The Global Gag Rule Comes Home

By Sera Bonds, CEO, and Heather Busby, Texas Sexual Reproductive Health Advocacy Director, of Circle of Health International

The ProFamil clinic in Haiti, which has been left empty due to the cut-off of funding from the Global Gag Rule.

Recently, the Trump administration issued new rules for Title X funding that are a domestic version of the ‘global gag rule,’ prohibiting any health care providers that receive Title X family planning funds from offering the full range of reproductive options to their patients or referring patients to an abortion provider, even if they request the information. As Circle of Health International (COHI) has seen on a global scale, the implications of such policies can have a devastating impact on reproductive health care.

In recent years, states across the US have enacted abortion restrictions that have resulted in an alarming loss of safe, legal access to abortion. In Texas, access to abortion was dramatically reduced in the aftermath of an omnibus abortion law passed by the Texas Legislature in 2013, portions of which the U.S. Supreme Court struck down in 2016. Anti-abortion lawmakers in Texas have since enacted a number of restrictions that continue to make abortion very difficult to access, including laws that prohibit state-funded providers and state employees from referring patients to abortion providers or discussing abortion as an option. In addition, the state health department publishes materials that include medically inaccurate, biased, and misleading information about abortion and fetal development.

Anti-abortion politicians have made it clear they want to outlaw abortion in the United States. COHI, a Texas-based nonprofit that provides reproductive, maternal, and newborn health care in crisis settings around the world, has witnessed firsthand that illegal abortion does not stop women from getting abortions; it only increases the risk to their health.

One of COHI’s partners, Profamil, is the largest family planning provider in Haiti. An international Planned Parenthood Federation partner, ProFamil is one of the few providers in Haiti that treats patients with abortion complications and is bravely honest about the impact of illegal abortion in Haiti. Worldwide, organizations refrain from discussing the impact of illegal abortion, often coding abortion complications as miscarriages to avoid risking their funding in the wake of the global gag rule. As a result of their honesty, ProFamil has lost hundreds of thousands of dollars in international funding because of the global gag rule and has had to drastically cut staff and services.

In Haiti, 33% of maternal deaths each year are due to botched abortions. Despite this horrifying statistic, 35% of women in Haiti who want family planning don’t have access to it (one of the highest rates in the world). COHI founder Sera Bonds spent time with ProFamil in March and saw numerous women come in for treatment after botched abortions.

“It’s too easy for those of us not living the daily reality of women in Haiti to experience these numbers as just and only that — numbers. But they are women, mothers who are disappearing because they don’t have access to the care they want and deserve,” said Ms. Bonds.

“When I am in the room with these women, these brave women who want only the dignity, the protection that we all deserve, it’s infuriating to me that we aren’t doing more. Family planning availability would save lives, real in-the-flesh lives, of mothers in Haiti. So that is one of the key places in the world in which COHI is investing our time, talent, and treasure in 2018.”

As restrictions on providers moves from a global to local scale, the United States can expect to see similar effects. While the 40% of patients who are served through Title X at Planned Parenthood clinics will be affected by a loss of funding, patients going to other Title X providers will also be denied the full range of reproductive options. If they ask their provider for help in finding a safe abortion provider, they will not get the information they seek. Out of fear of losing funding, providers will have no choice but to practice medicine with one eye to the political implications of everything they say and do. COHI has seen this in the international context and in Texas. The rest of the nation should be very concerned.

Learn more about Circle of Health International and their global work at cohintl.org.

Topics: Maternal Health