These US Abortion Restrictions Threaten Reproductive Health Everywhere

The US Supreme Court’s recent decision overturning Roe v. Wade has sparked debate in the United States about how to protect reproductive freedom. President Biden proposed ending the Senate filibuster rule in order for Congress to pass legislation legalizing abortion rights, and he signed an executive order to “protect access to reproductive healthcare services.” In some states, legislators have enacted new laws that expanded abortion rights. However, what is missing in this debate is similar discourse and concrete actions by Democrats to protect reproductive rights not only in the United States but also in less-developed countries, which are directly affected by Republican attacks on US funding for reproductive health around the world.

Developing countries are struggling to improve reproductive health services, even where abortion is legal. For instance, safe abortion services have been legal in Nepal since 2004. Nepal’s constitution enshrined “safe motherhood and reproductive health” as fundamental rights of people. Despite these constitutional and legal protections, Nepal witnesses at least three maternal deaths every day due to its limited capacity for providing health care, particularly in remote areas, and lack of easy access to safe abortion if childbirth poses risks to maternal health.

This is a problem for many developing countries victimized by US policies on abortion overseas, including the 1973 Helms Amendment, which prohibits US taxpayer money from being used for abortions, even if the abortion is legal in that jurisdiction. Although the Helms Amendment includes exemptions for cases of rape, incest, or risk to maternal health, many recipients do not provide any abortion-related services for fear of losing US funds.

The United States’s funding restrictions on reproductive health care services don’t end at the Helms Amendment. In 1984, Republican President Ronald Reagan announced that overseas health care providers could not receive US funding if they provided abortion services even with non-US funds. This Rooted in US politics, this policy is abortion policy, known as the “Mexico City policy” or the “global gag rule,” also bans NGOs receiving US aid from even referring to abortion when counseling pregnant people or engaging in abortion rights advocacy anywhere. Rooted in US politics, this policy is rescinded every time a Democrat is president and reinstated every time Republicans regain control.

The “global gag rule” disproportionately targets poor, marginalized, and often indigenous women living in low-income countries who do not have access to private health care. Studies show that the “global gag rule” does not reduce abortion but instead causes abortion rates to go up. When the United States, the world’s largest global health donor, withdraws funding from health clinics that provide, refer, or advocate for abortion services, those clinics often cease to operate, making contraceptives unavailable, thereby leading to more unplanned pregnancies and thus more abortions—often unsafe procedures.


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