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The Mexico City Policy: 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 Mexico City Policy (sometimes called 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 Mexico City Policy?

The Mexico City Policy 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 Mexico City Policy 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 Since then, successive presidents have alternatively rescinded and re-enacted the policy.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 Mexico City Policy.

The re-introduction of the Mexico City Policy 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.

Through our partnership with USAID, Marie Stopes International has been able to provide voluntary contraceptive services to millions of poor and disadvantaged women, girls and communities across Africa and Asia.

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 Mexico City Policy 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.

Through our partnership with USAID, Marie Stopes International has been able to provide voluntary contraceptive services to millions of poor and disadvantaged women, girls and communities across Africa and Asia. We estimate that if USAID funding continued to support family planning services delivered to our clients, we would reach approximately 1.5 million women and girls annually, preventing an estimated 1.6 million unintended pregnancies, averting 530,000 abortions (505,000 of them unsafe), and averting 5,265 maternal deaths each year.

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 Mexico City Policy 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 Mexico City Policy.

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 21.6 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

The re-enactment of the Mexico City Policy will drastically limit the impact of US development assistance for family planning in some of the world’s poorest countries. It is women and girls in these countries who will pay the price.

We estimate that, as a result of this policy, each year approximately 1.5 million fewer women across the developing world will have access to contraception from a trained Marie Stopes International provider.

Additionally we estimate that without alternative funding, the loss of our services during Trump’s first term, between 2017 and 2020, could result in: 

  • 6.5 million unintended pregnancies 
  • 2.2 million abortions
  • 2.1 million unsafe abortions
  • 21,700 maternal deaths
  • $400 million in direct healthcare costs

 

As these figures relate to Marie Stopes International services only, the global impact of the Mexico City Policy 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 Mexico City Policy 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 11 minutes, another woman dies as a result of an unsafe procedure.

A counter-productive policy

As a policy that seeks to reduce the number of abortions, the Mexico City Policy 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 11 minutes, another woman dies as a result of an unsafe procedure.

More broadly, the re-enactment of the Mexico City Policy 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.

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 Mexico City Policy, we are seeking new partnerships with others who share our vision.

To find out more about partnering with Marie Stopes International, please contact Andrew Tuttle - 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.

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.

Before her pregnancy, her plan was to save enough money to pay her way through nursing school. The father of her child was a friend from church but, when she told him she was pregnant, he refused to accept any responsibility.

Read more

The Mexico City Policy means millions in the developing world will lose access to contraception

We need to take strong, collaborative action to ensure women and girls don't pay the price.

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