It’s Not An Alternative Fact: Millions Of Lives Are At Risk Because Of The Global Gag
Earlier this month, I had the privilege of spending some time with an incredible team from Marie Stopes International that works to provide reproductive health services to women and men in southwestern Uganda. Only 32% of women in Uganda use a modern contraceptive method and in the southwest region, women have more than six children on average.
One of the senior trainers on the Marie Stopes International team is a woman named Cathy. Cathy is a force to be reckoned with. She has been working as a nurse in Uganda for about 30 years and has dedicated the last 20 years of her life to training and mentoring younger health providers.
During my trip, I was able to watch Cathy in action as she trained younger nurses and midwives to safely insert and remove contraceptive implants. Cathy operates like a professional football coach, mom and professor all rolled into one. She commands attention (partially because at six feet tall she stands above nearly everyone in any room she’s in) and no one wants to disappoint her. At every health center we visited, she sat with each health provider for hours coaching them on the proper technique to remove implants, drilling them on their infection prevention practices, and showing them how to counsel clients with respect and compassion.
While Cathy was training health providers, the rest of her team was working like a well-oiled machine. The Marie Stopes International outreach team visits public, government health facilities — including those in the most remote areas — on a quarterly basis to provide free, quality reproductive health services. The team visits a different health facility every day of the week and serves anywhere from 75–200 women and men per day. They insert IUDs and implants, provide pills and condoms, perform vasectomies, and screen for cervical cancer.
And in many other countries around the world, Marie Stopes International also provides access to safe abortions.
This means that as of last week, the organization will be prohibited from receiving any new funding from the United States Agency for International Development (USAID) as long as President Trump’s executive order to reinstate the Mexico City Policy is in place. Marie Stopes International estimates that without alternative funding, the loss of their services between 2017 and 2020 could result in 6.5 million unintended pregnancies, 2.1 million unsafe abortions and 21,700 maternal deaths around the world.
Following in the footsteps of the three Republican Presidents who came before him, President Trump issued an executive order to reinstate and expand a policy that puts the lives of thousands of women across the world at risk. The Global Gag Rule, otherwise known as the Mexico City Policy, is a restrictive and antiquated policy that prevents organizations receiving U.S. government funding from providing lifesaving reproductive health services.
The policy in its original form requires all foreign organizations receiving family planning support from the U.S. to certify that they will not perform or actively promote abortion as a method of family planning, even if they do so with non-U.S. funds. Under Trump’s executive order, this policy now applies to ALL U.S. global health assistance, including global HIV funding under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Centers for Disease Control and Prevention (CDC).
As a woman, an advocate for universal access to sexual and reproductive health services, and a Global Health Corps fellow working in Uganda, this executive order, out of all of the restrictive and controversial orders issued this week, hits closest to home for me.
There is no question about the impact this policy will have. Studies have found that the use of modern contraceptives declined and the induced abortion rate increased significantly from 10.4 to 14.5 per 10,000 woman in 20 countries where organizations lost funding and services were cut during the years that the Global Gag Rule was in place.
Preventing international nonprofits from providing safe abortions will not and does not stop women from seeking and obtaining abortions. The reinstatement of the Mexico City Policy will simply force more women to risk their lives by opting for an unsafe abortion.
What can we do? We must keep marching. We must keep calling our elected officials. We must keep talking about why contraceptive access is important, and keep supporting organizations like Marie Stopes International so that nurses like Cathy can do what they do best — save lives.
