Global Gag Rule Just the First Step: The US International Abortion Funding Ban

Patty Skuster

The impact of repealing the global gag rule will be significant. But repealing the gag rule will not end the longstanding ban on foreign aid for safe abortion care.

After eight years of a policy that
denied funding for crucial health services, stifled democratic debate,
contributed to deaths from unsafe abortion, and stood in the way of
global progress toward access to safe abortion, the Global Gag Rule
should soon be history.  The impact will be certainly be significant –
clinics refunded, organizations again able to speak out on abortion
issues. But repealing the Gag Rule will not actually end the
longstanding ban on foreign aid for safe abortion care. 

The ban on foreign aid for abortion
is based on the government’s interpretation of the Helms Amendment,
adopted in 1973.  The Helms Amendment states "No foreign assistance
funds may be used to pay for the performance of abortion as a method
of family planning or to motivate or coerce any person to practice abortions."   

The language of the ban is as peculiar
as its implementation.  One might wonder, under what circumstances
is abortion used as a "method of family planning?"  Abortion
certainly isn’t family planning when a pregnancy threatens a woman’s
physical or mental health or where the woman is a victim of sexual violence. 
Under Helms, could USAID have a role in ensuring women’s access to
safe, legal abortion under these circumstances? 

In countries where abortion is legal
under a broad set of conditions, the ban has meant that no U.S. assistance
can help the government make services safer (for example, through training
or equipment), or indeed to make safe abortion care available at all.
In Nepal, where the government is working to implement the 2002 abortion
law, USAID-funded training facilities and clinics dedicated to treating
complications of unsafe abortion may not be used for safe abortion care.
The government instead had to build new facilities or compromise quality
of care by using less appropriate facilities. 

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

U.S. administrations have applied
the Helms language to effectively prohibit any use of foreign assistance
funds for safe abortion care, but also to prevent dissemination of information
about abortion or the purchase of equipment to treat abortion complications. 
The prohibitions are applied equally to non-governmental organizations
(NGOs), foreign governments and multi-lateral organizations (by contrast,
the global gag rule only applies to NGOs and dictates what they do with
their own, non-USAID funding, while Helms applies only to US funding).

This includes the purchase and distribution of manual vacuum aspiration instruments,
life-saving equipment that can be used to both provide safe induced
abortion as well as to treat complications from unsafe abortion and
miscarriage, particularly in low-resource settings.  Though USAID
funds train providers to treat complications from unsafe abortion, funding
for the equipment to put this training into practice must be acquired
elsewhere. 

The Helms Amendment has even led
to the control of information about the scientific, public health, and
human rights aspects of abortion – far beyond any reasonable interpretation
of the language of the law.  USAID-funded journals and databases
have been censored systematically and through outlandish intrusions. 
In April 2008, administrators of the U.S.-funded Popline database made the word abortion an unsearchable
stop word, all because of a phone conversation over USAID’s concerns
that Popline may be violating
the abortion ban
by
including what they thought were abortion advocacy materials. 
The items in question were articles in A:
the abortion magazine
,
published by Ipas, in an issue on the growing recognition of the linkages
between abortion and human rights. Abortion was shortly reinstated as
a search term but the offending articles remain banned from the "world’s
largest bibliographic database" on reproductive health literature.   

It does not have to be this way.
A 1994 policy interpretation by USAID stated that the Helms Amendment
permits funding for abortion in cases of rape, incest, and danger to
the life of the woman. But USAID has yet to fund any programs or services
that meet these conditions.  Annual foreign aid appropriations
bills specify that the Helms Amendment should not prohibit providing
information or counseling about all pregnancy options, and this also
has never been implemented – indeed the global gag rule has undermined
this condition. 

Only Congress can repeal the abortion
ban, although President-elect Obama certainly has signaled his opposition
to bans on public funds for safe abortion care.  The wording of
the Helms Amendment does give the next president the opportunity to
request USAID to issue guidance on what activities are permissible under the Helms Amendment.  Such activities would include
but are not limited to: creating awareness of unsafe abortion
as a public health problem, equipping providers with appropriate technology,
training providers to provide legal abortion under certain circumstances
and providing abortion information, counseling, and referrals. 

Millions of women have died of unsafe
abortions in the 35 years since the Helms Amendment was enacted, and
tens of millions more have suffered injuries and disabilities due to
complications. The end of the Global Gag Rule will begin a new era of
U.S. foreign policy that will improve women’s health and lives. 
But the Helms Amendment will remain a major impediment to efforts by
governments, advocates and organizations to ensure that the world’s
poorest do not have to face unsafe abortion.   Even with Helms
in place, through new and clarifying guidance, the administration can
lessen its harm, comply with U.S. international commitments, and save
lives of the world’s poorest women.

Analysis Politics

The 2016 Republican Platform Is Riddled With Conservative Abortion Myths

Ally Boguhn

Anti-choice activists and leaders have embraced the Republican platform, which relies on a series of falsehoods about reproductive health care.

Republicans voted to ratify their 2016 platform this week, codifying what many deem one of the most extreme platforms ever accepted by the party.

“Platforms are traditionally written by and for the party faithful and largely ignored by everyone else,” wrote the New York Times‘ editorial board Monday. “But this year, the Republicans are putting out an agenda that demands notice.”

“It is as though, rather than trying to reconcile Mr. Trump’s heretical views with conservative orthodoxy, the writers of the platform simply opted to go with the most extreme version of every position,” it continued. “Tailored to Mr. Trump’s impulsive bluster, this document lays bare just how much the G.O.P. is driven by a regressive, extremist inner core.”

Tucked away in the 66-page document accepted by Republicans as their official guide to “the Party’s principles and policies” are countless resolutions that seem to back up the Times‘ assertion that the platform is “the most extreme” ever put forth by the party, including: rolling back marriage equalitydeclaring pornography a “public health crisis”; and codifying the Hyde Amendment to permanently block federal funding for abortion.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Anti-choice activists and leaders have embraced the platform, which the Susan B. Anthony List deemed the “Most Pro-life Platform Ever” in a press release upon the GOP’s Monday vote at the convention. “The Republican platform has always been strong when it comes to protecting unborn children, their mothers, and the conscience rights of pro-life Americans,” said the organization’s president, Marjorie Dannenfelser, in a statement. “The platform ratified today takes that stand from good to great.”  

Operation Rescue, an organization known for its radical tactics and links to violence, similarly declared the platform a “victory,” noting its inclusion of so-called personhood language, which could ban abortion and many forms of contraception. “We are celebrating today on the streets of Cleveland. We got everything we have asked for in the party platform,” said Troy Newman, president of Operation Rescue, in a statement posted to the group’s website.

But what stands out most in the Republicans’ document is the series of falsehoods and myths relied upon to push their conservative agenda. Here are just a few of the most egregious pieces of misinformation about abortion to be found within the pages of the 2016 platform:

Myth #1: Planned Parenthood Profits From Fetal Tissue Donations

Featured in multiple sections of the Republican platform is the tired and repeatedly debunked claim that Planned Parenthood profits from fetal tissue donations. In the subsection on “protecting human life,” the platform says:

We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare. We urge all states and Congress to make it a crime to acquire, transfer, or sell fetal tissues from elective abortions for research, and we call on Congress to enact a ban on any sale of fetal body parts. In the meantime, we call on Congress to ban the practice of misleading women on so-called fetal harvesting consent forms, a fact revealed by a 2015 investigation. We will not fund or subsidize healthcare that includes abortion coverage.

Later in the document, under a section titled “Preserving Medicare and Medicaid,” the platform again asserts that abortion providers are selling “the body parts of aborted children”—presumably again referring to the controversy surrounding Planned Parenthood:

We respect the states’ authority and flexibility to exclude abortion providers from federal programs such as Medicaid and other healthcare and family planning programs so long as they continue to perform or refer for elective abortions or sell the body parts of aborted children.

The platform appears to reference the widely discredited videos produced by anti-choice organization Center for Medical Progress (CMP) as part of its smear campaign against Planned Parenthood. The videos were deceptively edited, as Rewire has extensively reported. CMP’s leader David Daleiden is currently under federal indictment for tampering with government documents in connection with obtaining the footage. Republicans have nonetheless steadfastly clung to the group’s claims in an effort to block access to reproductive health care.

Since CMP began releasing its videos last year, 13 state and three congressional inquiries into allegations based on the videos have turned up no evidence of wrongdoing on behalf of Planned Parenthood.

Dawn Laguens, executive vice president of Planned Parenthood Action Fund—which has endorsed Hillary Clinton—called the Republicans’ inclusion of CMP’s allegation in their platform “despicable” in a statement to the Huffington Post. “This isn’t just an attack on Planned Parenthood health centers,” said Laguens. “It’s an attack on the millions of patients who rely on Planned Parenthood each year for basic health care. It’s an attack on the brave doctors and nurses who have been facing down violent rhetoric and threats just to provide people with cancer screenings, birth control, and well-woman exams.”

Myth #2: The Supreme Court Struck Down “Commonsense” Laws About “Basic Health and Safety” in Whole Woman’s Health v. Hellerstedt

In the section focusing on the party’s opposition to abortion, the GOP’s platform also reaffirms their commitment to targeted regulation of abortion providers (TRAP) laws. According to the platform:

We salute the many states that now protect women and girls through laws requiring informed consent, parental consent, waiting periods, and clinic regulation. We condemn the Supreme Court’s activist decision in Whole Woman’s Health v. Hellerstedt striking down commonsense Texas laws providing for basic health and safety standards in abortion clinics.

The idea that TRAP laws, such as those struck down by the recent Supreme Court decision in Whole Woman’s Health, are solely for protecting women and keeping them safe is just as common among conservatives as it is false. However, as Rewire explained when Paul Ryan agreed with a nearly identical claim last week about Texas’ clinic regulations, “the provisions of the law in question were not about keeping anybody safe”:

As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”

Myth #3: 20-Week Abortion Bans Are Justified By “Current Medical Research” Suggesting That Is When a Fetus Can Feel Pain

The platform went on to point to Republicans’ Pain-Capable Unborn Child Protection Act, a piece of anti-choice legislation already passed in several states that, if approved in Congress, would create a federal ban on abortion after 20 weeks based on junk science claiming fetuses can feel pain at that point in pregnancy:

Over a dozen states have passed Pain-Capable Unborn Child Protection Acts prohibiting abortion after twenty weeks, the point at which current medical research shows that unborn babies can feel excruciating pain during abortions, and we call on Congress to enact the federal version.

Major medical groups and experts, however, agree that a fetus has not developed to the point where it can feel pain until the third trimester. According to a 2013 letter from the American Congress of Obstetricians and Gynecologists, “A rigorous 2005 scientific review of evidence published in the Journal of the American Medical Association (JAMA) concluded that fetal perception of pain is unlikely before the third trimester,” which begins around the 28th week of pregnancy. A 2010 review of the scientific evidence on the issue conducted by the British Royal College of Obstetricians and Gynaecologists similarly found “that the fetus cannot experience pain in any sense prior” to 24 weeks’ gestation.

Doctors who testify otherwise often have a history of anti-choice activism. For example, a letter read aloud during a debate over West Virginia’s ultimately failed 20-week abortion ban was drafted by Dr. Byron Calhoun, who was caught lying about the number of abortion-related complications he saw in Charleston.

Myth #4: Abortion “Endangers the Health and Well-being of Women”

In an apparent effort to criticize the Affordable Care Act for promoting “the notion of abortion as healthcare,” the platform baselessly claimed that abortion “endangers the health and well-being” of those who receive care:

Through Obamacare, the current Administration has promoted the notion of abortion as healthcare. We, however, affirm the dignity of women by protecting the sanctity of human life. Numerous studies have shown that abortion endangers the health and well-being of women, and we stand firmly against it.

Scientific evidence overwhelmingly supports the conclusion that abortion is safe. Research shows that a first-trimester abortion carries less than 0.05 percent risk of major complications, according to the Guttmacher Institute, and “pose[s] virtually no long-term risk of problems such as infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and little or no risk of preterm or low-birth-weight deliveries.”

There is similarly no evidence to back up the GOP’s claim that abortion endangers the well-being of women. A 2008 study from the American Psychological Association’s Task Force on Mental Health and Abortion, an expansive analysis on current research regarding the issue, found that while those who have an abortion may experience a variety of feelings, “no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.”

As is the case for many of the anti-abortion myths perpetuated within the platform, many of the so-called experts who claim there is a link between abortion and mental illness are discredited anti-choice activists.

Myth #5: Mifepristone, a Drug Used for Medical Abortions, Is “Dangerous”

Both anti-choice activists and conservative Republicans have been vocal opponents of the Food and Drug Administration (FDA’s) March update to the regulations for mifepristone, a drug also known as Mifeprex and RU-486 that is used in medication abortions. However, in this year’s platform, the GOP goes a step further to claim that both the drug and its general approval by the FDA are “dangerous”:

We believe the FDA’s approval of Mifeprex, a dangerous abortifacient formerly known as RU-486, threatens women’s health, as does the agency’s endorsement of over-the-counter sales of powerful contraceptives without a physician’s recommendation. We support cutting federal and state funding for entities that endanger women’s health by performing abortions in a manner inconsistent with federal or state law.

Studies, however, have overwhelmingly found mifepristone to be safe. In fact, the Association of Reproductive Health Professionals says mifepristone “is safer than acetaminophen,” aspirin, and Viagra. When the FDA conducted a 2011 post-market study of those who have used the drug since it was approved by the agency, they found that more than 1.5 million women in the U.S. had used it to end a pregnancy, only 2,200 of whom had experienced an “adverse event” after.

The platform also appears to reference the FDA’s approval of making emergency contraception such as Plan B available over the counter, claiming that it too is a threat to women’s health. However, studies show that emergency contraception is safe and effective at preventing pregnancy. According to the World Health Organization, side effects are “uncommon and generally mild.”

News Law and Policy

Outside White House Women’s Summit, Activists Demand Executive Action on Abortion Law

Christine Grimaldi

The Center for Health and Gender Equity, Amnesty International USA, Reproaction, and Catholics for Choice organized what they described as a “call to action” rather than a protest of the summit.

Reproductive health-care activists urged President Barack Obama to take executive action on the Helms Amendment early Tuesday morning during a demonstration outside the White House’s United State of Women Summit.

The two-day summit includes a variety of sessions across downtown Washington, D.C., around six main themes: economic empowerment; health and wellness; educational opportunity; violence against women; entrepreneurship and innovation; and leadership and civic engagement. However, none of the themes include abortion care. Even the description for the summit’s focus on health and wellness merely touts the Affordable Care Act’s coverage of preventive services, such as U.S. Food and Drug Administration-approved contraceptive coverage under the birth control benefit, and touches on maternal mortality and HIV prevention only as issues of global concern.

The word “abortion,” as Rewire previously reported, is nowhere to be found in any of the summit’s materials.

Some two dozen-plus activists gathered across from the Walter E. Washington Convention Center to press for action on an obstruction to reproductive health care globally: the Helms Amendment. The federal statute prohibits U.S. foreign assistance funds from paying for abortion care “as a method of family planning.” In theory, the Helms Amendment makes exceptions in cases of rape, incest, and life endangerment; in practice, the Obama administration has failed to enforce these guarantees, amounting to a total ban on foreign assistance for abortion care. The activists are asking the president to clarify those exceptions through executive action.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

The Center for Health and Gender Equity (CHANGE), Amnesty International USA, Reproaction, and Catholics for Choice organized what they described as a “call to action” rather than a protest of the summit. Several of the groups paid for a full-page ad in the Washington Post that appealed directly to Obama “on this historic day for women.”

“We know you can lead on abortion,” the ad said. “We know you can stand with women and girls raped in conflict. We pledge to stand by you when you do. What are you waiting for?”

Organizers mounted the campaign to pressure the White House in this way based on prior victories. Erin Matson, co-founder and co-director of Reproaction, attributed presumptive Democratic nominee Hillary Clinton’s and rival candidate Sen Bernie Sanders’ (I-VT) public embrace of repealing Helms and other pro-choice policy objectives to the tenaciousness of activists. The more mainstream party establishment, Matson said, would have preferred for activists to hold out for a “better time.”

“There’s never going to be a better time to do the right thing,” she said.

Imagine telling somebody who became pregnant “as a result of rape and war” to wait for a future administration, Matson said. In Nigeria, more than 200 women and girls freed in 2015 from Boko Haram insurgents were visibly pregnant upon their rescue. Last year, religious leaders and congressional Democrats urged Obama to fund abortions for the stated Helms exceptions. In Daesh strongholds, the terrorist group has enshrined a “theology of rape,” according to an extensive New York Times report.

“There’s really no excuse not to act now,” Matson said.

Another imperative: Policy changes don’t happen instantaneously. Should the Obama White House act in the remaining days of the administration, another Democrat in the White House would be able to assume the mantle of implementation at the outset of the presidency, said Joanna Kuebler, CHANGE’s director of external affairs.

“We fully support the summit, but you can’t take a victory lap on your women’s rights record without standing with women raped in conflict,” Kuebler said.