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Every time the White House changes political parties, the new president either gets rid of or reinstates something called the Mexico City policy. Essentially, it bars any organization that receives U.S. foreign health assistance from offering or even discussing abortion services. President Trump reenacted the policy just three days after his first inauguration. Many in the global health world expect he will do so again. NPR's Fatma Tanis reports.
FATMAS TANIS, BYLINE: Forty years ago, during a UN population conference in Mexico City, the Reagan administration made an announcement. Any group working in reproductive health overseas that wanted U.S. funding had to certify it would not offer abortion. It would not even counsel or discuss abortion. The Mexico City policy quickly got a nickname.
ELIZABETH SULLY: We call it the gag rule...
TANIS: Elizabeth Sully is the principal research scientist at the Guttmacher Institute, a research organization that supports abortion rights.
SULLY: ...Because it silences what organizations can even say about abortion in their own countries. I would say it's a policy that aims to limit abortion care that's available globally, regardless of who's providing the funding for that care.
TANIS: The policy was basically an expansion of an existing law that prohibited U.S. funding of abortion overseas. Elyssa Koren is with ADF International, an advocacy group that opposes abortion rights. And she says the policy aims to force NGOs to focus on providing health care to mothers and children rather than promoting abortion.
ELYSSA KOREN: This policy doesn't restrict NGOs from providing essential health services like maternal and child health care, and also from focusing on the alleviation of poverty, which we know is a primary driving factor for these really devastating maternal mortality and child mortality statistics.
TANIS: But several studies indicate the policy has made it harder for women in low- and middle-income countries to get health care. Linnea Zimmerman is an associate professor at Johns Hopkins University.
LINNEA ZIMMERMAN: One of the main consequences of the Mexico City policy is something that we call the chilling effect.
TANIS: So organizations, afraid to lose U.S. funding, tend to limit their programs more than they need to, leading to more restrictions on women's health care. And that, she says, has led to cutbacks in health services, like for HIV patients and cervical and breast cancer screenings. Zimmerman says research has shown that the policy has almost no effect on bringing down global abortion rates, but it has led to an increase in unsafe abortions.
ZIMMERMAN: When the Mexico City policy is in place, women have less access to contraception. They have less access to information about sexual and reproductive health. They're more likely to have an unintended pregnancy. And when that happens, women are less likely to have access to a safe abortion.
TANIS: When President Trump took office in 2017, he expanded the policy to apply to nearly all U.S. global health assistance, not just family planning and reproductive health. Elizabeth Sully says the effect was substantial.
SULLY: So that's going from just a little over $600 million a year to close to $12 billion. So just the scale, the number of organizations impacted, it was drastically different in this iteration of the policy.
TANIS: President-elect Trump and his team have not yet revealed their plans for the policy, and they didn't respond to NPR's request for comment on this story. But Trump, like all Republican presidents, is widely expected to reinstate the Mexico City policy soon after taking office in January.
Fatma Tanis, NPR News. Transcript provided by NPR, Copyright NPR.
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