Between a Woman and Her Doctor Is No Place for U.S. Policy | Commentary

Posted September 8, 2014 at 4:10pm

You’ve probably heard of this summer’s Supreme Court decision in Burwell vs. Hobby Lobby that let employers pick and choose what birth control methods they would cover, inserting themselves in a key decision between a woman and her doctor. Many Americans were justifiably angry. What you might not know is there’s a U.S. policy that’s been undermining the trust between women and their doctors around the world for the past 30 years.

This policy is the Global Gag Rule. Also known as the Mexico City Policy, it is a relic of the Reagan administration, first introduced at an international conference in Mexico City in 1984. It has been imposed by every Republican president and repealed by every Democrat since then.

In essence, the gag rule denies foreign organizations receiving U.S. foreign aid for family planning the right to use their own non-U.S. funds to provide information, referrals or services for legal abortion. This includes not only reproductive health care providers, but private hospitals and clinics.

Organizations are left with a no-win choice between losing their U.S. funding and losing their ability to be honest and provide comprehensive health care to patients. The Global Gag Rule is even more reprehensible because it endangers women’s health in countries where accessible and high-quality health care is already too scarce, and where pregnancy can pose serious health challenges.

Physicians take an oath to put their patients above all else. According to the American College of Obstetricians and Gynecologists, the policy’s restrictions “violate basic medical ethics by jeopardizing a health care provider’s ability to recommend appropriate medical care.” Trust is the cornerstone of the doctor-patient relationship, but this policy violates that trust by restricting health providers from providing information, counseling or referral on all legal pregnancy options.

By dictating what organizations can and cannot say and how they spend their money, the gag rule compromises women’s health and undermines health care infrastructure. Shortly after the reinstatement of the policy in 2001 under the Bush administration, shipments of U.S.-donated condoms and contraceptives completely ceased to 16 developing countries, primarily in Africa. In many countries, the policy forced providers that declined U.S. funding to close clinics, cut services and increase fees. Established health care referral networks collapsed as key family planning clinics downsized and struggled to cope with budget cuts.

No matter which choice an organization makes, a woman’s health care options shrink under the gag rule, increasing the likelihood that she will seek an unsafe abortion from an underground provider.

Though President Barack Obama repealed the gag rule upon taking office in 2009, the threat remains that it could be legislatively reinstated if an anti-choice candidate wins the White House in 2016. The good news is there’s also a way to get rid of the gag rule for good. The policy can be permanently blocked legislatively. That’s why we support the Global Democracy Promotion Act to do just that, along with 123 members in the House and 23 Senate colleagues.

Just because a woman lives outside of our borders doesn’t mean she deserves any less from her doctor. By failing to end the Global Gag Rule, U.S. policymakers have been telling women that we know better. Isn’t it time to send a different message?

Rep. Ami Bera, D-Calif., is a physician who has represented California’s 7th District since 2013. Suzanne Ehlers is president and CEO of Population Action International.