B. U.S. Policies Undermining Global Abortion Rights

Anti-choice policy makers within the U.S. have demonstrated that they are not content with limiting their assaults on reproductive choice to the established rights of women in this country. The exercise of U.S. influence in other countries has been a primary tool in their attempts to prevent access to safe and legal abortion worldwide. Of course, opponents of women’s reproductive rights have not always been successful, and at times the United States has been a leading proponent of women’s reproductive rights internationally. For example, the U.S. championed women’s reproductive rights during the 1994 International Conference on Population and Development, the 1995 Fourth World Conference on Women, and the five-year reviews of these conferences.¹⁰⁶ However, as the following examples demonstrate, U.S. foreign policy has also been used to impose incremental infringements upon women’s reproductive rights, beginning in 1973 and setting the stage for the start of the Bush administration.

1. The Helms Amendment

The United States government has supported international assistance for family planning and other reproductive health services since the 1960s.¹⁰⁷ However, in 1973—the same year that Roe was decided—ultraconservative Senator Jesse Helms sponsored an amendment to the Foreign Assistance Act prohibiting the use of federal money "for the performance of abortions as a method of family planning or to motivate or coerce any person to practice abortions." ¹⁰⁸ The following year, the U.S. Agency for International Development ("USAID") established its own policy, later codified, that prohibits U.S. funding for "information, education, training, or communication programs that seek to promote abortion as a method of family planning."¹⁰⁹ USAID later adopted an extremely restrictive interpretation of the phrase "abortion as a method of family planning," construing it to mean that no U.S. funding could be used for any abortion except to save the life of a woman or in cases of rape or incest.¹¹⁰ Moreover, U.S. government officials have attested that no U.S. funding has been used to provide abortions even in those limited circumstances.¹¹¹

2. The Global Gag Rule

In 1984, the Reagan administration imposed further restrictions on U.S. assistance for family planning and reproductive health services. The so-called "Mexico City Policy"—the predecessor to the current "global gag rule"—prohibited nongovernmental organizations ("NGOs") in other countries from receiving U.S. funds if, with their own funds and in accordance with the laws of their own countries, they "perform[ed] or actively promote[d] abortion as a method of family planning."¹¹² The Reagan administration issued extremely method of family planning" to mean almost all abortions, with the only exceptions for cases of rape, incest, or when the life (but not health) of the woman would be endangered if the fetus were carried to term.¹¹³

The three primary lawsuits challenging the original Mexico City Policy were unsuccessful.¹¹⁴ The courts in two of the cases addressed the issue of nonjusticiability, and concluded that although USAID’s implementation of the Mexico City Policy was deemed to be justiciable, the Mexico City Policy itself was deemed to be a nonjusticiable political question.¹¹⁵ The challenges to USAID’s implementation of the former Mexico City Policy on the First Amendment grounds of freedom of association and speech were also rejected.¹¹⁶ President Clinton abolished the global gag rule during his presidency,¹¹⁷ except for a brief period when anti-choice members of Congress demanded re-imposition of the restriction in exchange for payment of arrearages of U.S. dues to the United Nations.¹¹⁸

3. Abortion Politics Impacting United Nations Population Fund

Another sporadic victim of right wing activism has been the United Nations Population Fund ("UNFPA"), an agency that provides no abortion services.¹¹⁹ From UNFPA’s establishment in 1969 through the mid-1980s, the United States was a leading supporter of its work to improve the health of women and children around the world.¹²⁰ However, under the Reagan administration in the mid- 1980s, family planning opponents targeted U.S. assistance for UNFPA by alleging that it was complicit in coercive population policies in China, including forced sterilization and abortion.¹²¹ Even though a 1985 USAID review found that UNFPA did not promote or support coercive practices, the U.S. withheld its contribution from fiscal years 1986–1992, using the mere existence of a UNFPA program in China as its rationale.¹²² A lawsuit challenging the United States’ withdrawal of UNFPA funding was rejected.¹²³

Since that time, the United States has been an unreliable UNFPA funding source, because reproductive rights opponents exploit concerns about China’s policies as an excuse to withhold assistance for UNFPA’s reproductive health services.¹²⁴ In FY 1999, anti-family planning members of Congress succeeded in completely stripping UNFPA funds from the budget,¹²⁵ although U.S. funding was reinstated the following year.

III. The Present Crisis: The Resurgence of U.S. Anti-Choice Fundamentalism at Home and Abroad Under the Bush Administration

Since the installation of the Bush administration in January 2001, the core principles of Roe have been vigorously challenged through a variety of measures that threaten women’s reproductive rights. Moreover, the anti-choice forces within the Bush administration seem determined to project their ideology onto women throughout the world. This section provides a glimpse into both the heightened offensive against reproductive rights within the United States and the torrent of anti-abortion fundamentalism that is being exported throughout the world by the Bush administration and the anti-choice factions controlling Congress. The examples of initiatives discussed below expose a consistent pattern of measures that, when considered as a whole, reveal a mounting assault on women’s reproductive rights around the world.

A. Domestic Initiatives Eroding Abortion Rights

As described in previous sections, while abortion opponents have made significant strides between 1973 and 2000, their most severe attacks on women’s right to terminate unwanted pregnancies have to a certain extent been rebuffed (for example, a constitutional amendment outlawing abortion, abortion method bans, and spousal vetoes). During the Reagan and first Bush presidencies, federal anti-choice initiatives were held somewhat in check due to a Democrat-controlled Congress. This standoff reversed during the Clinton administration: after the Republican takeover in Congress in 1995, numerous attempts to roll back reproductive rights through federal legislation were largely unsuccessful due to the backstop of a pro-choice presidential veto.¹²⁶ Although anti-choice gains were certainly realized during these periods, the general impasse between anti- and prochoice forces in the federal government to a certain extent frustrated the anti-choice movement’s attempts to make greater progress on the national political front.¹²⁷ However, with the inauguration of President George W. Bush in 2001, the opponents of choice again embarked upon a quest to assert their power at the federal level. Additionally, as a result of the 2002 midterm elections, the reproductive rights movement is facing the most hostile political environment in this country’s modern history. As the various initiatives below demonstrate, the newly strengthened opponents of choice in the Bush administration and Congress are attempting to further undermine Roe’s core principles.

Several key initiatives demonstrate President Bush’s determination to undercut Roe’s principles within the United States. Perhaps most significantly, the President is stacking the federal judiciary with judges who oppose Roe v. Wade, and has vowed to do the same with U.S. Supreme Court appointments.¹²⁸ President Bush has indicated that he is seeking to fill the judiciary with individuals in the mold of Justices Antonin Scalia and Clarence Thomas, two of the most conservative members of the Supreme Court, who are opposed to women’s reproductive rights. With the addition of one additional anti-choice justice to the Court, the landmark decision in Roe v. Wade protecting a woman’s right to privacy could be overturned.¹²⁹ The President has also implemented numerous policy initiatives that undermine the legal underpinnings of Roe. For example, the Bush administration has implemented regulations bestowing rights upon fetuses, embryos, and even fertilized eggs, making them eligible as beneficiaries for the State Children’s Health Insurance Program ("SCHIP").¹³⁰ These regulations establish an embryo or fetus, from the moment of conception, as a separate beneficiary of government programs, in an attempt to undermine Roe’s finding that "the word ‘person,’ as used in the Fourteenth Amendment, does not include the unborn."¹³¹ While efforts should be made to expand women’s access to pregnancy-related health care, the extension of SCHIP to cover fetuses—rendering pregnant women’s health needs incidental— is fraught with legal and practical problems.¹³² In a similar vein, President Bush also directed the Advisory Commission on Human Research Protection to consider embryos as "human research subjects," ¹³³ which raises similar tension with Roe’s core principles.

In another bow to the right wing, President Bush has appointed Dr. David Hager—seemingly more credentialed in theology than in science—to the Reproductive Health Drugs Advisory Committee, which is the Food and Drug Administration’s ("FDA") committee overseeing women’s reproductive health.¹³⁴ Under the Bush administration, the FDA has let the committee’s charter lapse, thus allowing the president to fill all eleven positions with new members. During his career, Dr. Hager has reportedly refused to prescribe contraceptives to unmarried women, suggested that women who suffer from premenstrual syndrome should seek help by reading the Bible and praying, and endorsed the medically inaccurate assertion that the common birth control pill is an abortifacient.¹³⁵ Initially President Bush had floated the idea of appointing Dr. Hager to chair the committee, but due to the national outcry in opposition, the President ultimately decided against such a controversial move and appointed Hager to be a member of the committee, but not chair.

Additionally, under the Bush administration, the U.S. Department of Health and Human Services ("DHHS") has compromised minors’ access to confidential health services by modifying the federal privacy rules.¹³⁶ The new regulations give broad discretion to health care providers to disclose medical information to a minor’s parent, as long as the disclosure does not violate applicable state law. Right-wing lawmakers are also moving anti-choice legislation through Congress. Just one day after the 2002 midterm elections, the then-incoming Senate Majority Leader Trent Lott promised to enact a ban on so-called "partial-birth abortions."¹³⁷ As promised, in 2003, Congress passed and President Bush signed into law the "Partial-Birth Abortion Ban Act of 2003."¹³⁸ This abortion ban directly flouts the U.S. Supreme Court’s opinion in Stenberg v. Carhart, which the Center for Reproductive Rights successfully litigated in 2000.¹³⁹ The federal law is being currently challenged in federal district court by the Center for Reproductive Rights on behalf of Dr. Leroy Carhart, by the American Civil Liberties Union on behalf of the National Abortion Federation, and by Planned Parenthood Federation of America. All three challenges have yielded temporary restraining orders at the time of this Article’s publication.

Another example of a federal initiative aimed at undermining abortion access is the Child Custody Protection Act ("CCPA").¹⁴⁰ CCPA would criminalize the act of knowingly transporting a minor across state lines for the purpose of obtaining an abortion if the minor has not first complied with the forced parental involvement law of her state of residence. CCPA would apply to any person other than a minor’s parent, including another relative or a doctor.¹⁴¹

This legislation would place an undue burden on a minor’s ability to obtain an abortion by undermining her ability to have the procedure in a neighboring state. It would further violate principles of federalism and state sovereignty by imposing federal standards and foreign state laws on the state to which the minor is traveling. Finally, it would violate the constitutional right to travel.¹⁴²

In addition to promoting abortion method bans and undermining access, abortion opponents are also supporting the expansion of fetal rights through the Unborn Victims of Violence Act ("UVVA").143 This bill, similar to many introduced in state legislatures, would amend the federal criminal code to create a separate offense for death or bodily injury to a fetus during the commission of a federal crime. The penalty would be the same as that of death or injury to the pregnant woman herself.¹⁴⁴ The bill elevates the status of a fetus, embryo, blastocyst (pre-implantation embryo), or zygote (fertilized egg) to that of the woman for purposes of the offense, and would treat such entities as independent persons for purposes of federal law.145 Furthermore, lawmakers have rejected an approach that would accomplish the same end without establishing fetal rights.¹⁴⁶ The Abortion Non-Discrimination Act ("ANDA")¹⁴⁷ is another bill on the anti-choice agenda. Rather than providing protection from "discrimination" for those who decline to provide abortions, as the bill’s sponsors claim, this misleading and far-reaching legislation attempts to reduce available health care options for women, reverse longstanding state and federal protections for women’s reproductive rights, and usurp the authority of state and local governments to regulate health care. This bill would allow a broad range of health care entities to refuse to comply with federal, state, and local laws and regulations pertaining to abortion services. The vagueness of the bill’s language makes its exact implications unclear. However, the law arguably prevents states or local governments that receive any federal funding from enforcing laws requiring provision or referral for abortions, or payment or coverage for abortion services. Moreover, because the term "abortion" is not defined, anti-choice extremists will undoubtedly claim that certain forms of contraception, such as birth control pills, IUDs, and emergency contraception, are covered by the Act.¹⁴⁸

B. Abortion Politics in U.S. Foreign Policy

Along with the increasingly restrictive domestic abortion policies, the global anti-choice campaign through U.S. foreign policy has intensified since President George W. Bush first took office. For example, on January 22, 2001, President Bush re-imposed the global gag rule on funding for international family planning and reproduc- tive health programs provided through USAID.¹⁴⁹ In an attempt to take this policy a step further, in the fall of 2002, several members of Congress sent a letter to the Bush administration requesting that the global gag rule be extended to apply to U.S.-based organizations,¹⁵⁰ a move that would clearly be unconstitutional, and also to apply to U.S. assistance for international HIV/AIDS programs.¹⁵¹ Initially the Bush administration indicated its intent to impose a version of the global gag rule on HIV/AIDS funding, but it retreated in the face of significant protest against this proposal. However, there is no assurance that the global gag rule will not be applied to HIV/AIDS programs in the future.

Additionally, President Bush did expand the global gag rule in August 2003 to include all family planning programs funded through the U.S. Department of State.¹⁵² The original gag rule applied only to funding administered through the U.S. Agency for International Development. Senator Harry Reid (D-NV) quickly reacted to the expansion and included an amendment to the Commerce, Justice, State appropriations bill that would effectively block the use of State Department funds to implement the expanded policy.¹⁵³ In addition to the Reid amendment blocking the expansion of the gag rule, Senator Barbara Boxer (D-CA) offered an amendment to the Foreign Relations Authorization Act that would repeal the gag rule. The amendment passed the Senate by a vote of 53–43,¹⁵⁴ but will most likely be taken out in the conference report of the bill due to a veto threat from the president. In July 2002, after pressure from anti-family planning groups, the State Department announced that it was once again blocking the $34 million appropriated by Congress for the UNFPA.¹⁵⁵ Opponents of UNFPA again insisted that since coercive abortions and sterilizations have occurred under China’s population program, UNFPA must be deemed guilty by association.¹⁵⁶ Disregarding UNFPA’s documented efforts to convince the Chinese government to adopt a voluntary reproductive health program and abandon the "one-child policy," the conservatives in the U.S. demanded that the United States abandon UNFPA. They were even undeterred by the findings of a "blueribbon" panel of experts appointed by the Bush administration to investigate the allegations against UNFPA. The panel found that not only were the allegations unsubstantiated, but also that UNFPA’s work in China is an effort to encourage the Chinese government to adopt voluntary family planning services and should continue to be supported.¹⁵⁷

At the United Nations General Assembly Special Session on Children in May 2002—which was intended to address all issues affecting the lives of children, including the high rates of HIV/AIDS infection, unwanted pregnancy, sexual violence and exploitation, and child marriage—the Bush administration’s delegation opposed the phrase "reproductive health services" in the consensus document, claiming that it implied access to abortion.¹⁵⁸ In the end, the U.S. agreed to retain references to reproductive health care, and in return was granted its bid to weaken references to the importance of the Convention on the Rights of the Child in the agreement.¹⁵⁹ This is but one example of the Bush administration’s continued opposition to reproductive health services at numerous international conferences, with others including the HIV/AIDS Summit¹⁶⁰ and the Summit on Sustainable Development.¹⁶¹

Additionally, in December 2002, U.S. officials at the Fifth Asian and Pacific Population Conference in Bangkok, Thailand, indicated that they would not "reaffirm" provisions from previous agreements on reproductive health and family planning, and would only "take note of, acknowledge or recall" these commitments agreed to at earlier international conferences.¹⁶² One of these agreements was the Programme of Action adopted at the International Conference on Population and Development ("ICPD"), which was adopted in 1994 by 179 nations, and which the United States had been instrumental in drafting.¹⁶³ The Bush administration delegation in Bangkok stated that the United States does not support language promoting the concept of "reproductive rights," since that term can be interpreted as promoting abortion.¹⁶⁴

The United States’ refusal to ratify the Convention on the Elimination of All Forms of Discrimination Against Women ("CEDAW")¹⁶⁵ is also due in part to anti-abortion politics. Numerous opponents of CEDAW have made unsubstantiated claims that this treaty creates an obligation to allow "abortion on demand."¹⁶⁶ The treaty, itself, however, does not mention abortion, and the U.S. State Department has indicated that the treaty is "abortion neutral."¹⁶⁷ Senator Helms, during a 1994 hearing, added an "understanding" to the treaty that reaffirms the position that the treaty is "abortion neutral" and does not promote abortion as a method of family planning.¹⁶⁸ Numerous countries with restrictive abortion laws have ratified this treaty without reservations.¹⁶⁹ The committee¹⁷⁰ monitoring implementation of the treaty has made no direct calls for recognition of a right to choose abortion. It has, however, reiterated internationally shared concerns about women’s inability to prevent unwanted pregnancy and about high levels of maternal mortality due to unsafe and illegal abortions. It has further recommended that governments address these problems by reviewing their countries’ family planning and abortion laws and policies. The committee has also condemned coercive abortion and the use of abortion for sex-selection.¹⁷¹ In light of these facts, the claims of CEDAW opponents are, at best, misleading attempts to derail U.S. ratification of this important foreign policy instrument.

IV. VIEWING THE WHOLE PICTURE: REFLECTIONS ON THE GLOBAL IMPLICATIONS OF U.S. ANTI-CHOICE POLICIES

Just as Roe v. Wade’s positive reverberations were felt worldwide in the decades that followed, U.S. backpedaling on reproductive choice has had negative implications around the world. The mounting assault on women’s reproductive rights in other countries through explicit U.S. foreign policy directed at undermining those rights is pain fully apparent. However, all too often the policy makers in Washington, D.C., do not make the connection between their actions and the significant impact those actions have upon the health, well-being, and, indeed, the very lives of women living in remote areas of the globe.

It is much easier for opponents of choice to convince U.S. lawmakers to impose restrictions on the reproductive rights of women in other countries than on the rights of women in the U.S. For one thing, the protections of abortion rights guaranteed to American women under the U.S. Constitution do not apply beyond the borders of the United States.¹⁷² Additionally, women in other countries have little influence over U.S. politics. As one writer observed:

[G]iven that abortions are legal in the United States and are required to be medically sound, why would an American president seek to deny that standard of healthcare protection to the rest of the world?

Here’s why: Women in other countries can’t vote in U.S. elections, but the members of the National Right to Life Committee not only vote but also donate to candidates and political action committees.¹⁷³ U.S. policy makers can placate a conservative constituency by imposing severe abortion restrictions on women in other countries and, at the same time, turning a blind eye to the impact of those policies.

Moreover, U.S. policy makers and the general public are also largely unaware of the significant impact that the domestic abortion debate within the U.S. has upon the issue of abortion in other countries. Foreign governments and nongovernmental organizations who depend upon U.S. assistance for survival have every incentive to implement policies within their own countries that will not offend the U.S. government and jeopardize their funding. When anti-choice rhetoric surrounding domestic politics in the United States increases, it has a ripple effect upon public response to abortion in other countries.

This section briefly examines the impact that the anti-choice U.S. foreign and domestic policies have upon women’s access to abortion around the world. The U.S. foreign policy decisions made in Washington, D.C., based on anti-choice political considerations, have drastic consequences upon the lives of women throughout the world, especially in impoverished countries. An estimated forty to fifty million abortions take place annually, and at least twenty million are performed under unsafe, illegal conditions.¹⁷⁴ Up to half of women undergoing unsafe abortions require post-abortion care for complications. Millions of women suffer permanent physical injuries, and at least 70,000 women die each year.¹⁷⁵ Most of these deaths and injuries are preventable, and occur in countries where abortion is either illegal altogether or highly restricted.

Although the restrictions on women’s right to choose imposed upon women within the United States are considerable and growing, as discussed in the previous sections, the restrictions that the U.S. government imposes upon women in other countries have much more severe consequences. Within the United States, almost no deaths or injuries result from unsafe abortion, and the maternal mortality rate is relatively low at seven deaths per 100,000 live births.¹⁷⁶ By way of contrast, in Kenya, where abortion is forbidden except to save the life of a pregnant woman, the maternal mortality rate is 590 deaths per 100,000 live births, and 35% are due to unsafe abortions. Between 30% and 60% of all admissions to gynecology wards in Kenya are women needing medical care for post-abortion complications. ¹⁷⁷ Yet the United States is exporting policies that ensure that the legal status quo will remain in place in countries such as Kenya, and that women will not have access to safe abortion services. Where abortion is restricted, the legal constraints on women’s decisions will not end abortions, but will inevitably lead to higher health risks, especially for indigent women.

It is extremely difficult to determine the full extent of the harm to women caused by the global gag rule,¹⁷⁸ in large part because the restriction "gags" organizations from discussing abortion. Nonetheless, some reports of its impact have emerged.¹⁷⁹ The government of Bolivia has reportedly indicated that, as a direct result of the U.S. policy, it will no longer endorse life-saving care for women suffering complications from illegal, unsafe abortions.¹⁸⁰ Bolivian organizations also report that because of the global gag rule, their government has suspended efforts to permit distribution of emergency contraception, which prevents pregnancy and thereby reduces abortions.¹⁸¹ In Zimbabwe, the director of a health care organization has privately indicated support for liberalization of Zimbabwe’s stringent abortion law to reduce the number of women dying from abortion. Since his organization is subject to the global gag rule, however, he stated in an interview for a newspaper article that his organization did not support the legalization of abortion.¹⁸² At the time President Bush reinstated the global gag rule in 2001, in Nepal over 500 women were dying from pregnancy-related complications for every 100,000 live births (compared with seven maternal deaths per 100,000 births in the United States)—half as a result of illegal, unsafe abortion.183 The global gag rule forced several organizations in Nepal to choose between giving up their desperately needed U.S. assistance or giving up their efforts to reform the abortion law (that allowed no exceptions, even if a woman would die as a result of a pregnancy) under which 20% of women in prison were incarcerated for the crime of abortion. 184 In Kenya, the global gag rule forced a vital health care organization to shut the doors of three of its health care clinics in rural areas of the country.¹⁸⁵

The outcry against the global gag rule has resonated across the globe. In the days immediately following President Bush’s announcement, countries including Australia, Canada, Sweden and the United Kingdom ran television, radio, and newsprint stories about the severity of the restriction.¹⁸⁶ Governments condemned the new U.S. directive as not only detrimental to women’s health and lives, but also as an affront to international human rights standards protecting freedom of speech and the right of citizens to participate in their own democratic political processes. In direct response to this outcry, four representatives from European parliaments traveled to Washington, D.C., in June 2002 to try to convince their American counterparts to listen to the rest of the world—or at least to their closest allies—and repeal global gag rule. Representative Tony Worthington from the United Kingdom stressed that, "[m]y colleagues and I believe that if America gives into the domestic pressures that it faces, it will not cut the number of abortions—it will stimulate them, particularly unsafe abortions for the poorest women in the world. [The global gag rule] will kill large numbers of people."¹⁸⁷

It is also difficult to measure the impact of the Helms Amendment upon women’s access to abortion around the world. As noted above, the Helms Amendment forbids U.S. funding of abortion services, as well as advocacy concerning abortion law reform. Because, like the global gag rule, its effect has been to petrify laws that criminalize abortion, law reform that may otherwise have taken place has not gone forward. Over the last three decades, such law reform might have prevented innumerable deaths resulting from unsafe, illegal abortions. The Helms Amendment’s chilling effect on discussion of the health impact of restrictive abortion laws is reflected in the "Guidelines for Authors" of the publication International Family Planning Perspectives, a peer-reviewed journal serving, among others, policy makers and members of the public health community. The guidelines state: "Because the journal receives funding from the U.S. Agency for International Development, it is prohibited under the Helms Amendment (P.L. 93-189) from publishing material that pro- 185 The Family Planning Association of Kenya ("FPAK") has closed three clinics. See THE GLOBAL GAG RULE IMPACT PROJECT, THE IMPACT OF THE GLOBAL motes abortion."¹⁸⁸ The president of Ipas, an organization founded in 1973 to prevent unsafe abortion in impoverished countries, stated (partly in response to the Helms Amendment): U.S.-funded family-planning clinics in developing countries where abortion is legal have systematically denied poor women the basic rights to safe abortion care that most American women would come to take for granted.

The Helms Amendment not only denied women services in U.S.- funded programs but effectively gave U.S. endorsement to unjust, restrictive policies that have endangered the lives and health of millions of women.¹⁸⁹

Furthermore, the Bush administration’s decision to eliminate funding for UNFPA due to domestic abortion politics is severely restricting that agency’s ability to provide reproductive health care services in approximately 140 countries, compromising the health, wellbeing, and even lives of millions of women and their children.¹⁹⁰ UNFPA provides women access to vital reproductive health care services such as emergency obstetric care, pre- and postnatal care, contraception, sexually transmitted infection prevention and treatment, post-abortion care, and other desperately needed services. The thirtyfour million dollars in funding that was withdrawn by the United States in 2002 could have enabled UNFPA to prevent two million unwanted pregnancies, nearly 800,000 abortions, over 77,000 infant and child deaths, and 4,700 maternal deaths.¹⁹¹

By withholding funding for reproductive health services due to domestic abortion politics, and by imposing the global gag rule and Helms Amendment, which deny women access to safe and legal abortions, the United States government is complicit in the injuries and deaths of hundreds of thousands of women throughout the world each year.

B. U.S. Contribution to Hostility Toward Global Abortion Rights

As discussed in previous sections, although the global trend is a movement toward increasing human rights for women, including reproductive rights, there is a small but growing countertrend bent on dismantling these rights. This international countercurrent has been significantly strengthened by the reinvigorated anti-choice agenda espoused by the current U.S. government—not only through its foreign policy agenda, but also through international exposure of the assaults on abortion rights in the U.S.¹⁹² Therefore, in addition to the direct impact of U.S. foreign policy restrictions, such as the global gag rule, the Bush administration’s high profile condemnation of abortion in its domestic policy and positions taken at international fora may also be having an effect on national-level campaigns to liberalize abortion in countries where it is illegal.

The United States government has given ammunition to conservative forces in other countries who couch opposition to abortion in moral—and even misguided health-related—terms, based upon their interpretation of U.S. abortion policies. For example, in Mali, a women’s rights activist spoke of a common assumption that if the United States takes a position on an issue, it has done so following evaluation of concrete, scientific evidence.¹⁹³

In addition, the United States’ willingness to withhold funding as punishment for support—or perceived support—of abortion has led to a fear in some countries that abortion law reform may result in a loss of U.S. financial assistance. For example, prior to the liberalization of abortion in Nepal, there were fears among those aware of the de-funding of UNFPA that abortion law reform would lead to a similar reprisal against the government of Nepal.¹⁹⁴ While these fears ultimately did not prevent reform in that country, they may have a more significant chilling effect in other countries.

The Bush administration and anti-choice members of Congress have ignored the fact that women’s rights advocates in every nation where abortion remains restricted continue to fight for safe, legal abortion because they see it—as the majority of women in the U.S. do—as integral to their ability to control their fertility, preserve their health and well-being, and participate as equals in their societies. Women in these countries want what women in the U.S. have come to take for granted—access to safe abortion services as part of their reproductive health care. In response, the Bush administration is joining forces with its fundamentalist counterparts at the United Nations and in regional venues, thereby giving strength to emerging far right religious movements worldwide.¹⁹⁵

The U.S. government’s renewed fundamentalism raises questions about further consequences, especially when considered in the context of women’s struggles to achieve fulfillment of their broader reproductive rights. For example, is the fundamentalism and traditionalism that the United States exports to other countries helping to foster the climate in which the Vatican launches a campaign against life-saving condoms in the midst of a worldwide HIV/AIDS crisis?196 In which the government of Iran can contemplate promoting "temporary marriages" to allow men to purchase the sexual services of women—who are often young and forced into prostitution by abusive families or husbands, a practice defended as permissible under the Shiite branch of Islam?197 In which pregnant women needing emergency obstetric care in Afghanistan are still inhibited from seeing a doctor by religious clerics stating that their situation is "Allah’s will"?¹⁹⁸ According to a press release from the Alan Guttmacher Institute concerning the Bush administration’s string of anti-choice initiatives, "the Bush administration has sided with the Vatican, as well as ‘axis of evil’ countries Iran and Iraq and others not known for their support of women’s rights, including Libya, Sudan and Syria."¹⁹⁹ The press release quoted Adrienne Germain, president of the International Women’s Health Coalition, as stating that "[t]his alliance shows the depths of perversity of the [U.S.] position. On the one hand we’re presumably blaming these countries for unspeakable acts of terrorism, and at the same time we are allying ourselves with them in the oppression of women."200 As noted in the conclusion, prochoice policy makers must vocally oppose all forms of reproductive rights abuses against women, which are exacerbated globally by the United States through what has been described as President Bush’s "war against women."²⁰¹

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