In the short time since President Trump took office, women’s rights have been assaulted, most recently by the administration’s efforts to defund Planned Parenthood. The Republican plan to replace the Affordable Care Act (ACA) would bar Medicaid from reimbursing Planned Parenthood for health services because the organization offers abortion services.
A report by the nonpartisan Congressional Budget Office (CBO) this week forecast that 24 million Americans would lose healthcare coverage over the next decade as a result of the repeal of the ACA. Other sources this week have put the estimates even higher — with 26 million people losing coverage. Furthermore, the CBO estimates that cutting off Planned Parenthood from federal funding for one year would result in thousands of additional unintended pregnancies and increased Medicaid spending by $21 million.
The rule applies even if the money is not being used to fund abortions. Under Trump, the rule has been expanded to include all global health organizations, even those that focus on issues such as infectious diseases. The rule effectively makes most international NGOs that provide vital sexual and reproductive health services, such as contraception and HIV testing, ineligible to receive funds.
There is no evidence to support that the global gag rule reduces abortions, but there is plenty of evidence to demonstrate that the rule hurts women around the world. Eran Bendavid and colleagues found in a study published in 2011 in the Bulletin of the World Health Organization that the induced abortion rate increased in sub-Saharan African countries where U.S. support was cut most due to the global gag rule. They concluded that “reduced financial support for family planning may have led women to substitute abortion for contraception.”
Erika Guevara-Rosas, Americas Director at Amnesty International, said that the rule “has a dangerous impact on the sexual and reproductive rights, health and life of women and girls across the world, particularly those who are most at risk of human rights abuses. The gag rule during both Reagan and Bush´s administration was a barrier to comprehensive sexual and reproductive health in many parts of the Global South.”
Abortions only account for about three percent of the wide range of services that Planned Parenthood provides, including contraception, cancer screening and testing and treatment for sexually transmitted infections (STIs). In 2014, Planned Parenthood provided nearly 11 million medical services for almost five million Americans, 327,653 of which were abortions. Most Planned Parenthood clients have incomes at or below 150 percent of the federal poverty level.8 The women who are most likely to suffer from the attempts to defund Planned Parenthood are young, low-income women.
It is ironic that the Republicans would seek to restrict funding for Planned Parenthood and other NGOs engaged in providing family planning services because this will make women more vulnerable to unintended pregnancies, increasing the need for abortions. Nearly half of all pregnancies in the United States each year—almost three million—are unintended. Under the ACA, contraception was provided essentially for free to millions of women. As a result, abortions declined to a record-low rate as of 2014, when, for the first time since 1975, the number of abortions in the U.S. dropped under one million.
Here in the U.S., without the publicly funded family planning services that Trump will cut by defunding Planned Parenthood, a report by the Guttmacher Institute estimates that the rates of unintended pregnancy, unplanned birth and abortion in the U.S. in 2014 might have been 68% higher and the rate of teen pregnancy might have been 73% higher. Another report shows that the services provided at publicly funded family planning visits resulted in a net savings to the federal and state governments of $13.6 billion in 2010 alone.
Why would it make sense to enact policies that would increase rates of unintended pregnancies? Simple: it doesn’t. Globally, women’s achievement of optimal sexual and reproductive health rests on the realization of a wide range of human rights. Sexual and reproductive rights are fundamental to ensuring the good health of women around the world. Access to family planning is a crucial part of global health.
A coalition of more than 140 global health organizations, including Planned Parenthood and the ACLU, has joined forces to oppose the global gag rule, with the effort being led by Refugees International. The NGO recently issued a statement that “[the] U.S. has been a leader when it comes to promoting democracy, women’s health and human rights around the world. U.S. foreign aid should never be used as a tool to limit women’s access to healthcare or to censor free speech.
Organizations should not be disqualified from receiving U.S. assistance because they use their own funds to provide health services and information that are legal in their home country and legal in the U.S. Supporters of global health and development, women’s rights, gender equality and free speech oppose the harmful global gag rule and reject efforts to undermine the health and rights of women around the world.”
Defunding Planned Parenthood is misguided and represents an alarming trend of Trump’s administration to restrict women’s sexual and reproductive rights both in the U.S. and abroad. Increasing access to contraception is one of the most effective ways to prevent unsafe abortion, ultimately saving thousands of women’s lives around the world. We should promote more access to contraception, not less.
Mellissa Withers, PhD, MHS, is an Assistant Professor at the University of Southern California Keck School of Medicine at the Institute for Global Health. She also leads the Global Health Program of the Association of Pacific Rim Universities.
The views of contributors are their own and are not the views of The Hill.