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Global Gag Rule Must Not Be Domesticated

Wednesday, June 25, 2008

If Democrats take back the White House, a U.S. restriction on overseas family planning aid should be lifted. Meantime, Carol Roye says, watch out for a domestic version of the "global gag rule" in the Bush administration's final days.

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If Democrats take back the White House, a U.S. restriction on overseas family planning aid should be lifted. Meantime, Carol Roye says, watch out for a domestic version of the "global gag rule" in the Bush administration's final days.
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Carol Roye

(WOMENSENEWS)--Reproductive health advocates far and wide are hoping for a Democratic victory in November to unbind us all from the "global gag rule."

But now is not the time to look ahead. During the waning days of the Bush administration, the Family Research Council--founded in 1988 by Dr. James Dobson to lobby for such "traditional family values" as abstinence-only sexuality education and stamping out women's right to choose--is doing what it can to domesticate this destructive foreign-aid policy.

As several major international family planning organizations have reported, the Mexico City Policy--as the global gag rule is formally known--compromises the health of millions of women, men and children in poor nations by eroding access to contraceptives and condoms.

It has led to more unwanted and high-risk pregnancies, more unsafe abortions and more maternal illness, injury and death. It has also prevented couples from reducing their risk for HIV-AIDS because they have no access to condoms. The gag rule costs poor countries tens of millions of dollars in lost aid every year.

The Family Research Council and its allies are petitioning President Bush to "make the necessary changes to Title X regulations to prevent U.S taxpayer funds from being used to promote and facilitate abortion" and expand the international policy to restrict domestic health clinics.

Their petition says that locating family planning and abortion services in the same facilities "sends the wrong message, defies congressional intent and should not be allowed." Translation: If Title X funds are used to pay for Pap smears in one room, then abortions performed in another room are also being paid for by Title X so all funding must be withdrawn.

Petitioners appear to be taking this step now so Bush can take the political heat for instating a domestic gag rule, leaving a would-be President John McCain in the clear on this issue.

As a nurse practitioner this gives me a horrible case of deja vu. I've worked under a gag rule and I can tell you that everyone who cares about women's health should move to prevent it.


Partisan Benchmark

Party flags don't fly over the White House but for many years the global gag rule has shown whether Democrats or Republicans are in residence.

The Reagan administration first imposed the rule in 1984 at a world population meeting in Mexico City--hence its formal policy name--the Democratic Clinton team took it away in 1993 and the GOP George W. Bush administration reinstated it in 2001 as one of its first acts.

Just what is this partisan standard bearer?

It's a ban on U.S. family planning aid--including shipments of free condoms and contraceptives--to foreign nongovernmental organizations and clinics that have anything at all to do with abortion. It's called a gag rule because it not only bans U.S. aid for abortions in all but the most dire circumstances it goes so far as to silence--or "gag"-- clinicians from even talking about the option of abortion or lobbying to legalize abortion in their country.

Since many clinics have foregone U.S. aid under these conditions they have missed shipments of condoms and contraceptives, thus curbing their ability to help prevent unwanted pregnancies and HIV transmission. Whatever Dobson's Family Research Council may say, the gag rule, whether global or domestic, is anti-family because it jeopardizes the health of women and thus harms children.


Title X Funds at Stake

A domestic gag rule here in the United States, as envisioned by the Family Research Council and its allies, would change the rules on Title X funds.

Regulations already restrict these funds from paying for abortions except under specified circumstances such as threat to the woman's life. But they do require that pregnant women be offered nondirective, accurate information about their options and referral for appropriate care.

If the Family Research Council has its way--and given its strong influence it might--Title X facilities would either have to stop providing abortions or build separate facilities in which to do so, which would be prohibitively expensive.

For over 30 years Title X funds have provided vital public funding to clinics such as those operated by Planned Parenthood to pay for a range of services for women, including Pap smears, breast exams, screenings for sexually transmitted diseases and contraception.

Over the past seven years the rising number of uninsured women of reproductive age has made Title X an increasingly important source of essential health services. At present, over 17 million women are uninsured, an increase of 1.2 million since 2004.

The Family Research Council is also demanding that health care providers withhold information about abortion, overruling American Medical Association guidelines that require doctors and nurses to inform pregnant women of all their options.


Practical Experience

Between 1988 and 1993 Title X legislation did prohibit doctors and nurses from providing information about abortion, even if the patient requested it. This domestic gag rule was so controversial that it was not implemented nationwide. However, it was very much in effect at the inner-city clinic in New York where I was a nurse practitioner.

Many of my patients were teen mothers. When I asked the representatives of the federal government who came to our clinic what I could tell a tearful, frightened 16-year-old who asked about abortion, I was told to say it is "outside the purview of what I can discuss."

Saying this to a patient, especially an adolescent, is tantamount to refusing to help her. It is dismissive and dishonest. Incredibly, I was also not permitted to refer her to an obstetrician who might mention abortion.

A domestic gag rule would only increase the number of women who cannot get Pap smears, breast exams or birth control and who face unwanted pregnancies and abortions. It would inflict hardships on low-income women and their families.

In this election year, we must make sure that the candidates--and voters--know how important it is to defend the right of all women--both here at home and overseas--to receive accurate information and comprehensive care.

Carol F. Roye, EdD, RN, CPNP, is a professor at Hunter - Bellevue School of Nursing at Hunter College and director of the school's Center for Nursing Research. She is also a pediatric nurse practitioner, with a practice in adolescent primary and reproductive health care. You can visit her Web site, Women's Health Is A Family Value, at http://www.carolroye.org.

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