Stealing Choice

The devastating impact of U.S. ban on abortion counseling in women's clinics around the world

Revolutionary Worker #1094, March 11, 2001, posted at

Two days after George W. Bush entered the White House--in one of his first public acts--the new president signed an executive order cutting off U.S. funds from any women's clinic or counseling center around the world that discusses abortion or promotes its legalization.

The timing was calculated: January 22 was the 28th anniversary of the Roe v. Wade Supreme Court decision that legalized abortion in the United States. Bush was starting his presidency with a public act of suppressing women's right to choose. And outside the White House, a rally of Christian-fascist opponents of abortion rights cheered his decision.

Bush's executive order resurrects old Reagan-era rules called the "Mexico City Policy." This ban denies U.S. funds from any organization that performs or supports "abortion as a form of family planning" in any way--even if those operations are funded from non-U.S. sources. In other words, this ban dictates how international family planning organizations can use funds they receive from other sources. U.S. funds will be cut off from any organization that engages in abortion counseling, abortion referrals, or performing abortions. Women's doctors and counselors will be forbidden to tell their patients where they can get safe abortions, even if those abortions are legal and available in that country. And more: this "global gag rule" requires that women's clinics and family planning organizations agree, in writing, that they will not campaign politically, within their own countries, for the legalization or funding of abortion. It forbids important medical services and political activity that still remain legal within the U.S.

At the same time the stage is also being set for new assaults on women's right to choose in the U.S. as well. George W. Bush's public position is that he supports the criminalization of abortion within the U.S.; and he intends to press for that in two ways: by increasing restrictions on abortion and by actively fostering a political, cultural, and religious climate that makes the complete abolition of abortion possible. Bush spokesmen have expressed support for the banning of RU 486, the morning-after contraception pill, the increasing criminalization of late term abortions, and the increase in parental consent laws which deny teenage women the right to choose.

In remarks leaked from a private meeting Bush recently held with Catholic Church officials, Bush said he expected that his plan for funding "faith-based" social work would contribute to a climate in which abortion could be made illegal again.

Blackmail and the Global Gag Rule

Even before Bush's new restriction on U.S. funds for "family planning," women around the world have suffered from a deadly lack of reproductive health services--especially in the poor and oppressed countries. International public health studies estimate that as many as 600,000 women die each year from the complications of pregnancy and childbirth. According to international health studies, infant and child mortality could be decreased 25 percent if women had more control over reproduction and could space out their pregnancies.

Birth control and safe abortions are widely unavailable and often illegal throughout much of the world. In South Asia alone it is estimated that more than 327 million couples who wish to practice family planning do not currently have access to affordable contraception. The World Health Organization estimates that 20 million abortions (40 percent of the total number of abortions) take place under extremely unsafe conditions--most of them in oppressed countries. At least a quarter of these unsafe abortions involve teenage women. Over 70,000 women die every year from such back-alley or self-inflicted abortions--and hundreds of thousands of women are injured in ways that will cause lasting health problems, including sterility and chronic pain.

The worldwide struggle for women's reproduction rights--including the right to safe, legal, affordable abortions--is crucial to the liberation of women from intense conditions of subordination and enslavement. And, as this latest White House decree shows, that struggle is tied in direct ways to the larger global struggle against imperialist domination and all the reactionary conditions imperialism imposes on the world.

There are about 450 overseas family planning organizations in over 50 countries that have been dependent on USAID funds to run their clinics and services--and have for years been developed in ways that serve U.S. policies. This year, in order to qualify for $425 million that USAID has allocated for "family planning, these NGOs (non-governmental organizations) have to conform to these new outrageous demands from the White House.

Those who comply will wear a U.S.-imposed gag over their mouths--knowingly denying women abortion counseling and services, while they agree to be politically silent in the important political struggle for reproductive choice in their own countries. Those who don't comply will be punished. They lose crucial funding for their operations, not just their abortion services but also other services like AIDS prevention, birth control distribution, sex education, and so on.

Who Controls Women's Lives?

The history of U.S. involvement in international "family planning" makes it clear that the imperialists are interested in funding "population control" but not "women's reproductive choice"--they want to stabilize the social order and labor supply in countries they dominate, without fundamentally undermining the traditional patriarchal domination over women.

It is revealing that even as the Roe v. Wade decision legalized abortion within the U.S., the U.S. government passed the notorious 1973 Helms Amendment that specifically denied any U.S. government funding for abortion outside the U.S.

During the Reagan-Bush years, these international anti-abortion policies were further strengthened with the "Mexico City Policy," which denied funds to any international agencies that discussed or performed abortion with non-U.S. funds. In 1993, the Clinton administration at first overturned the Mexico City Policy--U.S. aid recipients were allowed to provide such services provided they didn't use U.S. money to fund that part of their operation. But then in 1999, Clinton reversed his policy and cut back U.S. aid to international organizations that performed abortion-related activities with non-U.S. money. Clinton did this as part of a "deal" with Congress, in exchange for agreement to pay U.S. dues to the United Nations. In November 2000, Clinton and Congress negotiated another deal that increased funds for international "family planning." They lifted the 1999 restrictions on paper, but also held back the family planning funds until February 2001, so that the new president would be able to decide who got them.

Here, as on so many other issues, the Clinton-Gore administration helped implement intensely reactionary policies while being portrayed by its allies as "the lesser evil."

The back and forth of the Clinton years has already had an intense chilling effect on the willingness of clinics in many countries to provide abortion counseling. International Planned Parenthood reported, for example, that in 1999 only eight of its organizations in 156 countries performed "abortion related activities" (ARAs)--including information counseling, advocacy, and lobbying, as well as clinical services. Planned Parenthood made major concessions to imperialist politics by claiming it will never treat "abortion as a form of family planning," even though abortion is precisely a birth control of last resort for women.

Now that Bush has brought back the Mexico City Policy, the worldwide impact of U.S. anti-abortion policy will intensify. Large numbers of women will be denied abortions and information about abortion. The cutbacks in clinics that continue to provide abortion services will mean many other services will be denied women. International Planned Parenthood estimates that the cutbacks will deny birth control to 7 million couples (who would otherwise have received it), and that as a result, 4 million more women will experience unintended pregnancies.

For example, in Guyana, on the northern coast of South America, the clinics facing a cutoff currently treat about 10,000 women a year with counseling on abortions, birth control and prenatal care, while providing laboratory tests like pap smears, HIV screening, diabetes, and hypertension tests for people who would have no other place to go. Seventy percent of their funding comes from outside the country. This same story is repeated in reports from all over the world, including Moldavia, Albania, and much of Africa.

In many countries, family planning services are connected to AIDS diagnosis and prevention, plus general education in sexuality and sexually transmitted diseases. These will be directly affected, though it is hard to estimate exactly what the impact will be. HIV positive women who are pregnant will be denied a full discussion of their options.

In many countries, this ban will have the effect of shutting down reform movements that tried to lobby for women's rights within the reactionary government structures. In Nepal, for example, abortion is illegal, and half of women's deaths associated with pregnancy and childbirth are due to botched abortions. Various NGO organizations in Nepal which have received USAID funds have also been involved in a reform campaign to legalize abortion--now their strings are being pulled by the imperialists. This shows vividly how the Western "model of development" and the current pro-imperialist parliamentary system in Nepal operate as ways of enforcing the oppression and abuse of women.

In South Africa, where abortion only recently became legal, Planned Parenthood has 22 centers that provide information and counseling on abortion (along with information on detecting and preventing the epidemic AIDS disease). Twenty-five percent of their annual budget (about $650,000) comes from U.S. funds. The head of this organization told a U.S. newspaper that his forces do not intend to comply with U.S. demands.

Naked Imperialism

This attack exposes how so-called "aid" operates as an important mechanism enforcing a U.S. stranglehold over much of the planet. The U.S. government's "global gag rule" for women's clinics is an act of naked imperialism.

There are other imperialist moves going on: Now that the U.S. is threatening to cut off family planning aid, some European powers have stepped up to tweak the U.S. In response to Bush's announcements, Poul Nielson, the European Union's Development Commissioner, suggested that various European powers may step in to provide funds that Bush's "gag rule" cuts off. The European imperialists have long used NGO activities as a major way of strengthening their domination over Third World countries--and they are apparently willing to take advantage of the U.S. ban to increase that influence. This whole sick game underscores how oppressive it is that the lives of millions of people and worldwide networks of medical providers should be controlled by the interests of the imperialists and manipulated in games of global rivalry.

The questions must be asked: Why exactly does the U.S. government hold the purse strings and set policy for health care of people all over the world? Why are the most basic social services in so many countries run by NGOs controlled by the U.S., a few European imperialist countries and imperialist-dominated agencies like the UN? And how do we get these oppressors out of women's lives?

This article is posted in English and Spanish on Revolutionary Worker Online
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