The U.S. Supreme Court sent shockwaves throughout the country this June by overturning Roe v. Wade, the landmark decision deeming abortion a constitutional right. I happened to check my social media feed that day, unsuspectingly, while visiting family in Pakistan. After spending the day with my relatives, excitedly discussing the strides being made for women’s rights in Pakistan, it was surreal to learn that those same rights were under threat back home in America. Given the influence of the U.S. on the world stage, I was left wondering whether the aftermath of the Court’s decision could have an impact on women in Pakistan, or in other developing nations struggling to advance reproductive healthcare. That question led me to discover that, for decades before pro-life activists even challenged Roe v. Wade in court, the United States has already been keeping abortion inaccessible to millions of desperate people worldwide by using an unlikely tool: foreign aid policy. 

The Helms Amendment is a policy that makes it illegal for U.S. foreign aid funds to be spent on the “performance of abortion as a method of family planning.” Enacted in 1973, the amendment was passed in retaliation to Roe v. Wade and aimed to block humanitarian efforts to help foreign governments provide abortions. Today, even though nearly 50 other nations have since liberalized their abortion laws, this deeply antiquated policy remains U.S. federal law. The United States is the largest bilateral donor for family planning assistance in the world, but as long as the Helms Amendment is enforced, none of that funding can be used for programs that provide safe abortions. The term “family planning” may not sound like a severe humanitarian issue; however, being able to control one’s reproductive health can be a matter of life or death for women living amid violence or extreme misogyny. The World Health Organization finds that over one in three women in the world’s poorest nations have experienced physical and/or sexual abuse, putting them at higher risk of unwanted pregnancy. Preventing these individuals from accessing safe abortions can lead to lifelong poverty or even death, due to high maternal mortality rates in sub-Saharan Africa and South Asia. 

The harms that a lack of family planning access have on developing nations are manifold. It keeps families, communities and entire countries trapped in poverty due to unsustainable population growth. Additionally, it worsens food and water insecurity, since many nations that rely on U.S. aid have scarce resources due to climate change. Most insidiously, it keeps impoverished women trapped in a system of intergenerational oppression. Where my family originates from in Pakistan, rural women in village communities are often pressured into marriage and motherhood at an early age, even at the cost of their education. Of course, one can argue that increasing abortion access won’t fix these persistent issues due to factors like cultural norms or a lack of education about contraceptives. However, the U.S.’s refusal to fund organizations that provide abortion access makes it more difficult for aid workers to change mindsets or increase contraceptive use, as seen through the example of the global gag rule.  

The “global gag rule,” or Mexico City Policy, is a companion to the Helms Amendment instituted by Ronald Reagan in 1984. The gag rule prevents foreign nongovernmental organizations (NGOs) and health clinics from using U.S. funds to provide abortion services, information, or counseling. A key example is International Planned Parenthood, which was forced to scale back its contraceptive education and counseling programs from 2001 to 2009 after losing U.S. funding. Since Reagan’s presidency, the gag rule has been temporarily rescinded by Democratic presidents, such as Barack Obama, only to be enforced again by Republican presidents, such as Donald Trump, in an endless partisan tug-of-war. Enforcing the gag rule has had devastating results; a policy brief by the Stanford Institute for Economic Policy Research found that when the policy was enforced, abortions in sub-Saharan countries — many of them unsafe — increased by as much as 40%, whereas contraceptive use fell. Much like how banning abortions leads to an increase in “back-alley jobs” in the U.S., defunding programs that provide safe abortions in the developing world only increases the number of unsafe procedures performed out of desperation. Luckily, President Biden has already rescinded the global gag rule via executive order earlier this year. However, this is only a temporary fix for the larger problem: the global gag rule and the Helms Amendment will remain permanent law, ready to be enforced by the next Republican president, unless Congress repeals both policies. This midterm season, abortion rights have been front-and-center in many Democratic political campaigns, but America’s outdated and dangerously anti-abortion foreign policy has remained unaddressed. Nancy Stearn, an attorney who challenged abortion bans back in the 1970s, described the importance of abortion access best in an interview with The New York Times: “If you cannot control your reproductive life, you cannot control your life.” This reality is felt as harshly by Americans as it is by a woman in Pakistan struggling to determine how she will raise another child. For women in developing nations to empower themselves, they need to have control over what happens to their bodies. This basic right may have been revoked in our country, but the fight to protect it is not over. Repealing the Helms Amendment and gag rule and safeguarding global access to reproductive health must be a priority in our efforts to protect the right to choose.