The Bush Global Gag Rule: Endangering Women's Health, Free Speech and Democracy

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On January 22, 2001, on his first business day in office (and the 28th anniversary of Roe v. Wade, the landmark U.S. Supreme Court decision establishing a woman's right to an abortion), President George W. Bush re-imposed the Global Gag Rule on the U.S. Agency for International Development (USAID) population program. This policy restricts foreign non-governmental organizations (NGOs) that receive USAID family planning funds from using their own, non-U.S. funds to provide legal abortion services, lobby their own governments for abortion law reform, or even provide accurate medical counseling or referrals regarding abortion. The 1973 Helms Amendment is a legislative provision that already restricts U.S. funds from being used for these activities.

78,000 women die every year from unsafe abortion, a statistic that could be virtually eliminated by the provision of appropriate health information and services and law reform efforts. Despite this, President Bush's Executive Memorandum directs USAID "to reinstate in full all of the requirements of the Mexico City Policy in effect on January 19, 1993." According to this policy, foreign organizations--often the only health-care providers in remote, rural areas--are prohibited from using their own, non-U.S. funds for:

  • providing legal abortions even where a woman's physical or mental health is endangered (the only exceptions are in cases of rape, incest, or where the woman's life is endangered),
  • providing advice and information regarding the availability and benefits of abortion and from providing referrals to another health clinic,
  • lobbying their own governments to legalize abortion, to maintain current law and oppose restrictions, or to decriminalize abortion, and
  • conducting public education campaigns regarding abortion.

In addition, even the provision of services that are "permitted"1 on paper, such as life-saving abortions and post-abortion care, are often curtailed because NGOs fear jeopardizing their funding through any association with abortion. Providers may even be reluctant to dispense emergency contraception--which acts to prevent pregnancy and is not an abortifacient --because of the Global Gag Rule.


The U.S. has been a supporter of international family planning and population assistance since the 1960s. However, in 1984, the Reagan Administration imposed restrictions on U.S. funding for international family planning. The so-called "Mexico City Policy," also known as the Global Gag Rule, prohibited overseas NGOs from receiving U.S. funds if, with their own funds and in accordance with the laws of their own countries, they "perform[ed]" or "actively promote[d] abortion as a method of family planning." Further, the Reagan Administration issued extremely restrictive regulations that interpreted the phrase "abortion as a method of family planning" to mean all abortions, except when performed in cases of rape, incest, or when the life (but not health) of the woman would be endangered if the fetus was carried to term. The Clinton Administration ended the Global Gag Rule in 1993 by executive order.

Since 1995, U.S. congressional foes of family planning and abortion rights have sought to enact funding restrictions similar to the original Global Gag Rule. These ultra-conservative members of Congress inappropriately and unconscionably held payment of U.S. arrears on its UN dues hostage to earlier versions of the Global Gag Rule by attaching riders to bills authorizing the dues payment. In 1999, they forced through a "one-year deal," temporarily re-imposing a modified version of the Global Gag Rule to avoid the looming foreign policy crisis they had created, including pending loss of the U.S. vote in the UN General Assembly. In 2000, Congress and the Clinton Administration eliminated the Global Gag Rule from the FY 2001 appropriations legislation, but withheld the release of international family planning funding until February 15, 2001 to allow the new president to decide whether or not to re-impose the Global Gag Rule. President Bush made the wrong decision.

The Global Gag Rule Undermines the Human Right to Free Speech

By stifling public debate and the ability of foreign NGOs to lobby their governments, the Global Gag Rule undermines NGOs' right to exercise freedom of speech.

  • Nepal has one of the highest maternal mortality rates in South Asia: 539 women in 100,000 die from pregnancy-related complications (as compared to 7 in 100,000 in the United States). Half of these deaths are caused by unsfe abortion. On September 26, 2002, however, the King of Nepal signed a historic law that legalized abortion on broad grounds.

    Despite the landmark reform of the abortion law, safe abortion services will remain out of reach for many women in Nepal, particularly rural and low-income women. The Bush Administration’s global gag rule will pose an added barrier to ensuring abortion access. The global gag rule will prevent the organizations that receive U.S. family planning assistance from providing or advocating for any aobrtion-related services. These organizations also will not be able to provide counseling or referrals for women to obtain abortion services elsewhere. To provide safe abortion services, these organizations would have to risk bankruptcy and forego U.S. family planning assistance-the largest source of such foreign aid in Nepal. li>

  • U.S.-funded NGOs in Russia, where most abortions are legal, cannot meet with governmental officials to express support for policy changes to make legal abortions safer. Nor can they discuss their concerns regarding the negative health impact of a proposed restrictive abortion law in Russia. The Global Gag Rule forces health care organizations to make an immoral choice: either give up desperately needed funds for family planning and other reproductive health-care services, or give up their right to free speech and to provide patients with full and accurate medical information. However, anti-choice groups are not gagged and can lobby their governments to make abortion laws more severe while receiving U.S. aid. On an issue that causes so much political debate in the U.S., the Bush Administration is arrogant to think it is entitled to suppress that same debate in other countries, especially in such a one-sided manner.


The Global Gag Rule Undercuts U.S. Foreign Policy

The Global Gag Rule erects barriers to the development of the democratic process in other countries, the promotion of civil society and development of NGOs abroad, and the enhancement of women's equality and participation in the political process. Thus the Global Gag Rule severely undermines bedrock U.S. foreign policy objectives. It also impacts international assistance provided by other donors--including Canada and the European Union--who will not be able to collaborate with foreign NGOs on abortion-related projects if those NGOs also receive USAID funding. Furthermore, it inappropriately challenges foreign governments' sovereignty by constraining their implementation of national health-care policy decisions.

Various international instruments--which the U.S. has strongly supported-establish reproductive rights as fundamental human rights. These instruments also provide that where abortion is legal, it should be fully integrated into reproductive health care to ensure that it is safe and accessible. The Global Gag Rule flies in the face of the U.S.'s leadership on the promotion of reproductive rights internationally.

The Global Gag Rule Affects Women's Reproductive Health

Organizations that are well suited to provide comprehensive reproductive health-care services, including abortion in countries where it is legal, will lose their funding or be frozen out of seeking U.S. aid. By reducing funding to reproductive health care providers in under-served areas, the Global Gag Rule will decrease women's ability to access pregnancy-related care, family planning, and services for HIV/AIDS and other sexually transmissible infections. Cuts in family planning funding mean higher rates of unintended pregnancy and higher rates of abortion.

The Global Gag Rule is Unconstitutional Censorship of Speech Promoting Law Reform:

The Global Gag Rule is government censorship of political speech that President Bush disagrees with: speech that promotes abortion law reform and public education. Organizations working to criminalize abortion or to increase restrictions on abortion access are not censored by the U.S. government, but groups like the Center for Reproductive Rights and its foreign partners who support abortion rights as human rights are gagged. Certain actions are technically permitted under the Global Gag Rule, including the provision of abortion services in cases of rape, incest or threat to the pregnant woman's life. Providers are only permitted to "passively" respond to a question from a pregnant woman regarding where a safe, legal abortion could be obtained if she "clearly states that she has already decided to have a legal abortion, and the family planning counselor reasonably believes that the ethics of the medical profession in the country requires a response regarding where it may be obtained safely."

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