To reverse the recent decision of the US Supreme Court Roe v. Wade has sparked a debate in the United States on how to protect reproductive freedom. President Biden proposed ending the Senate filibuster rule so Congress can pass legislation legalizing abortion rights, and he signed an executive order to “protect access to reproductive health care.” In some states, lawmakers have passed new laws that expand abortion rights. What is missing from this debate, however, is a similar discourse and concrete actions by Democrats to protect reproductive rights, not only in the United States, but also in less developed countries, directly affected by Republican attacks on US funding for reproductive health over worldwide .
Developing countries are struggling to improve reproductive health services, even where abortion is legal. For example, safe abortion services have been legal in Nepal since 2004. The Nepalese constitution enshrines “safe maternity and reproductive health” as basic human rights. Despite these constitutional and legal protections, Nepal is witnessing at least three maternal deaths every day due to limited capacity to provide health care, especially in remote areas, and lack of easy access to safe abortion when childbirth poses risks to maternal health.
This is a problem for many developing countries that are victims of US policies on abortion abroad, including the 1973 Helms Amendment, which prohibits US taxpayers’ money from being used for abortions, even if the abortion is legal in that jurisdiction. While the Helms Amendment includes exceptions for rape, incest or maternal health risks, many recipients do not provide abortion-related services for fear of losing US funds.
The United States’ funding restrictions on reproductive health care do not end with the Helms amendment. In 1984, Republican President Ronald Reagan announced that foreign health care providers would not be able to obtain US funding if they provided abortion services, even with non-US funds. Known as the “Mexico City Policy” or the “global gag rule,” this policy even prohibits NGOs receiving US aid from referring to abortion when advising pregnant people or campaigning for abortion rights everywhere. Rooted in American abortion politics, this policy is revoked whenever a Democrat becomes president and reinstated whenever Republicans regain control.
The global gag rule disproportionately targets poor, marginalized and often indigenous women who live in low-income countries and lack access to private health care. Studies show that the global gag rule does not reduce abortion, but increases the number of abortions. When the United States, the world’s largest health donor in the world, withdraws funding from health clinics that provide, refer or advocate for abortion services, those clinics often cease to function, rendering contraceptives unavailable, leading to more unplanned pregnancies and thus more abortions—often unsafe procedures.
Health workers in poor countries like Nepal have witnessed the cruel means of unsafe abortions – from cow dung to glass to thorns. Such practices can affect women’s long-term sexual and reproductive health and can lead to permanent injury or maternal death, which in turn increases infant mortality and malnutrition.
Proponents believe they are defending the lives of the unborn. Still, a recent Guttmacher Institute study calculated that repealing the Helms amendment alone could prevent 19 million unsafe abortions and 17,000 maternal deaths each year and reduce abortion-related maternal deaths by 98 percent. The global gag rule censors what health professionals can say to patients in private conversations about their health and imposes the American culture war on women in low-income countries. How is it moral for a country that wants to be a model for free speech to censor those private conversations and impose a non-universal way of thinking in an imperialistic way?
When Biden was inaugurated, health professionals and policymakers in Nepal and other developing countries hoped his administration would address the lack of access to reproductive health care for disadvantaged people around the world. Biden has effectively repealed the global gag rule and signed the Memorandum on Protecting Women’s Health at Home and Abroad, repealing the expanded version of Mexico City’s policies by the previous administration. However, because Biden’s campaign for reproductive rights advocated, many hoped that Biden would lead the way in passing the Global Health, Empowerment, and Rights (HER) Act, which allows foreign NGOs to use non-U.S. funds to promote abortion or post-natal providing abortion care and permanent invalidates the global gag rule and closes the way for future US presidents to re-impose a gag rule exclusively with executive power.
Two months before the midterm elections, that hope is faltering.
While Democrats control Congress, they must act immediately to pass legislation such as the Abortion Is Health Care Everywhere Act, which permanently repeals the Helms amendment. Biden should also lead the way in passing the Global HER Act, which Vice President Kamala Harris co-sponsored as a senator. While fighting for reproductive rights at home, President Biden must do all he can to ensure those same rights for pregnant people in less developed countries around the world.
As President Barack Obama once said, “In the eyes of God, a child on the other side of the border is worthy of no less love and compassion than my own.” In that vein, American reproductive rights advocates should not limit their advocacy to the United States, because a pregnant person on the other side of the border may need just as much abortion as an American woman.