ONE THING IS likely to be overlooked tomorrow when camps representing the two sides of the nation's divide over reproductive rights mark the 31st anniversary of Roe v. Wade: the extent to which the battlegrounds in this conflict have shifted overseas.

President Bush wasted no time in drawing women from around the world into the United States' most bitter culture war. On his first full day in office three years ago (also a Roe v. Wade anniversary), Bush reinstated the "global gag rule," a policy first imposed by President Reagan in 1984 and overturned by President Clinton. The measure prevents U.S. assistance from going to foreign nongovernmental organizations that use non-U.S. funds to perform abortions or provide abortion counseling and referrals (the Helms Amendment, passed in 1973, already prohibited direct use of U.S. aid for abortion).

The gag rule clashes with our nation's democratic principles and would probably be declared unconstitutional here. It also puts family-planning and reproductive-health organizations in an impossible position: They must either accept U.S. funding-but with constraints that are undemocratic and may endanger the health of some patients-or reject what is often their largest source of assistance.

Evidence suggests that the gag rule has undermined the health of some of the world's most vulnerable women, men, and children. In Kenya, where NGOs are the main providers of reproductive health care, the policy has impaired the invaluable work of groups such as the Family Planning Association of Kenya, which refused to sign on to the gag rule even though it does not perform abortions or offer abortion counseling and referrals. Due to the loss of U.S. funds, such groups have been forced to cut staff and shutter clinics, effectively eliminating some people's only access to family-planning services and pre- and post-natal care.

The gag rule also is hampering the battle against HIV/AIDS. In theory, the policy shouldn't affect HIV/AIDS programs; but in reality, the rule has weakened organizations on the front lines of the battle against the disease.

The Family Planning Association of Kenya, for example, was forced to release half of its educational outreach staff after losing U.S. assistance. As a result, the association had to scrap a youth program on AIDS-an especially troubling cutback considering that Kenya's public schools offer little or nothing in the way of sex education.

The gag rule has had similar effects in neighboring countries in eastern and southern Africa, as well as in other poor nations such as Romania, according to a report released in the fall by a coalition of international reproductive-health organizations.

What's especially tragic about the gag rule is that it probably doesn't even achieve a net decrease in abortions; in fact, it may cause more of them. That's because when clinics lose U.S. funding and slash services, women are deprived of access to contraceptives and reliable family-planning advice. This leads to more unintended and high-risk pregnancies, which in turn lead to more abortions-including illegal, unsafe ones.

High-risk pregnancies and unsafe abortions, of course, cause more maternal illnesses, injuries, and deaths. These also hurt children: When a mother in the developing world dies or is incapacitated indefinitely, it greatly increases the chances that her young children will perish.

Nevertheless, a cadre of religious and social conservatives in Congress would like to see gag-rule restrictions expanded so that they are explicitly linked to funding for HIV/AIDS programs. Most public-health workers on the ground in Africa and elsewhere believe that such a measure would be disastrous.

The far right has, to a large extent, commandeered our nation's policies governing aid to overseas reproductive-health programs, and they have done it without drawing much attention to themselves. This is exactly what they want, because they understand that they are way out of step with the majority of Americans.

So tomorrow, on the anniversary of Roe v. Wade and the reinstatement of the gag rule, take some time to think about where you stand not only on abortion, but on guaranteeing access to the full range of family-planning and reproductive-health services. Then compare your views to those of the Bush administration and its far-right allies, and store all of this away for when you go to vote in November.

RICK MERCIER is a writer and editor for The Free Lance-Star. He can be reached at rmercier@freelancestar.com.

Copyright 2004, The Free Lance-Star

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