House GOP Revives Global War on Women's Health With "Gag Rule"

While Congress was playing fiscal roulette last month, House Republicans quietly advanced their attack on reproductive choice, too. Conservative legislators are working to reinstate the so-called Global Gag Rule, which would block international aid to organizations that provide abortion-related information and services in other countries. Exporting their domestic anti-abortion agenda to the Global South, conservatives seek to hold international family planning programs hostage to America's culture wars.

The proposed policy, part of a larger bill funding the State Department, is based on a Bush administration executive order that President Obama repealed. Under the previous gag rule, overseas organizations receiving U.S. family-planning funds were not allowed to provide abortion-related care or counseling, to help women avoid unsafe abortions, or to advocate on abortion issues. In addition to damaging women's health, the policy undermined political dialogue on providing comprehensive family planning in aid-dependent countries. The bill passed the House Foreign Affairs Committee last month.

But the new gag rule would go beyond previous executive orders (Bush's policy was a reinstatement of Ronald Reagan's "Mexico City Policy," which Bill Clinton rescinded) by codifying an expanded version of the restrictions in federal law.

Ellen Marshall, a foreign policy consultant with the International Women's Health Coalition, said the political forces driving the gag rule were

completely irresponsible in [their attempt] to block contraceptive and other sexual and reproductive health services for women, including services that prevent the need for abortion--all in the name of ending abortion. Doubly troubling is their willingness to stomp all over people's right to speech and to participate in public and political dialogue in their own countries, as a condition for receiving U.S. assistance.

On top of the gag-rule revival, House Republicans are also attacking family-planning funding overall, by trying to kill U.S. support for the United Nations Population Fund.

The federal budget doesn't account for the grim mathematics of this global reproductive health crisis. The Guttmacher Institute estimates that every $10 million that is cut from international family planning and reproductive health aid means "610,000 fewer women and couples would receive contraceptive services and supplies, 190,000 more unintended pregnancies, and 82,000 more unplanned births." Ultimately, reports the Huffington Post, the "pro-life" family-planning cuts proposed by the GOP would lead to roughly 7,700 maternal deaths and leave about 35,000 more children without mothers.

Millions Stifled

If reinstated, the gag rule would affect groups serving in a huge swath of the Global South, because the majority of countries that receive USAID funds allow some form of legal abortion, according to a 2009 report by the Center for Reproductive Rights.

The Bush gag rule had a massive ripple effect, according to Population Action International:

shipments of U.S.-donated condoms and contraceptives completely ceased to 16 developing countries, primarily in Africa. Leading family planning agencies in another 16 countries--mostly in Africa--have lost access to much-needed U.S. condoms and contraceptives as a result of their refusal to accept the gag rule restrictions.

In Kenya, the rule led to major funding losses for two large service providers, FPAK and MSI Kenya, which had to severely curtail their community health outreach and clinic programs:

Funding shortages have also led to a lack of regular contraceptive technology updates for community health workers. As a result, community health workers are uninformed of the types of family planning methods available to HIV-positive people. They avoid discussing condoms or reproductive health issues because their training has been restricted. Yet an emerging public health challenge involves those HIV-positive Kenyan women who are sexually active and desire pregnancy, but do not have the knowledge or tools to prevent transmission of the virus to their child.

The struggle against HIV/AIDS in Africa has been further hindered by the so-called "anti-prostitution pledge" embedded in the U.S.'s global HIV/AIDS funding program. The policy forces groups to actively disavow activities that may be considered supportive of sex workers. A federal appeals court recently ruled that the pledge amounted to overreach when applied to certain U.S.-based groups working overseas, but the restriction remains in force for foreign groups.

Abortion Wars

The groups at risk of getting gagged are a critical, often singular resource for women who are exposed to all forms of violence and exploitation. And this is another sad parallel between domestic and foreign policy: barriers to abortion and family planning services in the U.S. most acutely impact the health of poor women and women of color.

The gag rule isn't about preempting direct taxpayer support for abortions; that's already ensured under the policy known as the Helms Amendment.* Rather, the gag rule punishes overseas organizations that are focused broadly on women's health needs. As the Center for American Progress puts it, "Under the global gag rule, these organizations face a choice: either participate in the American right's global campaign to restrict women's rights and access to reproductive health care or lose critical U.S. funding."

The latest attempt to resurrect the gag rule is particularly threatening because many of the countries at risk now face unprecedented health challenges, from gender-based violence in war to refugee crises to a global epidemic of preventable maternal deaths.

International aid often serves as a cudgel for exporting conservatives' domestic anti-choice campaigns (read: the wholesale defunding of Planned Parenthood). Marshall told Colorlines that it's easier to use foreign policy as a "test market" for measures that would face more resistance in the U.S., she said, "because quite honestly ... fewer Americans are likely to get up in arms on restrictions on their foreign assistance dollars, because they don't see really a direct impact of that."

In many ways the gag rule reflects endemic problems in the foreign aid funding model, which hinges more on the election cycle than real human needs. Women's health advocates have long called for a comprehensive, community-oriented approach to aid that integrates reproductive and sexual health together with family planning--and above all, upholds human rights, not just political agendas.

While a wholesale restructuring of foreign aid remains a distant goal, New York Rep. Nita Lowey wants to at least revamp funding for family planning with the proposed Global Democracy Promotion Act. The measure would prevent lawmakers from forcing overseas groups "to sacrifice their right to free speech and their obligation to provide truthful, comprehensive information to patients in order to participate in U.S. supported programs."

But in a political arena dominated by deception and stonewalling, promoting integrity in international aid inevitably ranks low on the agenda. In the right's ongoing quest to gag the movement for reproductive health, the aid that was intended to improve women's lives has instead been used to smother them.