Project 2025 pushes stricter antiabortion rules on foreign aid recipients.
The first time Donald Trump was president, he imposed a strict, overseas antiabortion policy that caused 108,000 women and children to die and 360,000 people to contract HIV/AIDS, according to a journal of the National Academy of Sciences. If voters send him back to the White House, those numbers, staggering as they may be, would be dwarfed by what comes next, reproductive rights advocates contend.
Trump, who claims responsibility for overturning the constitutional right to abortion in the United States, is widely expected to adhere to a conservative blueprint called Project 2025, which proposes to drastically reduce reproductive freedoms at home and abroad. In the U.S., that could lead to a national abortion ban or a marked reduction in medication abortions and insurance coverage of contraceptives. In other countries, it would prevent governments, nonprofits and international agencies that receive U.S. foreign assistance from providing, counseling or educating on, referring or advocating for abortion as a method of family planning—even with their own money.
It could also force thousands, perhaps millions, of women who are desperate to end unintended pregnancies to resort to unsafe, back-street procedures that put their lives at risk.
“I think the impact of these policies would be devastating for people around the world,” said Amy Friedrich-Karnik, director of federal policy for the Guttmacher Institute, a research organization that supports sexual and reproductive health and rights.
As the Republican presidential nominee, Trump has tried to distance himself from Project 2025, a guide for the next conservative president drafted by the Heritage Foundation and like-minded groups with the help of numerous former Trump administration officials. It mentions Trump and his administration a few hundred times in nearly 900 pages. (Trump’s campaign did not respond to inquiries for this story.)
“There’s every reason in the world to believe that he will do this,” said Terry McGovern, a professor of health policy and management at the City University of New York. She cited Trump’s eagerness to win over conservatives in 2016 by pledging to nominate Supreme Court justices who would overturn Roe v. Wade, which came to pass, and said he is the “wind beneath the wings” of the movement to ban medication abortion.
Project 2025 advocates a monumental expansion of a 40-year-old Republican policy that prevents some recipients of U.S. foreign aid from providing or discussing abortion. Although previous GOP presidents, including Ronald Reagan and both Bushes, applied the so-called Mexico City Policy to foreign non-governmental organizations that received U.S. family planning aid, Trump in 2017 enlarged it to encompass recipients of all foreign healthcare assistance. He also prohibited aid recipients from subcontracting with groups that did any abortion-related work, even if that’s not what they were hiring them to do.
Under Trump’s expanded policy, women lost access to safe abortion, to contraception, even to routine medical care such as cancer screenings.
Trump was able to make the changes legally via executive orders, without going through Congress. Each Republican president since Reagan has invoked the 1994 policy, called the “global gag rule” by detractors, and each Democratic president has revoked it. When it is imposed, the Mexico City Policy is layered atop a 1973 law known as the Helms Amendment, which prohibits using U.S. money to pay for overseas abortions.
Under Trump’s expanded policy, clinics in some of the poorest parts of the world had to choose between accepting U.S. money—often the bulk of their budget—and eliminating abortion-related care, or rejecting the money and reducing services, seeing fewer patients or, in many cases, closing down entirely. As clinics in remote villages shuttered, women lost access to safe abortion, to contraception, even to routine medical care such as cancer screenings.
Without access to birth control, more women had unintended pregnancies. Without access to safe abortions, particularly in countries that restrict or ban the procedure, they turned to untrained providers, according to several studies and interviews with researchers and reproductive rights advocates in the U.S. and abroad. Many suffered infections from botched abortions conducted with dirty needles and other foreign objects. Many ended up in hospitals. Too many never went home.
Other women tossed their newborns in rivers or poisoned them with Coca-Cola, witnesses reported.
The bottom line: The policy that was promoted to reduce abortions actually drove up their numbers and caused women and children to die, studies show.
Women and men lost other services as well, including testing and treatment for HIV/AIDS, malaria and tuberculosis. Infections shot up. About two-thirds of the health-care assistance money went to the President’s Emergency Plan for AIDS Relief, known as PEPFAR, a bipartisan program spearheaded by then-President George W. Bush and credited with saving 25 million lives.
Now, Project 2025 wants to go further—much further—than Trump did before. “Protecting life should be among the core objectives of United States foreign assistance,” it says. The plan would apply the Mexico City Policy, which Trump renamed Protecting Life in Global Health Assistance, to all foreign aid, including money earmarked for humanitarian crises. It would have Trump do unilaterally what Republican members of Congress have been unable to do with legislation.
“The danger for abortion is the same as what happened last time, but more,” said Gillian Kane, director of policy and advocacy at Ipas, an international organization that supports access to contraception and abortion.
The policy that was promoted to reduce abortions actually drove up their numbers and caused women and children to die.
In 2020, Trump imposed abortion restrictions on $7.3 billion in healthcare assistance, according to KFF, a nonpartisan organization that conducts health policy research. The Congressional Research Service, which provides Congress with nonpartisan analysis, put the figure at $8.8 billion. Either way, it represented a sharp increase from the $560 million that would have been affected had he limited the policy to family planning aid. But it’s nowhere near the $51 billion in foreign assistance that Project 2025 would attach Mexico City restrictions to, KFF found in an analysis based on fiscal 2022 assistance.
What’s more, the antiabortion rules would apply to a significantly larger set of recipients, including U.S.-based nonprofits, foreign governments and public international organizations like the United Nations and the World Health Organization. (Project 2025 calls for eliminating U.S. support for the U.N. Population Fund, a sexual and reproductive health agency and a regular casualty of Republican budgets.) None of these groups has had to deal with the restrictions in the past, and abortion-rights advocates caution that all would have a steep learning curve.
“This would be a truly radical and unprecedented expansion,” said Caitlin Ryan Horrigan, senior director of global advocacy for the Planned Parenthood Action Fund. “It would be the global gag rule on steroids.”
Advocates said they are particularly concerned about the consequences to women affected by humanitarian crises such as wars and natural disasters. In those cases, nonprofits and international agencies have to get up and running quickly and can’t risk being slowed by too many obstacles, they said.
McGovern, the CUNY professor and a leading researcher on the Mexico City Policy, said humanitarian agencies were long reluctant to provide abortion services, but finally did in response to escalating violence around the world. She fears that under Trump, they would stop.
“It’s truly heartbreaking and shameful,” added Horrigan. “These are entities that have never lived under the global gag rule, but we know well the harms that the global gag rule causes. So this would really be an unprecedented expansion and also a dangerous example of putting politics above people’s needs.”
This article was produced in collaboration with The Fuller Project, a journalism nonprofit that reports on global issues affecting women.
Up next:
At Ms. magazine, our mission is to deliver facts about the feminist movement (and those who stand in its way) and foster informed discussions—not to tell you who to vote for or what to think. We believe in empowering our readers to form their own opinions based on reliable reporting. To continue providing you with independent feminist journalism, we rely on the generous support of our readers. Please consider making a tax-deductible donation today if you value the work we do and want to see it continue. Thank you for supporting women’s voices and rights.
