American abortion politics often have a greater impact on women’s
health abroad than at home. Republican presidents depend on the support
of the anti-abortion movement, but there’s only so much they can do
domestically, constrained as they are by the Supreme Court and the
political realities of a broadly if ambivalently pro-choice electorate.
So, ever since Ronald Reagan, they have used foreign policy to reward
their base, imposing the global gag rule and freezing the U.S.
contribution to the United Nations Population Fund (UNFPA). Obama, like
Clinton before him, revoked the gag rule during his first week in
office. Now, under his leadership, the United States is going to start
contributing to the UNFPA once again, rejoining most of the other
countries in the world in backing a global agency that does life-saving
and life-enhancing work all over the planet.

The just-passed
2009 omnibus spending bill contains $50 million for UNFPA.
Conservatives tried hard to thwart the appropriation – in the Senate,
most Republicans voted for an amendment sponsored by Mississippi
Senator Roger Wicker that would have cut the funding. It failed, 55-39.
But the agency remaining the bete noir of influential conservatives,
and the controversy over the U.S. contribution to it isn’t going away.
The right will just find other ways to attack it.

The UNFPA
works in more than 150 countries to promote reproductive and sexual
health and safe motherhood. It offers technical and financial
assistance to help countries expand access to family planning and
lessen maternal mortality by training midwives and doctors and
upgrading health centers. It works to fight fistula and prevent new HIV
infections. The vast majority of the world’s nations support it – in
2007, according to the agency’s annual report, 182 countries
contributed a total of $457.1 million. The United States, of course,
was not among them.

Indeed, Bush’s initial decision to defund
the UNFPA was an early and stark warning that, under his leadership,
American policy would be in thrall to the religious right. Probably at
Colin Powell’s behest, Bush’s first budget actually asked for a $25
million appropriation for the agency, the same as the year before. In
written testimony to the Senate Foreign Relations Committee, Powell had
said, “We recognize that the UNFPA does invaluable work through its
programs in maternal and child health care, voluntary family planning,
screening for reproductive tract cancers, breast-feeding promotion and
HIV/AIDS prevention.” Congress responded by exceeded the
administration’s request, appropriating $34 million.

Within
days, though, the right leapt into action. Several dozen congressmen
urged the president to freeze the US contribution, citing the report of
an anti-family planning Catholic organization, The Population Research
Institute, that the UNFPA was involved in coercive abortions in China.
A State Department team went to China to investigate, and concluded
that the charges were baseless. A three-person British delegation, led
by anti-abortion Tory MP Edward Leigh, also undertook a fact-finding
mission. Upon returning, Leigh told The Washington Times that “there
was evidence UNFPA is trying to persuade China away from the program of
strict targets and assessments. My personal line is British or U.S.
funds should not be used for coercive family planning, and I found no
evidence of such practices in China.” In the end, none of this
mattered. Bush froze the funds – which represented 12 percent of the
agency’s budget – anyway.

Now that Democrats are running things,
we’re seeing a return to reality-based policymaking on women’s health.
Even out of power, though, the right has found ways to interfere with
UNFPA. In 1999, during NATO’s war in Kosovo, the UNFPA worked to
provide reproductive health to Kosovar Albanian refugees. A systematic
rape campaign by Serb forces had left many with unwanted pregnancies,
and so the agency offered emergency contraception and tried to
facilitate access to safe abortion, which was legal in both Kosovo and
Albania. The UNFPA also provided safe delivery kits, including soap,
razor blades and plastic sheeting. All of this was standard practice
and would have received little attention, had the Population Research
Institute not gotten involved.

A few weeks after the bombing
stopped, a PRI consultant named Austin Ruse showed up in Albania on a
“fact-finding” tour. “The concern was that the refugee women were being
coerced into sterilizations and even abortions,” he wrote in an article
titled “UN Pro-life Lobbying: Full Contact Sport.” As even Ruse
acknowledged, they weren’t. “In the eight days I was there, I
discovered only one case that could be considered an abuse,” he wrote.
“A peasant woman in Vlora had been given an abortion at the
government’s regional hospital and not been told of the negative
medical consequences to her.” Nevertheless, Ruse insisted that the
UNFPA was aiding Slobodan Milosevic’s campaign to ethnically cleanse
the Kosovars, a slander he spread among both people in the region and
sympathetic right-wing pundits at home, where it made its way into The
New York Post, among other places.

Niek Biegman, Holland’s
NATO representative heard the rumors while visiting Dutch troops in the
field. He called it “criminally irresponsible.” After all, Biegman told
me, had the traumatized Kosovars believed that the UNFPA was complicit
with the genocidal Milosevic, “they might have killed the UNFPA people.”

Out
of power once again, opponents of global family planning will surely
find new fronts to fight on. Given the economic crisis, conservative
congressmen may demagogue against UNFPA support in much the same way
that they did against contraception provisions in the stimulus bill.
People who work in development and women’s health know that giving
women control over their fertility is a crucial way to save lives and
combat poverty. They are going to have to communicate this to a public
that may balk at what will surely be painted as at best a frivolous
foreign expenditure. While Congress’s move to restore the UNFPA’s
funding is a first step worth celebrating, it’s not the end of the
battle.