Banned and Gagged
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After the recent confirmation of Supreme Court Justices John Roberts and Samuel Alito, it was only a matter of time before a state like South Dakota passed a law that banned all abortions, even in cases of rape and incest. South Dakota's governor, Mike Rounds, signed the ban on Monday. While the ban is a turning point for abortion politics at home, it mirrors what's already been happening overseas. Abortion rights advocates say it's time for Americans to start connecting the dots.
"Because of the constitutional guarantees embedded in the Roe v. Wade decision, Republican administrations have been unable to completely defund abortion groups in the United States, so they've taken it out on poor women in developing countries, but those policies are coming home," says Steven Sinding, an American who serves as director-general of the International Planned Parenthood Federation (IPPF), a London-based organization that supports the poor, underserved and marginalized in 180 countries.
The United States has funded international family planning programs since the 1960s, but in 1984, the Reagan Administration passed the Global Gag Rule, which denies U.S. Agency for International Development funding to overseas organizations that perform legal abortions with exceptions for rape and incest or to save a woman's life; provide counseling and referrals for abortion; engage in abortion-related public policy debates; or lobby to make abortion legal or more available in their own country.
"Americans have the right to say where their funding is going, but we find it completely unfair to be asking others not to talk about certain topics which are not liked by the American establishment," says Tewodros Melesse, director of the IPPF's Africa Region Office. "We believe the American Constitution and virtue of the American democracy exists on individual choices, on freedom and on democracy and to deny that right to others sends the wrong message."
The Clinton administration ended the Global Gag Rule in 1993 by executive order; President Bush reinstated it on his first day in office in January 2001, halting an estimated $15 million per year in funding to the IPPF after it refused to sign the rule. A number of reproductive rights groups, including Ipas, which has offices in 11 countries, have also lost funding to other organizations.
As a result, community-based health services have been curtailed and contraceptive supplies have drastically decreased. The United States stopped giving Zambia donated condoms after it refused to sign the Gag Rule, and several family planning clinics across Africa and Asia have been forced to close.
"We used to have 17 clinics; now we have nine," says Dr. Joachim Osur with IPPF member Family Health Options Kenya, a nongovernmental organization that advocates for reproductive rights in Kenya, where abortion is illegal, with an exception to save a woman's life. "We've been closing them one after another; we were hoping that someone would come to our rescue, but it never happened. After the clinics closed, fetuses were thrown in the streets. We feel the rate of abortion has gone up because women have no access to family planning."
The British Department for International Development recently announced plans to defy the U.S. government by contributing $5.3 million to the IPPF's new Global Safe Abortion Program. "That by itself does not make up for the $15 million a year we estimate we are losing as a consequence of the Global Gag Rule, but it's greatly appreciated," says Sindig. "They've [the British government] asked other European governments to join them in supporting the safe abortion fund. I anticipate it could compensate for the loss of the American money"
The program aims to provide the services and information needed to reduce the growing number of unsafe abortions worldwide. This year alone, 19 million women will face serious injury, illness or death as a consequence of abortions performed by unskilled people under unsanitary conditions. Nearly 70,000 will die. Virtually all of those women live in the poorest countries in the world, and almost every death and injury could be prevented, according to the IPPF's report, " Death and Denial: Unsafe Abortion and Poverty."
A 42-year-old Ghanaian market trader named Esinam recently told the BBC why she decided to have an illegal abortion at a back-street clinic in Accra, after becoming pregnant for the fourth time despite using birth control. "My husband and I can barely look after our three children on the little income we have. How could we afford to feed another mouth?" She was four months pregnant when she had the back-street abortion.
"Even though I realized it wasn't a proper clinic, I was still determined to go through with the termination. I had no choice," she said. After the abortion, she bled profusely, lost consciousness and was taken to the hospital. When she regained consciousness, she was told her womb was rotten and had to be removed. "I cannot have anymore children, and if I had lost any more blood, I would have died. I am very grateful to the doctor and his team at Accra's Ridge Hospital who saved my life."
Esinam was lucky she survived. In Africa, four million unsafe abortions occur each year, and more than 40 percent of the world's deaths occur on the continent due to unsafe abortions.
"We can't tell you how many of those injuries and deaths are a direct result of the Global Gag Rule. There's just no way we can accurately calculate that," says Sinding. "But we have no doubt that the curtailment of services has led directly to suffering by women both because they had pregnancies they didn't want or because they acquired sexually transmitted infections."
Sinding says the Swedish, Japanese and British governments are the world's largest international family planning donors; the German, Denmark, Norwegian and Dutch governments also make substantial contributions.
Funding from the British government prevented three clinics from closing in Ghana, where abortion is permitted to protect a woman's health and in cases of rape, incest and fetal impairment; funding from the Dutch government prevented the closure of 10 clinics in Ethiopia, where abortion laws were relaxed in 2004 to allow abortions in cases of rape and incest. The law also makes an exemption for young women who suffer from psychological stress. The anti-choice movement overseas, which is heavily funded by American organizations, unsuccessfully challenged those exceptions.
"While the current [American] administration and anti-choice groups says abortion kills life, the very precise intervention to prevent abortion is leading millions of women to abortion and killing so many babies and so many mothers," says Melesse. "Over 50 percent of the maternal deaths in Africa are linked to complications due to abortion, which are preventable."
Almost 12 years ago, at an international conference on population in Cairo, 179 countries made a commitment to greatly improve reproductive rights and decrease maternal deaths around the globe by 2015. The Bush administration's policies are making it close to impossible to meet that goal.
"If American women understood what the actions of our government means to the lives of women around the world, particularly poor women in poor countries, they couldn't in good conscience support this administration for any reason," says Sinding. "The fact is, what the Bush administration is doing to women in the developing world hasn't really penetrated the consciousness of the American electorate."
Maybe not. But as we fume about the passage of South Dakota's draconian abortion ban, soon to be headed toward its first legal challenge, it's a good time to remember that we're now facing in the U.S. what women around the world have suffered since the day Bush took office.