OPINION: As the U.S. axes the anti-abortion gag rule, here's what must happen next

by Viviana Waisman | @womenslink | Thomson Reuters Foundation
Wednesday, 7 April 2021 11:02 GMT

A person holds a sign during a protest against the ruling by Poland's Constitutional Tribunal that imposes a near-total ban on abortion, outside the EU headquarters in Brussels, Belgium November 11, 2020. REUTERS/Yves Herman

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* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.

Revoking the Trump-era ‘global gag rule’ is instantaneous, ensuring access to abortion will take years

Viviana Waisman is president and CEO of Women’s Link Worldwide and an expert in women’s rights and human rights law

During the pandemic, approximately 12 million women worldwide were unable to access essential family planning services, resulting in an estimated 1.4 million unintended pregnancies.

The pandemic exacerbated the longstanding, deeply rooted inequities and shortcomings in global reproductive health care access — many of them able to be traced back to one singularly harmful U.S. policy: the global gag rule.

The global gag rule — first implemented under the Reagan administration and reintroduced with each incoming Republican administration — bars federal funding of non-governmental organizations (NGOs) working to expand health care access and provide health services abroad if that organization provides, advocates, provides referrals for, offers information about, or even mentions abortion.

Since its introduction, the gag rule has been enacted and rescinded every time the White House changes parties. Bill Clinton reversed it. George W. Bush reinstated it. Obama rescinded it. 

Within a year, the Trump administration reinstated the policy and made it even worse by expanding it far beyond abortion and family planning.

Representing a 20-fold increase in the amount of U.S. aid funding affected, the confusingly vague and far-reaching rule now covered funding of international relief efforts related to HIV/AIDS, nutrition, malaria, water and sanitation, and tuberculosis and other infectious diseases. 

Trump’s unprecedented expansion of the rule and changes to USAID policies have had devastating consequences for those who need these services most.

For example, Kenya’s sexual and reproductive health services are heavily reliant on foreign aid — 95% of which is funded by the United States.

According to one study, within the first 18 months of implementation, the effects of Trump’s expanded gag rule caused funding concerns among all health providers, disrupting collaboration between coalition partners, impeding health outreach and strengthening opposition to sexual health services and reproductive rights.

This led to closures of health facilities — including those providing comprehensive care such as HIV/AIDS treatment and child and maternal health service — as well as contraception being frequently out of stock or unavailable.  

One of President Biden’s earliest actions was to rescind the gag rule. It was an excellent policy decision — one that will have profoundly positive effects on the lives of women and people around the world, including saving lives.

Unfortunately, policies are not like lamps; they don’t turn on and off with the flip of a switch.

The result of the constant back and forth has been an ever-deepening sense of stigma around abortion and reproductive health care. Health care professionals are afraid to discuss abortion with patients.

There is uncertainty or unwillingness by various NGOs to work in partnership for fear that others may be in violation and could affect a partner’s funding. Some providers take an overly cautious approach, often self-censoring beyond what is actually required by the policy. 

While implementing or revoking the gag rule is instantaneous, providing access to abortion and abortion information takes time. Health care providers must collect information, train staff and ramp up services.

Groups such as Marie Stopes International have said it could take up to one year to reinstate services. When seeking an abortion, time is of the essence and delays can have devastating health impacts.

It is a harmful cycle that not only undermines the ability of local service providers to respond to their community’s needs, but also fuels the continuation of restrictive, repressive laws that criminalize women and girls who seek reproductive health services.

It makes it even harder for local movements to advocate for laws and policies to advance equality.

The U.S. needs to take a strong and permanent stand for reproductive health and rights and to put women and girls at the center of laws and policies that will impact their lives and health.

The U.S. must trust local organizations and activists to know their communities and enact policies that support consistent, safe, dignified care.

Policymakers must do more than just reverse the damage to women and girls around the world. Americans must demand that U.S. policies always support the women and girls mobilizing around the world, speaking out for their rights.

Policymakers can start by providing a more permanent fix to stop the gag rule once and for all.