I first met Fatima and her four young children at a coffee shop in downtown Amman in the summer of 2014. With tears in her eyes and her youngest son asleep in her arms, she recounted the details of her harrowing escape from Syria’s southwestern Daraa province and her experience crossing the border into Jordan.
Not everyone in Fatima’s family escaped safely. Her husband and brother, she explained, were missing and presumed dead after a raid in her village had left her home and community decimated. She was alone, struggling to make ends meet and desperate for help. She and her children were traumatized. And she was pregnant.
Unwanted pregnancy occurs everywhere, but it is especially concerning in crisis settings, where displaced and refugee women are among the most vulnerable of at-risk populations. As a recent Guttmacher Institute report on refugee reproductive rights points out, “Women’s needs do not suddenly stop or diminish during an emergency—in fact, they become greater.”
When Fatima reached out to me in 2014, I was working with a Jordanian non-governmental organization to strengthen protections against sexual and gender-based violence and provide critical sexual and reproductive health services to refugees from Iraq and Syria. Fully funded by the U.S. Department of State’s Bureau of Population, Refugees and Migration, our work involved developing strong referral pathways for refugees in need of family planning support, including abortion services.
Thankfully, I was able to connect Fatima with the medical and psychosocial support that she so desperately needed. She was able to safely terminate her pregnancy and was provided with contraceptives and counseling as she worked to rebuild her life in Jordan. But five years later, I would be barred from providing women like her with the same level of care. Under the Trump administration’s reinstatement and expansion of the dangerous and illegal Global Gag Rule, I would be “gagged”—and women like Fatima would be denied information critical to their health and their futures.
Renamed “Protecting Life in Global Health Assistance,” Trump’s iteration of the Global Gag Rule requires foreign non-governmental organizations to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source—including non-U.S. funds—in order to receive U.S. government global family planning assistance.
The Global Gag Rule, coupled with congressional funding restrictions such as the Helms and Siljander Amendments, has had a dangerous chilling effect on abortion services and speech. Many grantees actively avoid even permitted services and speech due the complexity of the regulations and fears of losing their critical U.S. funding.
As a State Party to the International Covenant on Civil and Political Rights (ICCPR), the U.S. is bound by specific legal obligations—including the right to non-discrimination, the right to life, the right to be free from torture, cruel, inhuman or degrading treatment and the right to free speech and free association. U.S. abortion restrictions on foreign aid, however, prevent women from accessing necessary healthcare, erode the freedoms of speech and association, limit democratic debate and restrain other countries from complying with their human rights obligations. In short: They violate international law.
Dangerous and illegal U.S. abortion restrictions on funding have weakened organizational networks and partnerships around sexual and reproductive health and rights. These restrictions place aid grantees in the often untenable position of choosing between limiting their essential sexual and reproductive health services to continue receiving U.S. funds or losing their U.S. funding completely.
Fatima’s case was far from unique. It is estimated that approximately one-quarter of the 129 million people around the world who require humanitarian assistance are women and girls of reproductive age. According to an April 2018 Inter-Agency Working Group for Reproductive Health Services in Crisis report, over 2,400 Rohingya refugees in Cox’s Bazar, Bangladesh, are pregnant or lactating and require urgent maternal health care support; a field report by Medecins Sans Frontieres found so many women coming into their hospitals bleeding that it was “easy to speculate that they’re starting termination of pregnancy at home.”
Whether at home, displaced or in crisis, women and girls like Fatima need and deserve comprehensive reproductive health services, including access to safe abortion. It is long past time for the U.S. to repeal these regressive and harmful policies that violate its human rights obligations.
Names have been changed.