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George W. Bush's global anti-abortion policy has spread confusion and alarm among international family-planning organizations that fear his "gag rule" could leave women, especially in Catholic Third World countries, without birth-control assistance and with higher death rates from botched abortions.
Criticism has poured in from international family-planning organizations that have battled the spread of AIDS, the abuse of women and the crushing burden of poverty in the Third World. But Bush has made clear he is determined to press ahead with a policy favored by his conservative, anti-abortion constituency in the United States.
To circumvent opposition in the U.S. Congress, Bush has decided to issue a presidential memorandum to implement the "global gag rule" barring federal aid going to international groups that use their own money to support abortion rights, according to press reports. The memorandum will give greater weight to a policy that Bush first announced on Jan. 22, two days after his inauguration.
"Under the gag rule, recipients of U.S. family-planning funds must give up the ability to provide legal health services and their basic human right to take part in important policy debates in their own countries -- in short the very integrity of their programs," complained Ingar Brueggemann, director of the International Planned Parenthood Federation. "Either choice hurts the poorest in the world."
Brueggemann said the IPPF opposes abortion as a method of family planning and seeks to reduce the number of abortions by making contraceptives available around the world. Still, its criticism of Bush's policy could cost it U.S. assistance that amounts to about 8 percent of its budget.
Though a relatively small amount of IPPF's budget, the loss of U.S. government money would curtail some of the group's programs that have nothing to do with abortion. For instance, IPPF supports Bemfam, a Brazilian family-planning organization that is dedicated to helping the people of Brazil control family size in a country where 60 percent of the people live in poverty.
In Brazil, a Catholic country, abortion already is tightly restricted. Those laws have contributed to women turning to illegal abortions to end unwanted pregnancies, dangerous procedures that have made botched abortions a major cause of women's deaths in Brazil, according to the Alan Guttmacher Institute.
Bush's restoration of the "gag rule" is viewed as likely to increase the numbers of women dying from unsafe abortions in Brazil and elsewhere, according to some family-planning specialists.
Besides the danger of death from botched abortions, women in Brazil and some other Latin American nations face at least one year in prison if they undergo a clandestine abortion and are arrested. The risks are heavier again for poor women who can't afford to pay for safe abortions and can face arrest if they seek emergency care in a public hospital.
Cutting the availability of the family planning services also might prove counterproductive to the goal of reducing the number of abortions. Susane Tew of the Guttmacher Institute said recent studies have shown that the better abortion and contraceptive services available in a country, the fewer abortions that country registers.
Though Bush's policy could curtail programs at some better-funded organizations, such as the IPPF, those group could survive a cutoff of U.S. aid. Other family-planning organizations are much more dependent on U.S. support and could be forced to close down.
The Center for Development and Population Activities, for instance, is concerned that it could lose 75 percent of its funding if it is judged in violation of Bush's rule. The center is nervous because it has urged the release of Min-Min, a woman in Nepal who was jailed after she was forced to have an abortion to end a pregnancy resulting from a rape when she was 13 years old.
Other supporters of family planning believe that Bush's policy could roll back broader progress that women have achieved in gaining power over their lives.
These critics note that even the Vatican -- a powerful male bastion that has led the fight against abortion rights -- has shown some interest in finding common ground with other religions. The Vatican hasn't compromised much but has begun to recognize that a problem with unwanted pregnancies exists and that there is a need for family planning.
In 1994, the International Conference on Population and Development in Cairo brought together Catholics, Muslims, Jews and Protestants with the goal of putting global population policies within the broader context of social development and improving the status of women.
The Vatican signed the conference document that accepted four points about abortion: that abortion should not be used as a method of family planning; that the numbers of abortions should be reduced by expanding access to family-planning services; abortions should be safe where legal; and that the consequences of illegal, unsafe abortions should be addressed.
That position was more in line with the international family-planning policies adopted by President Clinton who lifted the "global gag rule" that was first imposed in the 1980s by President Reagan at a population-control conference in Mexico City. The "gag rule" was reaffirmed by President George H.W. Bush and now is being restored by George W. Bush.
European organizations are upset and threatening to pursue their own course
Third World Consequences
Meanwhile, in the Third World, family-planning advocates see what one called "grave consequences" from Bush's strategy, especially in Catholic Latin America.
"The gag rule is neither going to affect Europe nor the United States nor many Asian developed countries where abortion is legal and safe," said Jacqueline Pitanguy, president of a family-planning institute in Rio de Janeiro, Brazil. "Bush's decision is going to affect us, the Latin American countries, where abortion is illegal, clandestine and deadly. It will negatively affect us in two ways: in a cultural perspective and in a practical way.
"The cultural consequence is that it will restore an immense power to the conservatives, to the rightist lobbies, that have been fighting against not only abortion but many sexually oriented programs."
Pitanguy said Bush's policies will give Latin America's right wing "lobbying and financial power to push backwards all the advances in terms of women's legal rights, in terms of how women are seen by the judicial and social institutions. … Secondly, it will deprive families of health services and family-planning programs."
While popular with social conservatives in the United States and in the Third World, Bush's strategy seems to have taken little account of the complex relationships that exist between the abortion/family-planning debate and the larger socio-economic conditions in poor countries.
In those countries, the poor find themselves the most likely victims of the anti-abortion policies, in part because poor women are the most common fatalities from unsafe abortions. They're also the most likely to be imprisoned if caught.
On a larger scale, the loss of family-planning assistance will mean more of the poor trapped in cycles of poverty. That development, too, seems certain to strengthen the hand of the old-line political forces throughout the Third World.
Marta Gurvich is an Argentine journalist who has written about political and social issues in Latin America for this publication for the past four years. One of her articles examined the "dirty war" in Argentina. Another looked at the economic dilemma in Brazil.