The Global Gag Rule, officially known as the Mexico City Policy, prohibits nongovernmental organizations from receiving US funding for performing or providing counseling or information about abortion. Under previous administrations, the policy was limited to organizations providing family planning services. It will now include global health assistance programs such as those for HIV/AIDS, maternal and child health, malaria and global health security. This means that an organization that receives US funding for HIV or malaria prevention, for example, will lose funding if it provides pregnant women with any counseling or information that even mentions abortion.
“The Global Gag Rule was already a misguided policy that threatened women’s lives,” said Jason Cone. “It puts government and politics between a woman and her doctor. The expansion of this rule to include nearly all women and children who rely on US government funding for lifesaving global health programs—some of the most vulnerable people in the world—makes this dangerous policy unfathomably worse.”
The expanded Global Gag Rule threatens progress on many fronts, including efforts to reduce HIV-related deaths and new infections, efforts to reduce mother-to-child transmission of HIV, and efforts to decrease childhood mortality through malaria prevention and global immunization programs.
Women should have the information and tools to protect their health and wellbeing. Women are highly vulnerable to HIV, and pregnant women require specific and targeted services so that their own health can be protected and the risk of sexual transmission or transmission to their child can be reduced.
Unsafe abortion is one of the five main causes of maternal mortality worldwide, together with hemorrhage, eclampsia, sepsis and obstructed labor. Unsafe abortion accounts for 13 percent of maternal deaths around the world, according to the World Health Organization (WHO). The rates are even higher in certain regions, such as Latin America, and in contexts such as refugee camps and conflict areas.
Where safe abortion care is not available, women and girls will put their lives at risk. When left with no safe options, they will resort to abortions carried out by untrained people or in environments lacking minimal medical standards.
“The Global Gag Rule is medically unethical policy because it limits health care providers from counseling their patients on medical care even when safe abortion services are legal in a country,” said Cone. “Knowing that hundreds of thousands of women die or suffer serious complications from unsafe abortions each year, keeping potential lifesaving information and services from women is another form of violence. It is violence against women by other means.”
According to the WHO, of the estimated 46 million abortions requested per year, roughly 20 million are considered unsafe. MSF teams around the world treat women and girls with abortion-related complications every day. In 2015, over 12,000 cases of abortion-related medical complications were reported from MSF projects. That same year, close to 220,000 women delivered babies in MSF-supported health centers.
"MSF does not receive any US government funding and is not directly affected by the reinstatement of the Global Gag Rule," said Cone. "However, as a medical humanitarian organization, we run maternal health programs and HIV treatment programs, we work with pregnant HIV-positive mothers to ensure their babies are not born with HIV, and we treat young children with complications from malaria every day. We know exactly who will be directly affected and hurt by an expansion of this policy.”
It is MSF’s policy to provide contraceptive and safe abortion care as part of its response to women’s and girls’ health needs. The treatment of abortion-related complications and the termination of pregnancy to save a woman from life-threatening complications are part of all MSF obstetric care. The decision on whether to terminate a pregnancy on request is taken very carefully, with the safety of patients and staff a primary concern.