Why Nurses Should Oppose the Global Gag Rule on Abortion

  1. The Global Gag Rule, also known as the Mexico City Policy, prevents any organization receiving US health aid from even discussing abortion in a positive light. Learn why this will deny care to patients around the world while not decreasing abortion rates.

    Why Nurses Should Oppose the Global Gag Rule on Abortion

    Coat hangers. Hot oil. Lye.

    The options women use to terminate unwanted pregnancy when safe medical or surgical abortions are unavailable or illegal. In Kenya, women resort to probing their vaginas with sharped sticks while women in other parts of the world frequently resort to beating their bellies with bats in hopes of ending the pregnancy. These and other methods of unsafe abortions expose women to debilitating or life threatening infections and hemorrhages. According to the World Health Organization, 4.7% to 13.2% of all maternal deaths each year are attributed to unsafe abortion.

    As nurses, we must do all we can to make sure evidence-based medicine reaches all corners of the earth so that potential patients do not resort to dangerous amateur techniques. It is our duty according to the nursing principles of beneficence and prevention of maleficence.

    What is the most effective way to prevent morbidity and mortality from unsafe abortions? Contraception and other family planning services. When the United States has imposed the so-called Mexico City Policy, under the last three Republican presidents, rates of abortion INCREASED in countries receiving US heath aid. During the second Bush administration, the policy was associated with a doubling of abortion rates in sub-Saharan Africa. The Mexico City Policy, also known as the Global Gag Rule, prohibits foreign organizations from promoting or providing abortions if they are to receive US aid for family planning (primarily contraceptive) services. Public health researchers believe that reduced financial support for family planning services under the gag rule resulted in women substituting abortion for contraception.

    At the start of their term in office, President Trump and Vice President Pence expanded the gag rule from affecting only family planning to pertaining to all foreign health aid receiving US funds. This means assistance will be denied to HIV/AIDS treatment programs, malaria and tuberculosis prevention, malnutrition efforts, and maternal-child health care if they are organized by foreign NGOs that also provide abortion. Organizations currently related to abortion services will have to refuse US assistance, leading to the closure of obstetric and infectious disease clinics throughout the developing world. How many more people should be infected with HIV because of a policy routed in ideology instead of evidence? How many starving children should loose access to nutrition assistance?

    Children and mothers will be those hardest hit during this presidential term. Large organizations with broad scopes including abortion are often the only ones that can reach remote or dangerous communities. Programs run by such organizations are the sole providers of any sort of conventional healthcare in many communities. Marie Stopes International estimates that an additional 21,700 women will die from pregnancy or childbirth complications while the gag rule is in place because they will no longer be able to support certain efforts without US funds. The International Planned Parenthood Federation, which provides far more reproductive health and contraceptive services than abortions, predicts that their loss of funding will lead to 20,000 more otherwise preventable maternal deaths. Real lives are being risked for an ideology contrary to scientific and historical evidence.

    To be clear, the Mexico City Policy means that services other than abortion cannot be funded; the passage of the Helms Amendment in 1973 already prohibits the use of foreign assistance funds towards abortion provision. Neither of the provisions have actually prevented abortion. Instead, they have given rise to gruesome, underground methods of termination that result in thousands of otherwise preventable deaths. Nurses cannot let this happen.

    Oppose the Mexico City Policy whether or not you are opposed to abortion as it does not decrease incidence but, instead, makes girls and women resort to torturous, dangerous techniques. Oppose the Mexico City Policy because it will dramatically decrease other healthcare services in the developing world. Oppose the Mexico City Policy.
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    About Maddy1

    Madeline Howe, RN works on a med-surg floor in Vermont. She is completing her Doctorate of Nursing Practice at the University of Vermont, where she focuses on topics affecting women and children.

    Joined: Aug '14; Posts: 1; Likes: 4

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    28 Comments

  3. by   chare
    Since you've written and posted this as an article, would you please provide some sources for the statements made here.
  4. by   Daisy4RN
    thehill.com/policy/healthcare/abortion/315652-trump-signs-executive-order-reinstating-global-gag-rule-on
  5. by   Rose_Queen
    Quote from chare
    Since you've written and posted this as an article, would you please provide some sources for the statements made here.
    An article on AN does not mean a peer reviewed article. It is simply a format that is different than a standard post.
  6. by   elkpark
    Quote from Rose_Queen
    An article on AN does not mean a peer reviewed article. It is simply a format that is different than a standard post.
    True, but if people are making statements of (presumably) fact, it's nice for them to provide some evidence that those facts are true and they didn't just make it all up. Links to articles, that kind of thing. Many of us do that in our posts here that aren't even "articles."
  7. by   toomuchbaloney
    Trump administration to revive Reagan-era abortion 'gag' rule | World news | The Guardian

    Trump is trying hard to agitate his single issue voters for the November election.
  8. by   macawake
    Quote from Maddy1
    What is the most effective way to prevent morbidity and mortality from unsafe abortions? Contraception and other family planning services.
    When the United States has imposed the so-called Mexico City Policy, under the last three Republican presidents, rates of abortion INCREASED in countries receiving US health aid.

    During the second Bush administration, the policy was associated with a doubling of abortion rates in sub-Saharan Africa. The Mexico City Policy, also known as the Global Gag Rule, prohibits foreign organizations from promoting or providing abortions if they are to receive US aid for family planning (primarily contraceptive) services. Public health researchers believe that reduced financial support for family planning services under the gag rule resulted in women substituting abortion for contraception.
    Hi and welcome to AN. I agree with other posters. If you start at thread and make claims, we'd all appreciate if you could also provide links which support your claims.
    It also hope to see you participate in the thread beyond just starting it.

    Making abortion illegal does not reduce number of women having terminations, study concludes | The Independent

    In the above article you can read that the fact that abortions are illegal, don't mean that women have fewer abortions than in countries where they're legally available. It shows that abortion rates in countries where abortions are legal and abortion rates in countries where they are illegal, are similar. The rate is actually slightly higher in the countries where they are illegal.

    That should not come as news to anyone with a nursing degree who's done their research. If we've done our research, we do know that the only thing making abortions illegal accomplishes, is endangering the health of women and increase women's morbidity and mortality.

    Yes, women actually choose the risk of death over being forced to give birth against their wishes. This is something I wish those who support banning abortions would grasp once and for all and learn to deal with reality such as it actually presents, rather than the idealized unicorns and rainbows version they wish was real.

    I have to believe that they aren't evil ***** who don't give two hoots if women suffer torturous pain, emotional anguish and potentially die, or control freaks who just want to keep women under their collective thumb, but that they are guided by a misguided notion that an abortion ban would actually accomplish something good.

    https://www.thelancet.com/journals/l...380-4/abstract

    This above link is the study linked in the Independent article.

    https://www.thelancet.com/journals/l...799-2/fulltext

    The above was published in 2009. It describes how abortion rates have fallen significantly in parts of the world where abortion is legal, but much less so in parts where abortions are illegal.

    It describes that worldwide maternal mortality due to abortions remains at a rate of 70 000 deaths per year. Most of these deaths occur in sub-Saharan Africa and in south-central Asia. This mortality is caused by the prevalence of unsafe abortions:
    14 per 1000 women of childbearing age, which at the time of the study translated to 20 million annually. And that meant that, somewhere in the world a woman died every 8 minutes because of an unsafe abortion.

    http://www.who.int/reproductivehealt...e_abortion.pdf

    Making abortion legal, safe, and accessible does not appreciably increase demand. Instead, the principal effect is shifting previously clandestine, unsafe procedures to legal and safe ones.
    In the above link you can find a list of methods women use instead of being forced to carry a pregnancy to term against their wishes.

    Some of the more frightening and desperate p.o. "treatments" that women will ingest include turpentine, laundry bleach and acid. They might also opt for "placing" foreign objects into the uterus through the cervix. Some of these foreign objects include: wire, knitting needles, coat hangers and ballpoint pens. Some try to induce a miscarriage through voluntarily subjecting themselves to forceful abdominal blunt trauma.

    Thousands and thousands of women either suffer permanent injuries or die each and every year because they are denied access to safe abortions. Women in childbearing ages die tragic, PREVENTABLE deaths.

    How can anyone with in good conscience argue for policies that we KNOW will cost many women their lifes? How can this be okay?

    http://apps.who.int/iris/bitstream/h...pdf;sequence=1

    When induced abortion is performed by qualified persons using correct techniques and in sanitary conditions, it is a safe surgical procedure. In the United States, for example, the death rate from induced abortion is 0.6 per 100 000 procedures, making it as safe as an injection of penicillin
    In developing countries, however, the risk of death following unsafe abortion may be several hundred times higher.
    Abortion attempts may involve: insertion of a solid object (root, twig or catheter) into the uterus; a dilatation and curettage procedure performed improperly by an unskilled provider; ingestion of harmful substances; and exertion of external force. In many settings, traditional practitioners vigorously pummel the woman's lower abdomen to disrupt the pregnancy which can cause the uterus to rupture, killing the woman. There are some signs that increased illicit, and often incorrect, use of medical abortion over other methods nevertheless may lower both the number of severe complications and maternal deaths.
    One recent study estimates that every year in developing countries 5 million women are admitted to hospital as a result of unsafe abortion, this would mean that therefore some 3 million of the estimated 8.5 million who need care for subsequent health complications following unsafe abortion do not receive it.

    WHO | United States aid policy and induced abortion in sub-Saharan Africa

    Results

    Overall, the induced abortion rate increased significantly from 10.4 per 10 000 woman-years for the period from 1994 to 2001 to 14.5 per 10 000 woman-years for the period from 2001 to 2008 (P = 0.01). Although the trend changed gradually, the timing of the rise is consistent with the reinstatement of the Mexico City Policy in early 2001.
    Discussion

    Some American presidential administrations care deeply about curtailing access to abortion, whereas others seek to promote it. Regardless of one's views, an understanding of the relationship between the Mexico City Policy and abortion rates in developing countries is important for foreign policy decisions. To the best of our knowledge, this study is the first quantitative analysis of the policy's possible implications for women living in countries that depend heavily on development assistance for family planning and reproductive health services.

    Our study found robust empirical patterns suggesting that the Mexico City Policy is associated with increases in abortion rates in sub-Saharan African countries.
    (I only included a part of the result and discussion, follow the link to read the entire thing).
    Last edit by macawake on Aug 14
  9. by   toomuchbaloney
    "How can anyone with in good conscience argue for policies that we KNOW will cost many women their lifes?"

    They argue from a religious conviction where the life of a fetus is more important than the woman.
  10. by   BCgradnurse
    Quote from toomuchbaloney
    "How can anyone with in good conscience argue for policies that we KNOW will cost many women their lifes?"

    They argue from a religious conviction where the life of a fetus is more important than the woman.
    If only these same people cared as much about the children already on this earth.
  11. by   heron
    Hmm ... OP seems to have seagulled. Now why would she do that?
  12. by   DaveICURN
    I would submit that for most the belief that the babies life is equally imporant to the mothers. A life is a life in the eyes of the detractor.
    Others would argue that the monetary costs of supporting these services to the world population is offering nothing to the healthcare of the US itself. Most often heard in the form of, "Why should I pay for another countries healthcare?".

    The scope of expanding the Rule just placed more pressure on the systems to stop abortion practice to keep the funding. If the concern is the loss of that funding to other services, then the one responsible for the services should step in to fill the gap. If they believe that they need the other services more than the abortion services, than they can stop the practice and continue to receive funding.
  13. by   toomuchbaloney
    Conservative health professionals won't be happy until poor women are dying from black market reproductive health services again.
  14. by   DaveICURN
    Quote from toomuchbaloney
    Conservative health professionals won't be happy until poor women are dying from black market reproductive health services again.
    It never hurts to put forth a meaningful argument ya know. All these straw man and ad hominem attacks are not making it look like you want civil discourse or are interested in any other viewpoint. Would you care to enlighten me on your viewpoint on this matter? Leaving out the social commentary on the opposing side?

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