Patty Skuster's blog

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

2008-12-19T08:00:00-05:00

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.

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.

World to Governments: Women Shouldn't Be Imprisoned for Abortion

2008-06-20T08:00:00-04:00

Abortion shouldn't be a crime, according to opinions of the majority of people polled in some of the world's most populous countries.

WorldPublicOpinion.org released data yesterday that shows that only 18 percent of people polled in 18 countries favor criminal penalties such as fines and imprisonment as a means to prevent abortion. Yet the laws of most countries that restrict abortion make criminals out of providers who perform abortion as well as women who seek abortion.

In other words, even if they disagree with a woman's decision to have an abortion, people don't want to see their sisters and daughters jailed for their reproductive health decisions.

The discord between the law and people's opinions is starkly illustrated in an advocacy video created by Ipas Brazil, who is working to change the restrictive law that imprisons a woman for up to three years for "consenting" to an abortion. The video talks to people on the street and asks first whether they are for or against abortion (all answer "against"), then whether they know someone who has had an abortion (yes, they do) and finally, whether that person should be imprisoned.

This last question is met with confused and sometimes surprised silence. The final message of the video? "Think about it."

It's in Portuguese - but you'll get the gist of it!

Certainly with polling, the choice of questions is everything. And the questions chosen by WorldPublicOpinion.org and featured in the Ipas Brazil video bring to light what it means to make abortion illegal.

We're not talking about simple disproval of someone's health choices - abortion laws aren't an abstract policy expression, like the Sense of the Senate. Abortion is penalized with fines, or in many countries, prison, which is one of the ways that governments control people's choices (here in the U.S. we've got the Hyde and Helms amendments).

Women have abortions, regardless of the law. And, since most of us know someone who has had an abortion, the thought of criminal penalties for that woman or for the medical provider who helped her is very unsettling, regardless of whether we think abortion is okay.

The polling data released today shows that public opinion is on the side of less government interference with women's choices around abortion. In Poland, Mexico and South Korea - three countries with restrictive abortion laws - the majority of those polled stated that decisions about abortion should be left to the individual.

Here in the U.S., where Congress recently enacted and the Supreme Court upheld a two-year jail sentence for doctors who perform a specific abortion procedure, only eight percent favored criminal enforcement of abortion laws. 69% of those polled were in favor of leaving the decision to the individual.

WorldPublicOpinion.org polls in 18 countries, which they purport to represent 59 percent of the world's population. However, there is a dearth of opinions from places where unsafe abortion is a high contributor to maternal mortality. Half of the world's 67,000 deaths from unsafe abortion take place in Africa, but Nigeria is the only African country represented in the data. More data from Africa and the other parts of the global south, where restrictive abortion laws are major contributors to the loss of women's lives, would have made for interesting comparison.

That people are opposed to the criminalization of one of the most common medical interventions is at the very least, logical. At most, the polls can contribute to a growing movement to reform abortion laws around the world.

To ask the question of criminalization helps move the discussion beyond the rhetoric of morality, maybe even beyond the statistics of unsafe abortion. Restricting abortion by law can make a criminal out of an often desperate woman who seeks medical care or the provider that helps her. When advocating for legal reform, how the law treats individuals we know is something everyone should think about.

For the Center for Reproductive Rights's map and fact sheet of abortion laws worldwide, click the image below!

Center for Reproductive Rights's Map of Abortion Laws Worldwide