Imagine this: You're a health care provider in a nation that receives foreign aid from the United States, and your patient has experienced an unplanned pregnancy. The patient knows they want an abortion, but you can't talk about abortion, provide counseling or offer a referral -- otherwise you'll jeopardize your clinic's funding.
That's the reality under the Mexico City Policy, also known as the Global Gag Rule. Republican presidents have been slapping this policy on recipients of foreign ai d since 1984, with Democrats reversing the order almost as soon as they get into office.
This back-and-forth dance imperils foreign aid for organizations providing assistance to people in developing nations all over the world -- and it's about nothing more than imposing ideology.
Let's be clear: This isn't an executive order mandating that foreign aid from the United States can't be used for abortions, although that would be bad enough. It also wouldn't be necessary, because the Helms Amendment already bars the use of foreign aid for this purpose.
Instead, the Global Gag Rule mandates that entities receiving aid from the United States cannot perform abortions, period -- even if the funds to provide them come from other sources. Health care providers also can't discuss abortion with patients in the course of pregnancy counseling, nor can they refer patients to facilities that provide abortions. Technically, there are supposed to be exceptions for rape and incest, but those tend to be more theoretical than practical.
In essence, the United States is dictating what kind of health care and counseling that aid workers provide.
Oddly enough, research suggests that these kinds of restrictions on foreign aid can actually lead to an increase in the abortion rate. Access to comprehensive, inclusive family planning and health care makes it easier for people to make informed choices about sexuality and their bodies.
Many organizations feel pressured into accepting this terrible deal because they rely on US dollars to function and reach as many patients as possible. Their work often includes STI screening and treatment, perinatal care, sex and health education, new baby wellness and a variety of other services that have nothing to do with abortion -- and are, in fact, things that the pro-life movement claims to care about, like providing babies with healthy starts in life and supporting new parents who are struggling to care for their children.
The Global Gag Rule isn't good for patients. This policy makes it hard to provide comprehensive counseling, education and outreach, for example. Patients who need abortions and can't get referrals may find themselves making unsafe and unhealthy choices on the basis of minimally available information. Lack of abortion care can make it challenging to treat patients experiencing complications after abortions, or bad pregnancy outcomes that may require surgical intervention.
Some entities aren't willing to make that choice, like Family Health Options Kenya, which provides a range of family planning and health care services -- including abortion. The group decided it didn't want to comply with the terms of Trump's executive order. As a result, the organization is losing some $2 million in funding -- all because it wants to ensure patients have access to a range of health care options that meet their needs, without stigma or compromise. That's nearly 60 percent of its operating budget, a harsh blow.
The clinic provides services like abortions for victims of child sexual assault, family planning for people who want to control the timing and spacing of their children, and a variety of sexual health services. It's cutting back staff and services in addition to implementing fees that not everyone can afford. That's going to exacerbate health care inequalities and, in turn, entrench poverty and suffering.
Family Health Options Kenya won't be the last in a growing list of organizations losing foreign aid over this issue, however. SheDecides, a Dutch program fighting the Global Gag Rule and promoting sexual autonomy for women worldwide, is working hard to address funding imbalances created by the Trump administration's cruel move.
But US residents aren't entirely powerless: We can contact our legislators to ask them to address this issue, and support organizations providing these services at home and abroad, like the International Planned Parenthood Federation.