(WOMENSENEWS)– U.S. foreign aid to family planning clinics in developing countries could face trouble when committees of the GOP-controlled 114th Congress begin work this week.

Funding for the United Nations Population Fund (UNFPA), which provides reproductive health services in 180 countries, may also be at risk.

Although the U.S. has supported international family planning programs since 1969, the amount and scope of the programs has varied, depending on which party controls Congress and the White House.

“The midterm elections increased the stark divide on reproductive rights between Democrats and Republicans in Congress,” said Brian Dixon, senior vice president for media and government relations of Population Connection Action Fund, the Washington-based political arm of Population Connection. Formerly known as Zero Population Growth, the grassroots organization seeks to stabilize world population at a level that can be sustained by the earth’s resources.

“The loss of seven Democratic senators who were staunch supporters of international family planning programs and the ascendancy of Mitch McConnell of Kentucky as majority leader ended the Senate firewall that had prevented House Republicans from eliminating valuable programs for six years of the Obama administration,” Dixon said in a phone interview.

One target may be the $630 million in foreign aid for international family planning programs for fiscal year 2015. A Republican-controlled Congress is likely to slash these programs as Rep. Paul Ryan of Wisconsin, author of the GOP’s plan to balance the federal budget by 2023, has proposed.

Rep. Chris Smith, a New Jersey Republican who has introduced scores of anti-abortion bills during his 33 years in the House, is expected to propose legislation that would permanently impose the Mexico City Policy, widely known as the global gag rule. The policy has been a political flashpoint for three decades.

Smith, chair of the House Foreign Affairs Subcommittee on Africa, Global Health, Global Human Rights and International Organizations, says U.S. foreign aid should not be used to pay for abortions overseas.

Funding Prohibitions

The Mexico City Policy prohibits nongovernmental birth control providers, HIV/AIDS clinics and other reproductive health organization that receive U.S. aid for family planning from using their own money to fund abortions, provide referrals to providers or support campaigns to liberalize their country’s abortion laws.

Initiated by President Ronald Reagan before the 1984 United Nations Conference on Population in Mexico City, the executive order has been dubbed the “global gag rule.” The reason for that nickname: It is so stringent that nongovernmental reproductive health organizations in the developing nations cannot even mention abortion while counseling women who have unintended pregnancies.

The executive order was rescinded by Democrat Bill Clinton in 1993 and reinstated by Republican George W. Bush in 2001. During his first week as president in 2009, Obama overturned it, claiming that it was too broad.

The chances of Smith’s permanent global gag rule finding support in the Senate was enhanced by the election of four first-time senators in November. Like Smith, the former director of New Jersey Right to Life, Thom Tillis of North Carolina, David Perdue of Georgia, Bill Cassidy of Louisiana and Joni Ernst of Iowa emphasize their “pro-life positions.”

“The global gag rule has had a dire impact on vulnerable women by allowing critical family planning programs in the developing nations to be held hostage by the ping pong game of U.S. partisan polices,” said Dixon.

Many reproductive health organizations that refused to go along with the global gag rule were forced to close because of the lack of funding, Dixon added. “As a result, many poor women were unable to access contraception, which increased the number of abortions, maternal mortality and complications of childbirth.”

A Stanford University study published in the Bulletin of the World Health Organization in September 2011 found that the number of abortions more than doubled between 2001 and 2008 in African countries most affected by George W. Bush’s executive order.

Sen. Barbara Boxer of California and Rep. Nita Lowey of New York have led the Democratic opposition to the global gag rule over the years, claiming that it prevented nongovernmental organizations from fulfilling their obligation to provide comprehensive medical advice. Boxer announced late last week that she is not running for reelection in 2016.

This spring, Boxer and Lowey may reintroduce the Global Democracy Promotion Act, which would permanently repeal the rule. The act would ensure that foreign nongovernmental organizations that use their own funds to provide comprehensive reproductive health information and services, which are legal in the countries in which they operate and legal in the U.S., are eligible to receive U.S. foreign aid for family planning.

If the proposal fails to come to the floor of either chamber for a vote as it did in 2013, Boxer and Lowey may introduce amendments to appropriation bills for State Department operations.

U.N. Group Also at Risk

Funding for the UNFPA may also be on the chopping block, as it was during the Reagan and George W. Bush administrations as well as some years of the Clinton administration when the GOP controlled both houses of Congress.

Reagan eliminated the entire U.S. contribution of $39 million to UNFPA in 1985 because he claimed that the organization’s presence in China was tantamount to support for coercive sterilization because of China’s one child per family policy. The ban continued until 1993 when Clinton decided that the UNFPA did not indirectly support the practice anywhere.

For seven years, the George W. Bush administration withheld a total of $244 million in funds appropriated by Congress for the UNFPA because of allegations that the money was supporting forced abortions in China. A State Department inquiry found that the allegation was false and Obama lifted the ban and restored funds in 2009.

Over the years, Democratic Reps. Carolyn B. Maloney of New York, Barbara Lee of California and Rosa DeLauro of Connecticut have championed the UNFPA and are expected to do so again.

They serve on key committees that recommend appropriations for the State Department. They are in a position to propose amendments designating funds for a U.S. contribution to the UNFPA to prevent and treat obstetric fistula, end female genital mutilation and ensure safe childbirth and emergency obstetric care as well as UNFPA family planning programs in places such as sub-Saharan Africa where there is a dire need.

Despite the obstacles, progress has been made in meeting the family planning needs of poor women in developing nations, notes Sarah Craven, chief of the Washington office of the UNFPA.

“Since UNFPA began in 1969, the number and rate of women dying from complications of pregnancy or childbirth has been cut in half,” she said in a phone interview.

But, she added, there are still 225 million women who want to avoid or delay childbirth who lack access to quality reproductive services. “These women account for 81 percent of all unintended pregnancies in developing nations,” Craven said.

Public support for international family planning programs may encourage Congress to continue funding. A World Public Opinion poll found that 68 percent of Americans in 2009 said they favored programs for helping poor countries provide family planning and reproductive health services to their citizens.

The poll, a project managed by the program on international policy attitudes at the University of Maryland, found that 79 percent of Democrats, 58 percent of Republicans and 58 percent of independents favored the assistance.

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