Introduction

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. 

By restricting U.S. aid, the Rule hinders access to sexual and reproductive health information and services, including contraception, maternal health care, abortion, HIV treatment, and more.

Impact on abortion access

The Global Gag Rule restricts access to safe abortion around the world.

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 counseling for people seeking abortions. 
• 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 very limited exceptions. It allows organizations to perform abortions and provide referrals and counseling only in cases of rape or incest, or when there is a threat to the mother’s life.

Threat to health

The Rule threatens health and lives.

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.

Origin & history

The Rule has been in effect on and off since the 1980s.

It was introduced by the Reagan administration in 1984 at the International Conference on Population held in Mexico City (which is why it’s often called the “Mexico City Policy”). Since then, every Republican administration has continued or reimposed the rule, and all Democratic administrations have reversed it.  

After returning to office in January 2025, one of President Trump’s first priorities was to reinstate the Rule, which he had expanded in 2017 during his first term.

Expansion under Trump

The Trump administration expanded the Rule to affect more organizations.

The original 80s version of the Rule applied only to NGOs receiving U.S. support for family planning. In 2017, President Trump expanded the Rule to all organizations receiving U.S. global health assistance. For example, groups funded for infectious disease prevention, nutrition, and water and sanitation programs would also fall under the Rule.  

Two years later he expanded it again to apply to local affiliates of “gagged” organizations, even if the affiliates don’t receive U.S. funding. 

The Rule 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.

Human rights violation

This is a human rights violation.

In addition to undermining global health, the Global Gag Rule violates a broad range of human rights. These include the:  

• 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.