Twice Victimized: U.S. Policy Obstructs Care For War-Rape Victims

This article originally appeared in Conscience magazine, published by Catholics for Choice.

In April 2009, Hillary Clinton appeared before the House Foreign Affairs Committee and voiced the strongest support for global reproductive rights ever heard from an American Secretary of State. She was speaking in response to a question from New Jersey Republican Congressman Chris Smith, who wanted to know if the Obama administration would work to "weaken or overturn 'pro-life' laws and policies in African and Latin American countries," and whether the United States considers "reproductive health" to include abortion.

For most politicians, such a question would evoke nervous hedging and temporizing, but Clinton was remarkably clear. She began by talking about the human suffering she's seen worldwide in places where abortion is restricted: "I've been in hospitals in Brazil where half the women were enthusiastically and joyfully greeting new babies, and the other half were fighting for their lives against botched abortions." She continued, "So we have a very fundamental disagreement. It is my strongly held view that you are entitled to advocate, and everyone who agrees with you should be free to do so anywhere in the world, and so are we. We happen to think that family planning is an important part of women's health, and reproductive health includes access to abortion."

Around the world, women's health advocates cheered. The United States, after all, has a profound effect on reproductive rights across the globe, and during the Bush years that effect was overwhelmingly negative. Already, President Obama had reversed two of the Bush administration's most hated polices. On his third day in office, he repealed the "global gag rule," the executive order that denied US funding to any group that performs abortions or counsels about the procedure, even if it does so with its own money. Then he reinstated American support for the United Nations Population Fund (UNFPA). Clinton's statement suggested that once again the United States could be a leader in pushing for reproductive rights worldwide.

But two years into President Obama's administration, many in the field are grumbling. They are grateful for much that the administration has done, but they complain that it hasn't been proactive in fighting for reproductive rights, and that a disorganized, risk-averse United States Agency for International Development (USAID) interprets restrictions on abortion funding more strictly than it has to. "What we're seeing on abortion-related policy is no change from the Bush administration," says Barbara Crane, executive vice president of Ipas, which promotes safe abortion worldwide.

The United States was once a leader in promoting safe abortion globally. The first head of USAID's population program, Reimert Ravenholt, was responsible for having the manual vacuum aspiration syringe, a device used in abortion care worldwide, engineered for mass production. But since 1973, even sympathetic American policymakers have been hamstrung by the Helms amendment, which says, "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 restrictions were compounded by the Siljander amendment, which bans foreign assistance funds from being used to "lobby for or against abortion."

Groups advocating for safe abortion were disappointed that the Obama administration didn't come out strongly against the Helms amendment early in his presidency, when there might have been the momentum for repeal. They also wish the president had pushed for permanent legislative repeal of the global gag rule, so that a future Republican president can't simply restore it with the stroke of a pen. "We've lost the opportunity to forever get rid of the policy, and we're likely back now to where it's a political football tossed from White House to White House," says Suzanne Petroni, vice president of global programs at the Public Health Institute.