NEW YORK― Women’s health clinics from Iowa to Kenya have been forced to close their doors. International nonprofits have lost the ability to provide birth control, HIV testing and fistula surgeries in the poorest communities around the world. Half a million U.S. teenagers no longer have access to sex education programs.
In a single year, President Donald Trump has already decimated reproductive rights and access to family planning in the U.S. and around the globe. He reinstated and massively expanded the Global Gag Rule, restricting $8.8 billion in U.S. foreign aid funding for international health programs that provide or even mention abortion. He defunded the United Nations Population Fund (UNFPA), a global maternal health organization that provides contraception and pregnancy care to low-income women in 150 countries. The group had relied on U.S. money to help to prevent 295,000 unsafe abortions ― a leading cause (13 percent) of maternal deaths around the world.
International health workers are already seeing the effects of Trump’s policies on women and girls.
“Girls aren’t able to get contraception, and they’re starting to come back pregnant, suicidal, bereft,” said Lisa Shannon, a global women’s rights advocate who works with reproductive health clinics in East Africa. “They’re desperate, and they’ll do whatever it takes. The only difference here is that the women will die from unsafe abortions.”
There is no comprehensive data yet on how many clinics around the globe have had to shut down because of the Global Gag Rule, but there is plenty of anecdotal evidence to show its effects. Family Health Options Kenya, a network of family planning and reproductive health clinics, is closing half of its 16 clinics this year because it had relied on the United States for 60 percent of its overall funding. The group’s Mombasa clinic has already shut down, leaving women and girls without a family planning clinic nearby. And its clinic in Kibera, the largest urban slum in Africa, has had to scale back services, lay off staff and stop its mobile outreach program, by which its staffers traveled to provide contraception, cancer screenings and medications to women in remote areas that otherwise have no health care access.
Any reduction in family planning access is devastating to women in Kenya, where unsafe abortion is a leading cause of death. The country also has one of the highest counts of HIV infections in the world, and the same clinics that provide retroviral medications and condoms are the ones being shut down or at least crippled by the U.S. anti-abortion policy.
“Trump’s Global Gag Rule was a death sentence,” Shannon said. “Women are dying right now because of it, and not in small numbers.”
His Policies Affect The U.S. Too
Meanwhile, here in the United States, Trump has assembled one of the most anti-abortion cabinets in history, stacked federal courts and the Supreme Court with anti-abortion judges who could serve for the next several decades, and interfered with access to birth control and abortion for low-income women and immigrants.
First, the president appointed Judge Neil Gorsuch to the Supreme Court, whose conservative record suggests that he would vote to overturn Roe v. Wade, the landmark 1973 abortion rights decision. Gorsuch has twice sided against Planned Parenthood funding and birth control access.
In April, Trump signed an executive order giving states the okay to defund Planned Parenthood, the nation’s largest family planning provider. The following month, Planned Parenthood had to close four clinics in Iowa due to state funding cuts, leaving 15,000 patients to find a new health care provider.
The Trump administration then cut more than $200 million in federal grants to 81 teen pregnancy prevention programs around the country, leaving an estimated 580,000 students without access to comprehensive sex education. And in October, Trump rolled back the Obama-era requirement that guaranteed birth control coverage at no out of pocket cost to 62 million women. All employers are now able to opt out of including birth control in their health insurance plans for any moral or religious reason.
The president has also stacked his administration with anti-abortion activists. Charmaine Yeost, the former CEO for Americans United for Life, is now the Assistant Secretary for Public Affairs at HHS. She believes abortion should be banned entirely, and she opposes some forms of birth control. And Teresa Manning, who has said birth control doesn’t work, is overseeing the nation’s Title X federal family planning program, which Trump is aiming to defund entirely in his budget.
Trump’s pick for director of the Office of Refugee Resettlement, Scott Lloyd, recently tried to block a detained immigrant teen rape victim from having an abortion because he personally opposes it. And just this week, the administration established a new federal office within HHS that would protect health providers who refuse to offer women abortion care on moral grounds.
“Now that the Trump administration has filled these agencies with right-wing appointees, they are busy under the cloak of darkness repealing access to care,” Cecile Richards, president of Planned Parenthood, told HuffPost. “The steady dismantling of women’s rights and access to affordable care is going to have long-term consequences, and it’s our job to make sure the American people are aware of it.”
“While the president is tweeting and saying crazy things, Pence is executing a campaign to really dismantle health care for women.”
Richards suspects that Vice President Mike Pence, rather than Trump himself, is driving the administration’s policies on women’s health. Before joining Trump’s campaign, Pence led the GOP’s fight against legal abortion in the House of Representatives for half a decade.
“[Pence] is the real mastermind in the White House, systematically trying to undermine women’s reproductive rights,” she said. “While the president is tweeting and saying crazy things, Pence is executing a campaign to really dismantle health care for women.”
Trump has stumbled and wavered on the issue of reproductive rights throughout his career. He once called himself “very pro-choice,” and he defended Planned Parenthood during a GOP primary debate in 2016, conceding that “millions of women are helped” by the organization. He then angered the anti-abortion movement when he said at a town hall event during his presidential campaign that if abortion became illegal, women should “face some sort of punishment” for undergoing the procedure. Many viewed him as playing into a progressive narrative about Republicans aiming to punish and patronize women.
But anti-abortion activists have warmed up to Trump since his administration has so relentlessly dismantled reproductive rights. And on Friday, Trump became the first sitting president in U.S. history to address the anti-abortion March for Life rally.
“Under my administration, we will always defend the very first right in the Declaration of Independence and that is the right to life,” Trump said in his speech.
But the Trump administration has so far failed to make good on two of his biggest campaign promises ― defunding Planned Parenthood and repealing the Affordable Care Act ― despite Republicans having control of the House and Senate. Richards offers that as a glimmer of a hope and a sign that women may have more power to resist Trump’s agenda than he realizes.
“You couldn’t go to a single town hall meeting without facing angry women in pink hats and T-shirts,” Richards said. “That was something we’ve never seen on that level.”
The 2017 Women’s March was likely the largest single-day protest in American history, and women are expected to show up in force again this weekend at the second annual march. Women are also running for office in greater numbers than ever before, so it may be more difficult after the 2018 elections for Trump to dismantle access to abortion.
“Because of Trump’s policies,” Richards said, “women are now the most important political force in the country.”