Some of President Donald J. Trump’s harshest critics admit that his reinstatement and expansion of the pro-life Mexico City Policy has been highly effective in advancing the United States’ moral influence to curb the international abortion lobby.
The policy has been implemented by Republican presidents since Ronald Reagan, blocking U.S. funding for foreign organizations that provide or advocate for abortions. Direct U.S. funding for overseas abortions is already prohibited in law by the Helms Amendment in 1973.
Despite the deeply entrenched political divide around abortion, the policy’s critics hope to sway pro-life stakeholders by arguing that the policy causes harm through its unintended consequences. They claim that it results in the denial of basic health services to women whose providers choose not to comply with the policy, lose U.S. funding, and therefore reduce their offerings or close their doors altogether.
Marie Stopes International and the International Planned Parenthood Federation, two of the largest international family planning providers—who also perform abortions—have notably refused to accept the terms of the reinstated policy. Instead, they have chosen to forego U.S. funding, even if it means cutting back their delivery of less controversial services or closing clinics entirely.
Because the Mexico City Policy involves U.S. aid work in foreign countries, the politics of abortion on the ground vary between locations, depending on local law, culture, and other donor organizations and countries. Nevertheless, there is clear evidence of the policy’s impact, often published by its critics. A 2010 report on the policy’s effects in Ethiopia cited erosion of trust in the legitimacy of abortion providers and quoted people as asking, “[I]f abortion is a positive development for Ethiopian women’s health, then why does the U.S. government not support it?”
Several speakers at a Gates Institute-sponsored seminar earlier this year spoke against the policy. Elisha Dunn-Georgiou of Population Services International pointed out that while the policy does not reduce U.S. funding for health or family planning, it takes it away from those she described as “the most competent providers of ‘sexual and reproductive health and rights’,” a term understood in international circles as including not only abortion, but also sexual orientation, gender identity, and a variety of other controversial elements.
When asked directly about the efficacy of the policy on abortion, Duff Gillespie, current Gates fellow and former head of USAID’s population and reproductive health division, said the policy “has set back, in a very dramatic way, even a discussion about the consequences of unsafe abortion.” Earlier, Gillespie acknowledged that it was impossible to frame such a discussion as anything other than advocacy for abortion. Dunn-Georgiou agreed that the policy had a “huge, huge chilling effect” on pro-abortion activism in countries receiving U.S. aid.
The panelists also said that the effects of the Mexico City Policy lasted even when the policy itself was not in place because potentially affected organizations knew “the next administration might be Republican.”
“It’s not irrational, the behavior that the Mexico City Policy has caused,” concluded Gillespie, “and I would say, yeah, unfortunately, it does work.”
Rebecca Oas MD writes for The Friday Fax.