Within 72 hours of his inauguration, President Donald Trump reinstated the "global gag rule." The gag rule (otherwise known as the Mexico City Policy) insists that the government can't allocate any federal assistance to organizations worldwide that provide abortions, refer women to abortion providers, or even advocate for liberalized abortion policies. A version of the rule has been on the books since 1984, and it has been struck down or revived based on who's in power. But this latest iteration marks a horrific expansion; under Trump, it's not only organizations that receive family-planning dollars that have to comply with the regulation. Now any initiative that receives U.S. health funds must observe the rule or else waive essential aid.
Moreen Majiwa is the advocacy adviser for the Africa Program at the Center for Reproductive Rights. She lobbies governments and intergovernmental bodies to prioritize women's access to reproductive health care across Africa. Devoted to the pursuit of women's progress, Majiwa has come to believe that a true power balance between the sexes depends on two essential and intertwined realities: economic empowerment and reproductive freedom. Without access to contraception and education around abortion, "if a woman gets pregnant at thirteen, fourteen, fifteen, sixteen, her life choices immediately are narrowed, not just economically, but socially," Majiwa says.
Majiwa warns that this regulation, particularly in its expanded form, won't end abortion around the world; it will only increase the likelihood of perilous, sometimes fatal procedures. But for all the harm it will do, the reinstated rule has only fueled Majiwa's commitment to her cause. If any good is to come from this, it will be, she tells me, a renewed global pressure on governments to write policies that provide for women and families and are less reliant on fickle international aid. It's a sad consolation, she admits. But it reminds her that no man, not even the president of the United States, should have the power to decide our fate.
Mattie Kahn: Before the global gag rule was reinstated, what kinds of obstacles were already keeping women from getting access to the reproductive health care they need?
Moreen Majiwa: The problem, nationally, regionally, and globally, I think, is a conservative attitude towards reproductive health care and particularly towards women's access to abortion. This view creates policies that limit the circumstances in which women can access safe and legal abortions and drives women to seek unsafe underground abortions, which can result in either death or severe complications.
MK: Do you mean the attitude itself is part of the problem? That it's not only a lack of literal access that's hurting women, but the taboo around the procedure?
MM: Yes. The conservatism is not just in law and policy. It's attitude, and attitude does affect — even where [abortion] is legal in certain circumstances — people's willingness to access the service, because of stigma, mainly.
MK: Until last month, how were United States funds used to promote family planning or education around reproductive health care for women?
MM: For years, the United States has been a big supporter of family-planning initiatives, and that has included access to contraception, to quality maternal health care, to post-abortion care, which is needed mainly in cases where women have had an unsafe abortion and then later seek care for complications that arise from that.
MK: Are there initiatives you've seen on the ground that you think have worked especially well in the past?
MM: Clinics like [Marie Stopes International] and [Family Health Options Kenya] are U.S.-funded. They do a lot of work and have access to rural areas, which [public institutions] may not always reach. They provide access to health care for the poorest and [most] rural women. And in some places, without these kinds of NGOs and international funds, women there would not otherwise be able to access health-care services, and reproductive-health-care services in particular.