President Donald Trump today signed an executive order banning foreign aid money to family planning organizations that provide counseling or referrals for abortion or “advocate for access” to abortion services in their country.
The rule, known as the “Mexico City policy,” has flip-flopped between Democratic and Republican presidents via executive order ever since President Ronald Reagan instated it in 1984.
Backers of the policy often muddy the waters by presenting it as a ban on foreign aid going to abortion services; in fact, the Helms Amendment, passed in 1973, already prohibits foreign aid money from going to abortion services. The Mexico City policy bans foreign aid money for other services to organizations that provide abortions with their own funds. It’s also a gag order against organizations that don’t provide abortions at all: it prohibits foreign aid organizations that receive family-planning funds from the U.S. from offering any information about abortion services or even mentioning abortion at all in family-planning conversations (again, even if they use their own funds to do so). A doctor working for such an organization, for example, would be banned from referring a patient to an abortion provider.
Here’s more from the Atlantic:
Sneha Barot, who works at the reproductive-health research and policy center The Guttmacher Institute, said that the restriction interferes with doctor-patient relationships, because preventing caregivers from informing patients about reproductive choices can ultimately expose women to unsafe abortions. Barot summarized the policy’s effect in a brief for Guttmacher: “Health providers have been forced to fire staff, reduce their services or even close their clinics altogether.”
The policy can also lead to a “chilling effect,” Barot explained in an interview. “We’ve seen in the past that NGOs are so afraid of the policy that they over-interpret it. … They self-censor activities that are permitted under the gag rule.” Now that the policy is back in place, she said, foreign organizations are “in a really untenable position: accepting USAID money and not providing comprehensive services to their patients.”
In New York magazine, the journalist Lisa Ryan recently reported on a set of studies that tracked the effect of the policy on abortion abroad. One, conducted by International Food Policy Research Institute in 2015, looked at the Mexico City policy’s impact in Ghana. When the policy was in place, a number of clinics curbed services or closed completely. There was an upswing in unintended pregnancies, with 20 percent ending in abortion, explains Ryan.
Another, from Stanford University in 2011, showed “robust empirical patterns suggesting that the Mexico City policy is associated with increases in abortion rates in sub-Saharan African countries.” The study’s authors wrote of the unintended consequence the rule seems to have: “If women consider abortion as a way to prevent unwanted births, then policies curtailing the activities of organizations that provide modern contraceptives may inadvertently lead to an increase in the abortion rate.”