How The U.S. Contributes To 47,000 Women’s Deaths A Year

An unwanted pregnancy can be devastating. When it's caused by rape, destroys the mother's health, or even kills her, it’s a tragedy. On December 17, the United States marks the 42nd anniversary of the Helms Amendment, and with it 42 years of refusing to help women in other countries terminate their pregnancies even in cases of rape, incest, or threat to the woman’s life. Even hard-line pro-life conservatives agree that American women should be able to access abortion care under these conditions (excluding a certain 2016 presidential candidate, Marco Rubio, who believes that women should be forced to carry pregnancies to term "irrespective of the circumstances"), and yet the government's blanket ban on funds for abortion care applies even in countries where abortion is legal. 21.6 million women experience an unsafe abortion each year. In settings with no other options, untrained and under-equipped practitioners puncture uteruses with unsanitary tools, local healers prescribe poisonous substances, or community elders stomp on pregnant women's bellies to induce abortion. 47,000 of these 21.6 million women die, while countless others suffer debilitating complications such as hemorrhage, sepsis, organ failure, genital trauma, hypertensive disorder, or internal organ damage.

The thing is, while the U.S. interprets Helms as an outright moratorium on foreign assistance funds for abortion care, it doesn't need to. Pushed through in 1973 by noted racist Senator Jesse Helms as he rode the wave of political backlash to the Roe v. Wade decision the same year, the amendment states only that "No foreign assistance funds may be used to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortions." As Population Connection Action Fund's senior vice president for media Brian Dixon points out, no definition of "family planning," the practice of regulating a family's number of children and the intervals between their births, includes the termination of pregnancies caused by rape or incest or that endanger the mother's life. "The president has the power to say, 'Abortion as a method of family planning certainly doesn’t include these victims of rape and incest and women whose lives are threatened,'" Dixon explains. "That’s something that a president can do on their own — they don’t need Congress to act. While we’re working to get Congress to recognize the harm of the law itself, we can at least make sure that we’re enforcing it properly." And, if you're wondering why developing countries that allow abortion in certain cases (Kenya, Ethiopia, and Tanzania, for example) don't just fund their own abortion care, the answer is that in many regions, they can't afford to.

"I think a lot of people don’t realize the U.S. is the largest donor to global health and one of the largest international family planning donors," says Chloe Cooney, director of global advocacy at Planned Parenthood Federation of America. "You can’t overstate how important the funding is. It really is the difference between life or death for so many people." But as many countries have liberalized their abortion laws over the past 20 years, U.S. still refuses to support any health programs that incorporate abortion care — and in some areas, care funded by the United States Agency for International Development (which oversees a $20 billion budget and counts five African countries among its top 10 aid recipients) is the only care available. "There are districts that wholly depend on USAID funding to run their reproductive health programs," says Joachim Osur, PhD, technical director of reproductive and child health for Kenya-based Amref Health Africa. "If you go to a hospital fully supported by USAID, women in those places will not get [abortion care]... As a health worker, I have come across a number of women who have suffered injuries, some have died, some have lost their uteruses at a very early age because of unsafe abortion." (Young women are particularly vulnerable to sexual violence and then unsafe abortion: In Kenya, for example, 32% of women experience sexual violence before age 18, and an estimated third of girls who are raped will become pregnant as a result.) "The interpretation is that women living in the U.S. are more of human beings than women living elsewhere in the world," he continues. "It is an injustice when we know what to do to save life and we can’t do it."

"The impact of [Helms] has not been equal over 42 years: It’s really grown in intensity," Cooney adds. "When it was first passed, it came against a backdrop where abortion was broadly criminalized in all the places where U.S foreign assistance was happening." Today, "You just think of a 1973 battle in Congress being what’s standing in the way of a woman in Kenya who has been sexually assaulted or who is facing a life-threatening pregnancy and can’t get the care she needs. It's absurd to me." The U.S., then, has blood on its hands. 42 years after the passage of Roe v. Wade, the government remains committed to cutting off aid to any program whose health workers dare to provide abortion care in any context. It's not only the Republicans who pushed this amendment through who are to blame, but every administration since — including Obama's — that has failed to exercise its right to redefine how Helms is interpreted. "Banning abortion isn’t stopping abortion. It's just driving it underground and making it dangerous," Dixon stresses. "What’s happening around the world is what happens when abortion is inaccessible and illegal: It doesn’t stop desperate people from taking desperate measures, that’s for sure, and too many women are facing desperate circumstances." Helms only limits women's options and intensifies their desperation.