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Global Health & Healthcare Governance: The Global Gag Rule.
In August of 1984, the Reagan administration put in place the Mexico City Policy, more commonly known as the Global Gag Rule. The policy lived on through Republican presidents and was put down but Democratic Presidents, but it has once again been implemented and in 2017, it is quite a controversial policy to be in use in the modern world. When president Trump announced the reinstatement of the policy people all over the world had instant objections. This essay will explore just what exactly is the Global Gag Rule, why it was first implemented, and discuss the implications of the policy on women’s rights and health throughout the world. The aim of this essay is to demonstrate the negative impacts of such a policy on a global scale and the many consequences to women it causes.
The Global Gag Rule states that any foreign country receiving US aid must restrict their non-government organisations in that they may not fund, offer, or even counsel abortions under any circumstance (Cohen, 2001). The reasoning behind this policy was captured most accurately by president George W. Bush when he stated that the Republican government did not wish to use taxpayer funds to pay for nor promote abortions either in the US or overseas (Crane, 2004). This is due the Republican Party being firmly “pro-life”, meaning that they believe abortion is wrong and should be banned outright. The United States’ own Planned Parenthood has locations all over the world, and the Global Gag Rule caused them to lose 20% of their funding which is disastrous for third world countries which are in desperate need of healthcare, especially for women (International Planned Parenthood Ferderation, 2017). In South Africa, the Marie Stopes clinics are in danger of losing their funding as well due to this law. Organisations such as Planned Parenthood and Marie Stopes provide millions of women and girls with contraception, maternal healthcare, STI prevention, safe abortions, and general gynaecological care. Without funding, those millions of women and girls may be without safe means of contraception and abortions, leading them to seek it elsewhere by unsafe means putting their health and lives at risk (International Planned Parenthood Ferderation, 2017).
The fight for women’s rights dates back quite a few decades, with Mary Wollstonecraft publishing an essay in 1792 on the rights of women to education. She challenged the roles of women in politics and the societal norms in which women were seen. Later, the poet William Blake wrote a thought-provoking poem on the treatment of women in society and how they are treated as sexual property. Women in the 1970’s in the United States fought and won their reproductive rights, such as the right to use contraceptives, which was a major step forward for women at the time. A decade later and Ronald Reagan put those rights in jeopardy with his policy (Cohen, 2001). Ironically, by ceasing funding to these organisations, women will no longer be able to successfully prevent unplanned pregnancies.
In January of 2017, the Marie Stopes organisation posted their opinion and concerns regarding this policy that was reinstated by president Donald Trump. They stated that the United States Agency for International Development (USAID) was the largest donor to family planning organisations, having invested up to $620 million a year (Marie Stopes Interntional, 2017). It is because of such funding that organisations such Marie Stopes can reach the poor countries of Asia and Africa and help their communities. Marie Stopes alone reaches 1.5 million women and girls every year (Marie Stopes Interntional, 2017), and Planned Parenthood reaching millions more. Both organisations are very concerned with the long-term effects this policy will have on the communities they are based in.
Looking deeper into the fears and concerns regarding the policy, there was an intensive study conducted in 2011 which looked at 261,116 women interviewed in Demographic and Health Surveys in 20 sub-Saharan African countries between 1994 and 2008 (Bendavid, 2011). The different countries involved in the surveys were placed into categories of being highly exposed to the US Global Gag Rule or being less exposed (Bendavid, 2011). The unit of testing used was the woman to year, the dependant variable regardless of whether the woman informed them of having had an abortion in each year. The investigators led a distinction in-contrast examination that thought about changes in the rate of premature birth in very presented nations to changes in the occurrence of abortion in less developed nations (Bendavid, 2011). Put another way, the examination controlled for stable between-nation varieties and normal cross-country common patterns, and a few observed women. The staying between-nation variety in change after some time in the rate of abortion may then be credited to contrasts in the degree of introduction to the impacts of the gag rule (Bendavid, 2011). Their conclusion was rather interesting as it was found that during the Bush presidency there was a 2.55 increase in undocumented abortions in the countries more exposed to the gag versus those less exposed (Bendavid, 2011).
The investigation pointed out a component which indicated that the gag rule further increased the rates of abortions (documented or otherwise, the latter being more harmful):The countries most heavily influenced by the gag rule fell behind their counterparts in terms of advanced contraceptives (Bendavid, 2011). Disturbance of family arranging administrations by the gag rule, it appears, may prompt lower utilization of contraception, bringing about more unintended pregnancies, some of which end in actuated abortions. This view is upheld by an investigation of review pregnancy, abortion, and birthing data from Ghana’s 2007 Demographic and Health Survey (Jones, 2011). Utilizing women to months as the unit of investigation, this examination evaluated settled impacts relapse models and found that the first gag rule of 1984 and its reestablishment in 2001 were related with a 12 percent expansion in pregnancies in rustic parts of Ghana and that roughly 25 percent of these extra pregnancies finished in actuated abortion (Jones, 2011).
The Ghana investigation portrayed above is the special case that has straightforwardly analysed the impacts of past restatements of the worldwide gag rule on healthcare. Notwithstanding evaluating impacts of the gag rule on pregnancy, abortion, and fertility, that review likewise assessed impacts of the approach on two key pointers of childcare: stature and weight-for-age (Jones, 2011). Indeed, utilizing women settled impacts investigation, the examination looked at children conceived when the gag rule was set up to the individuals who were conceived when it was most certainly not (Jones, 2011). The two pointers of childcare were adversely connected with initiation of the gag rule.
Comparable to lines of thinking propose that the Global Gag Rule might be connected by comparative chains of causation to numerous other health problems. Maybe the clearest of these is maternal mortality (Kassebaum, 2014). More recent estimations propose that almost 300,000 women die every year from blunders related to pregnancy and labour (Kassebaum, 2014). Overall, an expansion in the occurrence of pregnancy may be relied upon to prompt a corresponding increment in the quantity of maternal death. Given that the expanded rate of pregnancy achieved by the gag rule is because of interruption of family planning programs, an unbalanced share of the overabundance pregnancies is probably going to be unintended (Kassebaum, 2014). Unintended pregnancies, thusly, are more probable than planned ones to end in instigated abortions of which an expected 56 million happen every year (Kassebaum, 2014).
Despite the Trump administration claiming to impose the policy on the world for the benefit of women, they are in fact, setting women’s rights back decades and causing more harm than any possible good. The dangers to the health of women and the well-being of their families is too great to ignore. When taking into account the recent natural disasters, combined with global political unrest and economic uncertainty, the gag rule will continue to do harm to the countries it is imposed upon. The governments of each country affected will be forced to reach out to other organisations to help or be faced with rising death rates or unwanted pregnancies (causing more economic and healthcare issues). It is unfortunate that those in power play with the lives of innocents under the guise of it being for their benefit. Not only does the policy endanger women, but it does the exact opposite of its intention and the studies above have proved this yet they are ignored. The Global Gag Rule is a ridiculously outdated policy that was put in place by a man with no clear understanding of women’s health and has been reinstated by a man of similar principles.
- (2017, January). Retrieved from Marie Stopes Interntional: https://mariestopes.org/news/2017/1/re-enactment-of-the-mexico-city-policy/
- (2017). Retrieved from International Planned Parenthood Ferderation: https://www.ippf.org/
- Bendavid, E. P. (2011). United States aid policy and induced abortion in sub-Saharan Africa,. Bulletin of the World Health Organization, 873–880.
- Cohen, S. A. (2001). Global gag rule: exporting antiabortion ideology at the expense of American values. The Guttmacher Report on Public Policy.
- Crane, B. B. (2004). Power and politics in international funding for reproductive health: the US Global Gag Rule. Reproductive health matters, 12, 128-137.
- Jones, K. M. (2011). Evaluating the Mexico City policy: How US foreign policy affects fertility outcomes and child health in Ghana,. IFPRI Discussion Paper 01147, IFPRI, Washington, DC.
- Kassebaum, N. J. (2014). Global, regional, and national levels and causes of maternal mortality during 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 980–1004.
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