If Barack Obama's tour of Europe and the Middle East does anything, it will give the senator from Illinois a taste of just how desperate the world beyond US borders is for the very brand of change he's advocated these many months. Sure there are the obvious points: the promise to pull out of Iraq, the reinvigoration of a kind of outwardly focused global neo-liberalism and engagement with allies and foes alike on everything from climate change to countering terror. But this month's World Population Day pointed to another reason the Bushies can't leave office fast enough.
According to a new World Bank report, despite a worldwide increase in access to contraception and contraceptive technologies, some 51 million unintended pregnancies take place every year in the developing world, and an additional 25 million pregnancies are gestated by women who use faulty contraception or don't understand the methods they're using.
Of that number, according to the World Bank, some 68,000 women die from botched or unsafe abortions each year, and some 5.1 million are left permanently disabled by them. "Giving women access to modern contraception and family planning also helps to boost economic growth while reducing high birth rates so strongly linked with endemic poverty, poor education and high numbers of maternal and infant deaths," Joy Phumaphi, the World Bank's vice-president for human development, and a former health minister in Botswana, said in a statement.
How does that connect to the Bush administration? Simple. Since the moment he stepped into office, Bush's commitment to the foolish "abstinence only" training both domestically and internationally has been coupled with a slavish devotion to the restrictive, ghoulish, "global gag rule", introduced by Ronald Reagan in 1984, that cut off funding for any organisation that used USAID funds to even touch the word "abortion". That meant an organisation couldn't counsel a woman on abortion as an option, even if it received money from an entirely separate funding source to do so. Given that the 1973 Helms Amendment already banned US funds from paying for overseas abortions, Reagan's policy gagged healthcare providers and gave them a stark choice: lose crucial American funding (from the creation of USAID in 1965 to 1984, some 40% of all foreign funding to population control-oriented organisations globally came from the US), or severely limit the way they talked about reproductive choices.
Bill Clinton repealed the policy, but Bush reinstated it the moment he arrived in Washington, in January 2001. Then, in August 2003, he tried to deepen its impact, extending the ban from USAID to the entire state department, pushing to ban all employees at state from even discussing the consequences of abortion. Several reports issued at the time illustrated just how devastating Bush's policy had become. By 2002 USAID had ended shipments of contraceptives to 16 developing nations in Africa and Asia as a direct consequence of the gag rule.
Instead of ending abortions, the global gag rule pushed women into back alleys and undermined, even closed, organisations that would have counselled women on how not to get pregnant in the first place. By diminishing access to contraception, it was actually laying the groundwork for unsafe abortions. The global gag rule didn't just gag healthcare providers about abortion. It gagged them on contraception and education. Since 2002, the Bush administration has also withheld funding - to the tune of $39.7m - from the United Nations Population Fund, claiming - despite evidence to the contrary - that UNFPA is connected to forced abortions in China. The shortfall from the US has also helped undermine the spread of contraception and education around the world, particularly in Africa.
"Hundreds of women are dying every day in poor countries from botched abortions," says Barbara Crane, executive vice-president of the North Carolina-based reproductive rights organisation IPAS, who wrote me by email last week. "By repeatedly cutting the budget for international family planning and putting in place the global gag rule, the supposedly 'pro-life' Bush administration ignores this tragic reality - and without doubt causes more unsafe abortions, posing high costs to women, their families and society at large. It is ironic that the same groups that oppose abortion rarely step up and support better access to contraception."
The Bush administration has time and again put American women's lives second to a religiously inspired relationship to women and reproductive health. Take their latest attempt to restrict American women's access to contraception and the kind of pre-emptive contraceptive measures that pro-life forces should love. In this latest salvo, the US department of health and human services would allow any healthcare provider the right to refuse to treat a woman, and defines "abortion" in such a broad manner as to restrict access to IUDs, the morning after pill, and some birth control pills. This affects any entity - from public and private hospitals to pharmacies - that receives public funding from HHS, explains Jill Morrison, senior counsel at the National Women's Law Centre. "Under the guise of simply interpreting current law," Morrison explained, if this HHS proposal goes through it would "completely expand the federal abortion refusal laws to include some of the most commonly used forms of contraception." Morrison said it was fair to call this a "domestic gag rule".
The Bush administration's relationship to sex and reproduction has been consistently abysmal, from their utterly failed effort to promote abstinence only among teenagers to its unique ability to hire militantly anti-contraception "experts" like Susan Orr, a veteran of the religious Family Research Council, who was named acting deputy assistant secretary for population affairs in October of last year (and stepped down, quietly, in May). Orr was previously known for championing a measure that would strip funding for birth control for federal workers, saying she was "quite pleased because fertility is not a disease. It's not a medical necessity that you have it" and earlier calling contraception part of a "culture of death".
The Bush administration's notion of contraception and sex education has been consistently - maddeningly - oxymoronic. Abortion rates are lowest in countries where women have access to education, especially education on contraception. So while we in the US hold our collective breath, waiting out these last few months of Bush's efforts to restrict our freedoms, globally women are literally dying for him to leave.
Sarah Wildman is a senior correspondent for the American Prospect and a contributor to the New York Times.
© Guardian News and Media Limited 2008