Seeking protection from Russian bombing and shelling amidst a siege of their city, thousands of civilians in Bucha bunkered down in subways and basements. But for some, the reprieve from artillery was not enough. For women and girls, there was no shelter from the sexual violence inflicted by Russian soldiers.
Rape, sexual slavery and forced pregnancy are among the war crimes reportedly suffered by women and girls in Bucha and in wider Ukraine. Yet, the cruelty endured by these victims does not end there. Thanks to U.S. policy, abortion may be unavailable to these women and girls.
Because the Ukrainian health system is drastically strained, international humanitarian aid is playing an outsized role in delivering healthcare throughout the country. But all humanitarian aid provided by the U.S.—the largest single-country donor of humanitarian assistance to Ukraine—is subject to the Helms Amendment, which limits the use of U.S. foreign assistance funds for abortion. In this way, rather than alleviating their suffering, U.S. aid could be the reason that victims of wartime rape are denied abortions and forced to give birth.
First enacted in 1973 following its proposal by the infamous segregationist, Sen. Jesse Helms, the Helms Amendment is a pernicious force in restricting abortion globally. It provides that no U.S. foreign assistance funds “may be used to pay for the performance of abortions as a method of family planning or to motivate or coerce any person to practice abortions.” This language technically permits abortions for rape, incest and life endangerment (as these abortions are not forms of ‘family planning) but as currently implemented, Helms amounts to a total ban on abortion care. This means that if funded by the U.S., humanitarian organizations—who may be the only healthcare providers available—routinely deny pregnant people access to life-saving care.
Rather than alleviating their suffering, U.S. aid could be the reason that victims of wartime rape are denied abortions and forced to give birth.
Most would agree that it is morally repugnant to force anyone who has been raped to maintain resultant pregnancies. It is also a violation of international law: denying access to abortion in cases of rape violates the human right to be free from torture and cruel, inhuman and degrading treatment and from discrimination. For women in countries experiencing armed conflict, international humanitarian law provides a right to access non-discriminatory medical care, including safe abortion care.
In expansively applying the Helms Amendment, the U.S. runs afoul of international law and inflicts devastating consequences on those already bearing the barbarity of war. The need for safe abortion increases exponentially in a humanitarian crisis like Ukraine. In addition to sexual violence, women and girls in conflict zones experience impeded access to contraception. Early marriage rises. As does human trafficking. Many pregnant people feel unable to become parents amidst the death and displacement of war. Food and water may be scarce. Other women may be active in the defense of their communities and be disinclined to manage a pregnancy or become a parent while on duty. Women’s health deteriorates in crisis and maternal mortality rises.
Even outside of the contexts of war and disaster, as the largest global health funder in the world, the US plays an enormous and sometimes determinative, role in the availability of healthcare worldwide. In this way, the Helms Amendment can eliminate, or at least severely restrict, abortion care options even in countries where abortion is legal under national law. This forces millions of women to look outside healthcare systems for abortion access to unsafe, and often deathly, abortions. As identified in a study by the D.C.-based Guttmacher Institute, the Helms Amendment leads to approx. 19 million unsafe abortions and 17,000 maternal deaths annually. It is remarkable that the US considers itself a champion of women’s rights in the world while its policies exact such an extraordinary toll on women’s mortality.
Women and girls in conflict zones experience impeded access to contraception. Early marriage rises. As does human trafficking. Many pregnant people feel unable to become parents amidst the death and displacement of war. Food and water may be scarce.
In recent years, Democrats in Congress have attempted to eliminate Helms via the Abortion is Health Care Everywhere Act but this bill has stalled in the House and the Senate has not yet introduced a companion bill.
Notwithstanding this slow progress, there are steps the Biden administration can take now, on its own, to mitigate the harmful impacts of Helms. The Biden administration should issue guidance from its relevant agencies to immediately clarify that U.S. foreign assistance funds can be used to support abortion care in cases of rape, incest or life endangerment of the pregnant person. Failing to do so means U.S. policies on abortion will continue to brutally punish women for seeking to exercise their reproductive rights.
Though ensuring access to safe abortions for victims of sexual violence will not grab as many headlines as buying tanks for Zelensky’s military, decision-makers should not be in any doubt about its exigency. Anyone in Congress or the White House who is serious about their solidarity with Ukraine should ensure that the Helms exceptions are implemented, then commit to a full repeal of the amendment. Rhetoric on standing with war victims in Ukraine (and elsewhere) will ring hollow for victims of sexual violence until they do so.
Sign and share Ms.’s relaunched “We Have Had Abortions” petition—whether you yourself have had an abortion, or simply stand in solidarity with those who have—to let the Supreme Court, Congress and the White House know: We will not give up the right to safe, legal, accessible abortion.