat from New York. The legislation would permanently revoke the Mexico City policy, which was first enacted in 1984 by President Ronald Reagan. “The HER Act would ensure that eligible organizations can keep providing health services with U.S. funds, while continuing to pay for anything abortion-related on their own dime (per the Helms Amendment). It also hopes to help expand women’s health programs abroad.”

Democratic New Hampshire senator Jeanne Shaheen is set to introduce the HER Act in the Senate as well.

We must keep all available options open internationally (and locally). Using federal funds for abortion has been restricted since before the Global Gag Order went into effect, but as long as funds were segregated the medical community had options. This new directive removes all legal options, for women and physicians alike, to counsel in contraception and/or abortion. It forces medical personnel to withhold advice and medical procedures under the threat of losing much-needed aide instead of measuring a medical need. And the people lost in all this are the women that need medical advice, counseling and of all procedures available to them. Although there is little hope that the HER Act will be passed in a republican controlled congress, we must continue to advocate for these countries that will be devastated by The Global Gag Rule. We must continue to contact our representatives and let them know that we want them to vote yes on the HER Act.

We must find a way to keep contraception and abortion counseling services available for women globally. We should not be attempting to control medical decisions by restricting funds due to an archaic law that does not operate in the reality of the medical needs of women. We should not force doctors and trained medical personnel to withhold medical treatment they deem necessary by threatening the loss of funds. We have enough medical concerns and problems without the added stress of the possibility of loss of the medical facilities, which will further impact the health and welfare of the women they care for; medical professionals should be making these medical decisions, not congressmen with an agenda.

We need to use our voice to be heard.

We need to be heard to effect change.

Joan Hanna has published poetry, creative nonfiction, fiction, book reviews and essays in various online and print journals. Hanna’s first poetry chapbook, Threads, was named a finalist in the 2014 Next Generation Indie Book Awards. Both Threads and her second chapbook, The Miracle of Mercury, are available through Finishing Line Press. Hanna has previously served as Assistant Managing Editor for River Teeth, Assistant Editor for rkvry Quarterly Literary Journal, Managing Editor for Poets’ Quarterly and Senior Editor at Glassworks. Hanna holds a Master of Fine Arts in Creative Writing and teaches creative writing at Rowan University. You can follow her personal blog at Writing Through Quicksand.


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