What there is to know about the Mexico City Policy, also known as the Global Gag Rule

By: Karen Nassi, Director of Programs, Every Mother Counts

Last week, in an anticipated effort to halt U.S. funding and curb access to abortions worldwide, President Donald Trump signed a strict memorandum that hamstrings global health systems in their efforts to provide comprehensive care to countless women in their communities. Here at Every Mother Counts we are working with our global health networks around the world to better understand the near and long-term implications that this document will have on our grantee partners working on the ground in Bangladesh, Guatemala, Haiti, India, Syria, Tanzania, and Uganda — and everywhere else that the U.S. government aid traditionally supports life-saving health services to vulnerable populations in need of urgent and consistent healthcare.

The Mexico City Policy (also referred to as the Global Gag Rule, for the effect it has on health practitioners to go against the Hippocratic Oath taken by physicians to “Do no Harm,”) prohibits foreign organizations that receive health funding from the United States from:

· discussing abortion or providing referrals to providers
· performing abortions
· advocating for increased access to abortion

Note that this doesn’t apply to the use of U.S. funds — U.S. monies are never used for abortion services due to several other federal statutes. What the Mexico City Policy does is prevent clinics, NGOs, and other providers from using their own resources (funds received from their governments, other donors, and even patient fees) to provide care according to the highest possible standard.

Previous versions of the policy (in effect under each Republican administration since President Reagan) applied to non-governmental organizations receiving assistance for family planning services — such as condom distribution and contraception counseling — and as a result affected approximately $600 million of foreign aid. Local clinics and programs that relied on this assistance were forced to either turn down funding and close their doors or provide medically inadequate care and information, eroding the trust of their patients.

In its current iteration, President Trump has vastly expanded the policy so that the restrictions apply to virtually all U.S. foreign health assistance, approximately $9.5 billion. The Trump administration has yet to reveal the full extent of the regulations, which could even go so far as to prohibit hospitals from providing care to women in distress following unsafe abortions.

Contrary to its intended goal, and not surprisingly, research has shown that the gag rule has actually increased abortion rates during the periods in which it was in effect. With so many family planning programs forced to shut down, rates of unwanted pregnancies and abortions skyrocketed. In countries where abortion is illegal or tightly restricted, women will seek abortions clandestinely, with improperly trained providers and under hazardous conditions putting their lives at risk. The consequences are dire; unsafe abortion is a leading cause of maternal mortality and morbidity, accounting for 13% of maternal deaths globally. Make no mistake: this is not just a political playing card, the Mexico City Policy will directly lead to the deaths of many women, girls and children.

Moreover, by curtailing or eliminating these programs, many of which also offered HIV/AIDS testing and counseling, gender violence prevention initiatives, vaccinations, malaria prevention, tuberculosis treatment, and more, the Gag Rule undermines decades of progress in global health and further marginalizes the world’s most vulnerable populations. And it makes us in the United States more vulnerable too; in weakening the worlds’ on-the-ground frontline infrastructure, the Gag Rule leaves us more exposed to viral pandemics and other health emergencies that can’t be contained by inadequate healthcare systems.

In short, the Mexico City Policy is a giant step in the wrong direction, for everybody. We stand in solidarity with our partners and with hundreds of organizations and thousands of advocates around the world to say that women and girls around the world — indeed their families and their whole communities — deserve better than to be treated as political footballs.

For more details about the consequences of the Mexico City Policy, see this Kaiser Family Foundation Explainer and this Center for Health and Gender Equity Policy Brief.