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The Global Gag Rule: A world without choice

The Mexico City Policy or 'Global Gag Rule'

Millions of women in the developing world are likely to lose access to modern contraception, following the re-introduction of a Republican policy that blocks US Government funding to non-US organisations that perform abortion with their own funding. This will negatively impact not just women’s health and their opportunities for the future, but the longer-term economic prospects and stability of the world’s poorest countries.

The Global Gag Rule will prevent USAID from partnering with organisations that deliver comprehensive sexual and reproductive health services, often in places where no other services exist. This decision will not only deprive women of their right to have children by choice, not chance, but in many cases their access to primary healthcare.

What is the Global Gag Rule?

The Global Gag Rule is a US Executive Order that means any international organisation that provides or promotes abortion services – regardless of how those services are funded – is prohibited from receiving US Government funding.

The Global Gag Rule was first enacted by Ronald Reagan in 1984. Since then, successive presidents have alternatively rescinded and re-enacted the policy. In January 2017, the incoming Republican administration re-enacted the Global Gag Rule

The re-introduction of the Global Gag Rule will negatively impact not just women’s health and their opportunities for the future, but the longer-term economic prospects and stability of the world’s poorest countries.

On 23rd January 2017, the policy was re-enacted by President Trump as one of his first acts in office... The loss of funding has been most keenly felt in the organisation’s work with poor and marginalised communities, who often have no other way of accessing contraception.

The scale of the issue

Since 2009, the United States Agency for International Development (USAID) has made a significant investment in projects that expand access to voluntary contraception for women and girls in developing countries. Currently, USAID is the world’s largest bilateral donor in family planning, investing approximately $620 million a year in family planning services.

There are long-standing legislative restrictions in place to ensure that USAID does not ever fund abortion services. However, before the Global Gag Rule was re-enacted, USAID was able to fund family planning programmes with organisations like Marie Stopes International, which provide safe abortion services using funding from other donors. It is these organisations that will be affected by the policy.

On 23rd January 2017, the policy was re-enacted by President Trump as one of his first acts in office. At that time, USAID funding equated to 17% of Marie Stopes International’s donor income. The loss of funding has been most keenly felt in the organisation’s work with poor and marginalised communities, who often have no other way of accessing contraception.

Thanks to the generous support of other donor governments and foundations, Marie Stopes International has been able to secure replacement funding to keep most services running in the short term. However, from the middle of 2018 many of our programmes are facing a cliff edge, with an approximate $80m (£60m) funding gap in the remaining years of the current Trump administration.

Marie Stopes International’s position

Marie Stopes International strongly believes that safe abortion is a vital component of women’s reproductive healthcare, and that every woman has the right to choose whether and when to have children.

Although we use USAID funding exclusively for voluntary contraception services, agreeing to the conditions of the Global Gag Rule would restrict us from providing abortion services using other funding, in countries where they are permitted. It would even restrict us from talking to women about abortion. This goes against our core principles as an organisation, and therefore we will not agree to the conditions of the Global Gag Rule.

This means Marie Stopes International will be unable to partner with USAID to provide contraceptive services for as long as the policy is in place.

Every year 25 million women are so desperate to end their pregnancy they put their lives on the line by risking an unsafe abortion... Agreeing to the Mexico City Policy would be accepting their fate and turning our backs on the very women who need us most.
Marjorie Newman-Williams

Women and girls will pay the price

One year on from President Trump’s re-imposition of the  Global Gag Rule, the loss of USAID funding has left Marie Stopes International with a funding gap of nearly US$80m (£60m) that could have a devastating impact on millions of the world’s poorest for years to come.

Unless we can close this funding gap, we estimate that more than 2 million women will no longer have access to contraception services from a trained Marie Stopes International provider, leading to an extra:

  • 2.5 million unintended pregnancies 
  • 870,000 unsafe abortions
  • 6,900 avoidable maternal deaths
  • £107m increase in direct healthcare costs

As these figures relate to Marie Stopes International services only, the global impact of the Global Gag Rule will be even more pronounced.

Women and girls who lack access to a choice of family planning methods are less likely to complete their education, have a career, or be able to pursue their plans and dreams for the future. They are more likely to experience an unintended pregnancy, and more likely to risk death and disability by undergoing an unsafe abortion.

A reduction of funding for comprehensive, voluntary contraception services will negatively impact not just women’s health but their opportunities for the future.

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Contraception and maternal mortality

A lack of access to family planning is a major contributing factor to maternal mortality in the developing world. Contraception supports women to:

  • Delay first pregnancy, which carries higher risks in very young women.
  • Space their pregnancies, reducing the health risks associated with pregnancies that are too closely spaced.
  • Avoid unsafe abortion, which accounts for around 13% of all maternal deaths in the developing world.

Researchers have estimated that meeting unmet need for contraception in developing countries could reduce their maternal mortality rates by as much as one-third.

The impact of the Global Gag Rule will be catastrophic and it is women in developing countries who will pay the price.
Unsafe abortion remains a major contributing factor to maternal deaths across the developing world. Every year, up to 31,000 women die worldwide from complications of unsafe procedures.

A counter-productive policy

As a policy that seeks to reduce the number of abortions, the Global Gag Rule is counterproductive. By blocking funding to the world’s largest providers of modern contraception, women’s ability to prevent unplanned pregnancy will be reduced, and the number of women undergoing an abortion will actually increase.

In countries where access to safe abortion is restricted, women may risk death and disability by undergoing an unsafe procedure. These range from counterfeit drugs peddled by ‘quack doctors’ to industrial poisons or wire coat hangers. Unsafe abortion remains a major contributing factor to maternal deaths across the developing world. Every year, up to 31,000 women die worldwide from complications of unsafe procedures.

More broadly, the re-enactment of the Global Gag Rule will hinder USAID’s objectives to end extreme poverty and enable resilient, democratic societies to realise their potential. Countries where women lack access to contraception have slower economic and social development than those where access is guaranteed.

Access to contraception is an essential foundation for development. The Copenhagen Consensus, a group of economists which rates development policies, has estimated that every $1 invested in universal access to contraception would save countries $120 in reduced need for infrastructure and social spending.

Meeting the Sustainable Development Goals

In 2015, the global community agreed a set of 17 Sustainable Development Goals (SDGs) to end poverty, protect the planet and ensure prosperity for all. Each goal has specific targets to be achieved by 2030.

Expanding access to contraception brings transformational benefits to women, families, communities and countries, and is an essential foundation to achieving progress across all the SDGs.

Annie Ramasy

Annie Ramasy travels for up to six hours every day to provide family planning services to women in rural, isolated communities in Madagascar.

Kudzai’s story

Kudzai Mujuru has always dreamed of becoming a nurse. When she fell pregnant aged 17, she was forced to put those dreams on hold.

No woman left behind

Photos capture the lives and realities of the women we serve.

Seeking new partnerships

At Marie Stopes International, we strongly believe that no woman, once she has benefited from contraception, should ever be denied it again. Following the re-enactment of the Global Gag Rule, we are seeking new partnerships with others who share our vision.

To find out more about partnering with Marie Stopes International, please contact Layla Shaaban - our Director of Programme, Design and Development - for an initial discussion about our work, and the different ways you can work with us as a donor.

The Global Gag Rule means millions in the developing world could lose access to contraception

We will not turn our back on those who need us most.