Cutting US aid to family planning organizations in poor countries led to significantly more abortions: Study

The Mexico City Policy, which was reinstated by Donald Trump in 2017, prohibits US foreign assistance to any organization that performs or provides counseling on abortion


                            Cutting US aid to family planning organizations in poor countries led to significantly more abortions: Study

A US policy which bans federal funding to any organization that performs or provides counseling on abortion has led to substantially more and probably riskier abortions in poor countries, shows the most comprehensive study that measured the impact of the policy between 1995 and 2014.

Called the "Mexico City Policy" or the "Global Gag Rule", the policy prohibits US foreign assistance to any organization that performs or provides counseling on abortion.

Many organizations affected by this policy are also providers of modern contraception.

The latest study shows that the policy has led to a 40% increase in abortions in sub-Saharan African countries reliant on US foreign aid.

Besides, the use of modern contraception declined, and pregnancies increased among women living in countries highly affected by the policy when it was in effect.

This pattern of more frequent abortions and lower contraceptive use was reversed after the policy was repealed, suggesting a “causal effect”, the findings state.

“Our findings suggest that curbing US assistance to family planning organizations, especially those that consider abortion as a method of family planning, increases abortion prevalence in sub-Saharan African countries most affected by the policy,” say the researchers in the paper.

They add, “The analysis is the first to show that the Mexico City Policy is followed by increased abortions, which are likely to be unsafe abortions, and that this outcome is reversible with greater support for family planning organizations.”

According to the researchers, decisions about the allocation of global health resources from the US—the world’s largest donor of development assistance in absolute terms—are closely linked to domestic abortion politics.

“In particular, the Mexico City Policy has guided family planning aid from the US since 1984. First announced in Mexico City by the Reagan administration at the International Conference on Population, the policy requires all non-governmental organizations operating abroad to refrain from performing or counseling women about abortion as a strict prerequisite for receiving US federal funding,” says the paper. 

The study uses data from 26 sub-Saharan African countries and over two policy transitions—from Clinton to Bush, then from Bush to Obama (1995-2014)—and compares rates in countries that had high or low exposure to the policy.

Rescinded by Democratic President Bill Clinton on January 22, 1993, it was reinstated by Republican President George W Bush on January 22, 2001.

It was repealed by Democratic President Barack Obama on January 23, 2009, and reinstated again by Republican President Donald Trump on January 23, 2017. 

Results reveal that abortion rates rose considerably among women in sub-Saharan African countries with high exposure to the policy relative to countries less exposed.

According to the analysis, restrictions imposed by the policy are reflected in a reduction in modern contraceptive use (14% lower prevalence of modern contraception use), an increase in pregnancies (12%), and an increase in abortions (40%) among women living in countries highly affected by the policy during periods when it was in effect.

“The implications of the policy for fertility behavior and maternal health are ambiguous and unclear. On the one hand, the policy’s restrictions on abortion funding imply an intended goal to reduce abortions. On the other hand, if the policy curtails the operations of organizations that provide family planning services, it could also limit the supply of modern contraception. This, in turn, may have the unintended consequence of increasing abortions because modern contraception and abortion are substitutes in some contexts: lower modern contraceptive use might lead to more unintended pregnancies, and more abortions,” say the findings.

The study was published on June 27 in The Lancet Global Health.

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