Congress should repeal the ‘global gag rule’ permanently

Congress now has a chance to strike down the global gag rule, also known as the Mexico City Policy. It bars organizations abroad that receive U.S. aid from performing abortion, counseling clients about it, or referring them to abortion services. It’s an imperialist policy that has hurt women and weakened health service delivery around the world for decades. Congress should seize the opportunity to get rid of it.

Next week, the House Appropriations Committee will mark up the fiscal year 2022 appropriations bill for state and foreign operations, a bill that will incorporate the Global Health, Empowerment and Rights Act (Global HER Act). The HER Act would permanently repeal the global gag rule, preventing future administrations from being able to reinstate it.

First instituted by the Reagan administration in 1984, the rule has been a political football passed back and forth by U.S. presidents, with Democrats rescinding it, and Republicans reinstating it. For example, after the Obama administration rescinded the George W. Bush administration’s global gag rule, the Trump administration reinstated and expanded it in January 2017, broadening it to apply not only to family planning assistance, but to all U.S. global health assistance, impacting approximately $12 billion in foreign aid. President Biden in turn rescinded the Trump rule in January 2020.

When it is in force, the global gag rule confronts health providers with an untenable choice between retaining their U.S. funding or serving their mission of providing accurate information and a full range of safe and legal reproductive health services.

Proponents of the rule say their goal is to reduce the incidence of abortion, but it actually has the opposite effect. Withdrawing U.S. support from health clinics that provide or refer clients to abortion services means that many clinics are forced to shut down altogether. Access to contraceptives and other family planning services shuts down with them, which drives up unplanned pregnancies, which in turn drives up abortion demand.

For a moment, imagine you are a young woman, newly married. You and your husband are excited to begin your lives together, and plan to start a family in a few years, after you’ve completed your education and saved enough to build your own home. You head to the only health clinic in town for contraceptives, but the doors are locked. A sign reads, “Closed until further notice.” Your sister got contraceptives here just last year. The next nearest clinic is hundreds of miles away. What are you supposed to do now? And what happens if you get pregnant?

This has been the experience of millions of women around the world under the global gag rule. We don’t yet have the data on the impacts of the Trump administration’s especially virulent version of it, but we know from 2001 to 2008, the incidence of abortion among women in countries highly affected by the Bush administration’s version of the policy rose almost 40 percent.

The global gag rule has disproportionately hurt the women and families who need reproductive health services and information the most, because it has been especially damaging to organizations that should be our key partners in reaching remote, last-mile areas. According to Melvine Ouyo, a former clinic director of Family Health Options Kenya, “The policy’s impacts not only have been devastating to marginalized communities, but also to health care providers, organizations, and their partnerships, leading to clinic closures, staff layoffs, family planning program cuts, and generally disrupting the public health system.”

The U.S. has a long, proud tradition of championing reproductive health and rights and helping to deliver voluntary family planning services and information to people around the world. But our domestic culture wars over abortion and implacable efforts by abortion foes to roll back reproductive rights at home has politicized and besmirched that legacy abroad.

Thankfully, Biden suspended the global gag rule, but that may not bring back the clinics and access to services the Trump administration’s rule effectively closed down.

The endless partisan cycle of rescinding and reinstating the rule itself does lasting damage. Unpredictability of U.S. funding erodes trust and destroys relationships with recipient organizations. And the “gag” part of the global gag rule — dictating what health providers can and cannot say in confidential dialogue with their patients or in public conversations with their own governments on reproductive health policy — is a high-handed, ugly vestige of imperialism that should have no place in U.S. foreign assistance.

But we now have the opportunity to set a new course. The HER Act pending in Congress would repeal the global gag rule permanently. The bill was reintroduced in the Senate this year by two Democrats and two Republicans, joined by over 40 co-sponsors, plus a record 170 co-sponsors in the House. More than 150 organizations endorse it, including humanitarian organizations, health providers, and associations of medical professionals.

The global gag rule is inimical to reproductive health, rights and justice. If the U.S. is to be a champion of democracy and self-governance, if we are committed to promoting the health and well-being of women around the world, if we’re serious about equity for marginalized and hard-to-reach communities, then the time has come not just to suspend it, but to permanently repeal it once and for all.

Kathleen Mogelgaard is the president and CEO of the Population Institute, a nonprofit based in Washington, D.C. that supports reproductive health and rights.