What Is the Global Gag Rule?

Frequently asked questions about the regressive U.S. policy undermining reproductive rights and health worldwide.

After returning to office in January 2025, one of President Trump’s first priorities was to reinstate the 2017 expanded Mexico City Policy, also known as the Global Gag Rule. The policy threatens to harm the health of people—particularly women and children—around the world and represents a violation of their human rights.

The Global Gag Rule is a U.S. government policy that prohibits foreign non-governmental organizations (NGOs) that receive U.S. global health funding from providing information, referrals, or services for abortion. It also forbids the organizations from advocating for abortion access in their countries.  

Because of its silencing effect on providers, the policy is referred to as a “gag” rule.   

Under the Rule, NGOs are forbidden to perform or discuss abortion care not only with U.S. funds but also with any funds of their own, even in places where abortion is legal.  As a result, the Rule inhibits access to comprehensive sexual and reproductive health care and information, stifles local advocacy efforts, and undermines reproductive rights worldwide.

For health care providers, it’s a lose-lose: Either they sacrifice their funding, or their freedom to provide the care their patients need. 

When did the Global Gag Rule start? 

The rule was introduced by the Reagan administration in 1984 at the International Conference on Population held in Mexico City. Since then, each Republican administration has continued or reimposed the rule, while all Democratic administrations have reversed it.  

Before the Global Gag Rule, while there were laws that prevented U.S. foreign aid from directly funding abortions or abortion-related research or advocacy, organizations that received U.S. aid were allowed to provide those services using separate funds. 

What organizations does the Global Gag Rule apply to?   

The original version of the Global Gag Rule applied only to organizations receiving U.S. support for family planning.

In 2017, President Trump expanded the Rule to all organizations receiving U.S. global health assistance—including, for example, those getting funding for nutrition, water and sanitation, and the prevention of infectious diseases.

Two years later he expanded it again, making any local affiliates of “gagged” organizations, even those who don’t themselves receive U.S. funding, subject to the Rule as well. 

It does not directly apply to U.S. organizations that receive government funding. But it does require those organizations to enforce the Rule on their non-U.S. partners.

The Trump Administration’s expanded Global Gag Rule could affect more than $50 billion in U.S. foreign assistance to organizations focused on everything from children’s health to AIDS prevention.

What does the Global Gag Rule prohibit?  

Under the Global Gag Rule, organizations receiving U.S. health funds are banned from: 

• Providing abortions, even in cases where the health of the mother is at risk, or in cases of fatal fetal abnormalities.

• Offering referrals and counselling for people seeking abortions as a method of family planning.

• Advocating for government reforms to make abortion safe and legal.

• Conducting public information campaigns that promote abortion as a method of family planning.

The Rule has limited exceptions, allowing organizations to perform abortions or provide referrals and counseling only in cases of rape or incest, or when there is a threat to the mother’s life.  

How does the Global Gag Rule harm global health?  

Beyond blocking access to safe abortion care, the Global Gag rule also restricts a wide range of health services and treatments. The rule:

• Reduces the availability and use of contraception, which leads to unintended pregnancies, unsafe abortions, and increased maternal mortality.

• Discourages clinicians from providing critical care following unsafe abortions, which are a leading cause of maternal mortality worldwide.

• Disrupts other sexual and reproductive health services including maternal care, menstrual hygiene programs and HIV prevention and treatment—as well as treatment for tuberculosis, malaria, Zika, Ebola and other infectious diseases.

• Leads to the closure of clinics critical to the health and well-being of underserved populations.

• Discourages clinicians from providing accurate medical information to patients.

Between 2017 and 2021, the Global Gag Rule resulted in an estimated 108,000 maternal and child deaths and 360,000 new HIV infections.

How does the Global Gag Rule violate human rights?  

By implementing the Global Gag Rule, the U.S. is not only turning its back on global health—it’s also undermining a broad range of human rights. These include:  

• The right to life, by imposing abortion restrictions—shown to increase unsafe abortions and maternal deaths.

• The right to health, by restricting access to sexual and reproductive health services.

• The right to information, by censoring health care providers and advocates and forcing them to withhold information from patients.

• The right to privacy, by violating the confidentiality of patients’ care.

• The right to be free from torture, cruel, inhuman or degrading treatment, by restricting abortions performed for the physical or mental health of the mother, or in cases of fatal fetal abnormalities.

• The right to freedom of expression, by preventing doctors, clinicians, and advocates from expressing their opinions.

From reproductive and maternal health programs to sanitation and disease control initiatives, U.S. foreign aid funds essential health services for people around the world. By restricting that aid, the Global Gag Rule doesn’t just impact family planning—it represents a major blow to global health and a violation of human rights.

A repeal of the Rule is critical to the well-being of women, children, and the whole of the global community.

Read more about the Global Gag Rule and its impact on health and human rights:

• Fact sheet: The Global Gag Rule and Human Rights, Center for Reproductive Rights, January 2025