The Global Gag Rule: A Lesson in Unintended Consequences

• Edwin S. Rubenstein
• June 8, 2021
• Forum Papers
• Forum Paper
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The Global Gag Rule: A Lesson in Unintended Consequences
An NPG Forum Paper
by Edwin S. Rubenstein
June 2021

A deadly pandemic. Record unemployment amidst a collapsing economy. Illegal immigrants surging across the southwestern border. Racial fears and animosity tearing much of the country apart.

Not since FDR have so many mega-crises confronted a new President on his inauguration day.

Overlooked in the deluge of laws and executive orders signed by President Biden in his first 100 Days is a document that, at the end of the day, may be more consequential than the others.

We speak of the “Memorandum on Protecting Women’s Health at Home and Abroad” signed by the President on January 28, 2021. The memo rescinds the Global Gag Rule (GGR – AKA, the Mexico City Policy) which denies U.S. financial aid to nongovernmental agencies if they “…advocate for, suggest, or even mention the word abortion.”

Mr. Biden’s move is no surprise. Since its roll out at an international population conference in Mexico City in 1984, the Gag Rule has been adopted and rescinded along strictly partisan lines in the first week of every new presidential administration. It was rescinded by Democratic President Bill Clinton on Jan. 22, 1993; re-instated by Republican President George W. Bush on Jan. 22, 2001; rescinded again by President Obama on Jan. 23, 2009; and re-instated again by President Trump on Jan. 23, 2017.

Implications of the GGR for global population growth are ambiguous. On the one hand, the goal of reducing abortion funding implies a desire to increase the number of live births, thereby increasing population growth. On the other hand, if GGR reduces support for family planning services, it could also lower access to modern contraception, thereby increasing unwanted pregnancies. This, in turn, could increase abortions because abortions and contraceptives are often seen as substitutes for each other.

Several studies have quantified GGR’s impact on abortions. Their results are remarkably similar. We summarize two of them below.

THE LANCET STUDY

In 2019 researchers for The Lancet Global Health Journal looked at data collected from sub-Saharan African countries during the Clinton, Bush and Obama administrations. Years when the gag rule was in place saw a 40% increase in abortion in the countries analyzed. This increase was mirrored by a decline in the use of modern contraceptives and increased pregnancies. “

In other words: the policy worked directly counter to its purported anti-abortion goals.”

Sub-Saharan women reportedly want fewer children, but their political leaders still believe that education and economic growth alone will trigger a reduction in fertility and population growth. Their ultimate goal is the elusive “demographic dividend,” a reduction in the number of children each worker must support.

“…To trigger such a sharp fall,” demographic scholars John May and Hans Groth wrote in 2017, “countries must achieve a contraceptive revolution in which more than 75 per cent of couples are using modern contraceptive methods. The current rate in Sub-Saharan Africa is only 26 per cent.”4 Given the Trump Administration’s recent expansion of the GGR to include family planning services, the much desired “contraceptive revolution” in Sub-Saharan Africa is probably less likely in Africa today than in 2017 when May and Groth wrote.

The good news: the deleterious pattern of more abortions and lower contraceptive use is reversed after the GGR is rescinded. “These alternating patterns during periods when the policy is in place …both strengthen the case for the role played by the policy and suggest that the effects of the policy are reversible.”

The Lancet researchers acknowledge that the full health consequences of GGR for women are not captured in their study: “Because abortions are an important cause of maternal mortality, the increase in abortion that we find might also increase maternal deaths – and possibly disproportionately given that abortions under the policy could be less safe if they were less likely to be performed or guided by experienced organizations and providers.”

THE RUTGERS STUDY

Professor Yana Rodgers, faculty director of the Rutgers Center for Women and Work, researches women’s health and labor market status around the world. In a 2018 study she found that women in Latin America and Africa were up to three-times more likely to have an abortion when the gag rule was in effect during President George W. Bush’s two terms (2001-08) than under the prior eight years of President Clinton.

Rodgers analyzed demographic and health survey data from 51 developing countries, covering about 6.3 million women. Using a rigorous statistical method known as regression analysis, she calculated the likelihood that women would have an abortion during and after the gag rule was in effect…. Continue reading the full Forum paper by clicking here.