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By Cynthia Dailard
Senior Public Policy Associate
Alan Guttmacher Institute
On his first day in office, President George W. Bush issued an executive memorandum that reimposed the international family planning gag rule. The policy prohibits the transfer of U.S. family planning aid to overseas health care organizations that use their own, non-U.S. funds to provide legal abortion services, provide counseling to pregnant women that includes information about legal abortion, or conduct a "public information campaign about" legal abortion. The president’s restrictions also bar recipients of family planning funds from engaging in political speech designed to legalize abortion in their own country or to support an existing law legalizing abortion.
The Bush policy went into effect Feb.15, the date that $425 million in fiscal year 2001 international family funds became available.
As a result, any organization that applies for U.S. family planning assistance or seeks to renew its grant must sign an agreement with the Washington, DC-based United States Agency for International Development promising to comply with the new Bush policy.
Originally known as the "Mexico City Policy," the global gag rule was first announced by the Reagan administration at the 1984 United Nations International Conference in Mexico City and remained in place until President Clinton took office. President Bush justified the reimposition of the gag rule based on his "conviction that taxpayer funds should not be used to pay for abortions or advocate or actively promote abortion, either here or abroad" and on his desire to make abortion more rare.
Family planning supporters, however, were quick to point out that no U.S. funds are spent to perform or promote abortions overseas. In fact, a provision authored by Sen. Jesse Helms (R-NC) in 1973 and renewed on an annual basis as part of the foreign aid funding bill forbids any U.S. dollars from being used for this purpose.
Proponents speak out
Family planning advocates on Capitol Hill and elsewhere contend that rather than making abortion more rare, the gag rule will lead to more abortions by undermining the delivery of high-quality family planning services.
Sen. Olympia Snowe (R-ME) says, "Too often, women in developing nations do not have access to the contraceptive or family planning services they need because contraceptives are expensive, supplies are erratic, services are difficult to impossible to obtain, or the quality of care is poor. Yet it is now the policy of the United States not to support these organizations — a policy that is confounding to me, because these very organizations reduce the number of abortions through their services."
Along these lines, family planning proponents note that when the restrictions were in place between 1984 and 1992, many of the most effective and experienced family planning providers in developing countries chose to forgo U.S. population aid, rather than comply with restrictions that forced them to abandon their legal rights under the laws of their country and to abandon their ethical responsibilities to their patients.
Family planning advocates also point out that, historically, the global gag rule made abortion less safe instead of more rare. Fear of losing desperately needed family planning funds, they say, led some health care providers to refuse to treat women with severe complications or infection resulting from unsafe abortions. This, in turn, meant that medical personnel were not trained to deal with the consequences of unsafe abortions. Finally, family planning advocates contend that the HIV/AIDS epidemic, and the role that family planning programs play in providing condoms and information that curtails the spread of HIV, makes the imposition of a gag rule more dangerous than ever before.
In response to the president’s action, supporters of family planning introduced "The Global Demo-cracy Promotion Act." The legislation, introduced on a bipartisan basis by Barbara Boxer (D-CA) and Olympia Snowe in the Senate and Nita Lowey (D-NY) and Jim Greenwood (R-PA) in the House, would negate the Bush policy and ensure that U.S. foreign policy is consistent with American principles of medical ethics and free speech.
The legislation specifies that overseas health care organizations cannot be denied funding based on the medical services they provide, including counseling and referral services. It also says that foreign nongovernmental organizations, as a condition of eligibility for U.S. development assistance, cannot be forced to sacrifice their right to use their own funds to engage in free speech any more than U.S.-based groups are asked to do.
Bill sponsor Nita Lowey explains, "[Our legislation] says that it is wrong to withhold medical information from women in developing countries that women in the United States can access every day. It says it is wrong to force groups to stop talking to their elected officials about reproductive rights. And it says it is wrong to deny women in other countries access to legal abortions."
The sponsors, who were joined by 18 Senate and 79 House co-sponsors, hope to offer the legislation as an amendment to the annual foreign assistance funding bill with the goal of overturning the Bush policy.