It happened two days after the 2017 Women’s March.

In the United States alone, the Women’s March was the largest single-day protest in history. An estimated three–four million women attended across the country.

So it shocked many when President Donald Trump marked the march by spending his first day in the Oval Office passing an executive order that made access to healthcare more difficult for women around the world.

The Global Gag Order — also known as the Mexico City Policy or the “Global Death Warrant for Women” — strips foreign organisations of access to US funding if they offer abortion services, provide information about abortion services, refer women to other organisations for abortion services or advocate for pro-choice legislation. The policy was initiated by the Raegan administration in 1984 and reinstated by the second Bush administration in 2001.

But Trump has expanded the policy to have harsher effects on the global community. This version of the Global Gag Order does not only apply to family planning groups but covers all global health programs that receive US funding. Programs that prevent and treat the infectious diseases most prevalent in developing countries — HIV, tuberculosis and malaria — are now vulnerable to funding restrictions.

Upon signing the Global Gag Order, former White House press secretary Sean Spicer told reporters: “The President … has made it very clear that he is a pro-life president. He wants to stand up for all Americans, including the unborn, and I think the reinstatement of this policy … respects taxpayer funding as well.”

Although Trump’s pro-life position does affect American women’s access to reproductive healthcare, the Global Gag Order disproportionately impacts the lives of women and their families in developing countries — in ways beyond abortion access.

Before the Trump administration, the United States was the world’s largest donor to family planning and reproductive services. It was also the largest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Obama administration’s last annual donation, a sum of $1.35 billion, covered half of the Global Fund’s operating costs for 2016. This funding is now in question.

And this is just the start.

An array of evidence indicates that restrictions imposed by the Global Gag Order on family planning assistance could increase the number of abortions in developing countries. During the policy’s implementation under the Bush administration, the Planned Parenthood Association of Ghana saw 50 per cent more women come to their clinics for post-abortion care.

The paradox is that this policy is not only burdensome on NGOs but also ineffective. The trend is clear: when the Global Gag Order is imposed, the frequency of abortions only rises, with women pursuing dangerous and unregulated alternatives.

Current maternal health statistics are expected to worsen even further if funding for reproductive healthcare runs out. Currently, 225 million women in developing countries would like to prevent or delay pregnancy but do not have access to healthcare to do so. Complications from pregnancy and childbirth are the second leading cause of death for women aged between 15 to 19 globally; 22,000 women die from abortion complications annually.

Alarmingly, Marie Stopes International believes that the reinstitution of the Global Gag Order will cause in excess of 10,000 additional maternal deaths in Nigeria and approximately 2,000 in Malawi, Madagascar and Uganda respectively between 2017–2020.

Twelve months in, countries and private donors are attempting to lessen the Global Gag Order’s impact. However, even prior to the policy’s introduction, it would have taken the United States maintaining its input and international donors doubling their donations to provide sufficient family planning assistance globally.

The Global Gag Order is inhumane. Any adjustments to family planning in developing countries will only impose further challenges on women who are already among the most marginalised by policy.

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