Donald Trump's decision to block US funding for abortion services around the world could result in tens of thousands of women dying, with the decline of these services leading to millions of unsafe abortions in developing countries, aid organisations have warned.
Mr Trump signed an executive order reinstating a ban — known as the Mexico City Policy — which prohibits the US giving federal family planning funding to international health groups that provide abortion care. Shortly afterwards, the President's press secretary Sean Spicer said Mr Trump was “standing up for all Americans - including the unborn”.
But the policy is likely to hugely increase the rate of abortion in developing countries, causing the deaths of an estimated more than 21,000 women.
The ban, which was first implemented by Ronald Reagan in 1984 and has been enforced by all Republican administrations since then, has been called the “global gag rule” because it prevents medical professionals and aid workers whose work is supported by US grants from even discussing termination as an option for women with unwanted pregnancies.
The so-called 'gag rule' forces NGOs to choose between accepting family planning and being prohibited from providing abortion counselling, or refusing US family planning funds altogether and attempting to secure alternative sources of funding. This often means women and girls are prevented from accessing contraception and safe abortion consistent with the laws in their countries.
Mr Trump's move was condemned on Monday as an “assault on women’s health”, with activists warning the rule threatens to undermine the viability of countless groups that provide healthcare, including contraception and abortion services, to millions of women in the developing world.
Now it has emerged from reports in previous years that the policy is only likely to have the exact opposite effect to the one intended.
A 2011 study found enforcement of the gag rule by the George W Bush administration led to an increase in abortion rates in sub-Saharan Africa, likely because of lost contraception access, while a 2010 study stated that it “hampered Ethiopia’s efforts to address high rates of unsafe abortion”.
Marie Stopes International, an NGO that lobbies in favour of abortion and provides a variety of family planning services in both the UK and abroad, warned women in developing countries would “pay the price” for Mr Trump’s reinstatement of the Mexico City Policy, saying it would result in thousands more maternal deaths every year.
Because of its belief that safe abortion is a vital component of women’s reproductive healthcare, the organisation will lose all funding from the United States Agency for International Development (USAID) so long as the Executive Order is in place.
It warned the loss of services that will result from Mr Trump's reinstatement of the ban during his first term in office could result in 6.5 million unintended pregnancies, 2.2 million abortions, 2.1 million unsafe abortions and 21,700 maternal deaths.
Marjorie Newman-Williams, Vice-President and Director of Marie Stopes International’s international operations, said: “All the medical evidence, as well as everything we know from our daily interactions with women, is unequivocal: if you take safe abortion services out of the reproductive healthcare package, it exposes women to risk.
“Every year, 21.6 million women are so desperate to end their pregnancy they put their lives on the line by risking an unsafe abortion. Thousands of them die and millions more are left with life altering injuries.
"Agreeing to the Mexico City Policy would mean accepting their fate and turning our backs on the very women who need us most.”
Another NGO working on abortion services in developing countries, the International Planned Parenthood Federation (IPPF), warned that the impact of Mr Trump's decision would be "devastating".
Ms Amu Singh Sijapati, President of Family Planning Association of Nepal, where the organisation runs a -large US-funded project to strengthen family planning service delivery systems within Government Health Ministries, said: “Our USAID-funded projects have been really successful.
"Already we have been able to train health workers, expand clinics and provide a much broader mix of contraceptives choices like long acting methods through satellite services that are targeted to really disadvantaged groups.
"Funding cuts would mean we can't support 37 districts including supporting Government of Nepal effort on sexual and reproductive Health and rights. The impact also means we would lose essential medical staff like nurses, doctors and health experts. It would be devastating."
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