Global Reproductive Health at Risk


Photo: Days for Girls

Investments in reproductive health services have proven to be a highly cost-effective way to reduce extreme poverty globally. According to The United Nations Foundation, not only does access to voluntary family planning saves lives it also “reduces poverty, promotes environmental sustainability, increases security, and allows women to pursue educational and income-generating opportunities.”

Unfortunately, many reproductive health needs go unmet throughout the world, often with tragic results. Globally, more than 800 women and girls die each day from preventable causes related to pregnancy and childbirth, including unsafe abortions. And for every woman who dies in childbirth, 20 more will suffer debilitating childbirth-related injuries like obstetric fistula.

Reproductive health is a cross-cutting issue that encompasses everything having to do with the human reproductive system across all life stages. People who work in reproductive health services make sure that girls have access to menstrual pads, so they are more likely to stay in school. They educate families about the benefits of delaying child marriages, and thus early pregnancy, which can take a life-long toll on the health of adolescent mothers and their babies. They provide counseling and care for pregnant women infected with Zika. They conduct cervical cancer screenings for women in rural areas. And they ensure at-risk populations have access to HIV/AIDS screening and treatment.

Reproductive health workers do all this and more, while at the same time having to overcome societal taboos and stigma, threats of violence, a lack of stable funding, and to top it off, the high-stakes politics surrounding family planning and abortion services.

The Mexico City Policy

The Mexico City Policy is a U.S. government policy that originally required foreign non-governmental organizations (NGOs) that receive U.S. global family planning assistance to certify that they do not “perform or actively promote abortion as a method of family planning” with non-U.S. funds. It’s important to note that before the Mexico City Policy was established, foreign organizations were already barred from providing abortion services using U.S. funds.

Because the meaning of “actively promote” is unclear, organizations that are afraid of losing U.S. aid funding interpret this prohibition broadly, avoiding even the word “abortion,” let alone using their own non-U.S. funds to provide abortions or refer women to safe, legal abortion providers. This is why those who oppose the policy refer to it as the “global gag rule.”

On January 23rd, President Trump expanded the policy to apply to all of U.S. global health assistance, including funds that also support childhood vaccinations, as well as treatment for HIV/AIDS, malaria, Ebola, and other infectious diseases. According to PolitiFact this is approximately $9.7 billion, or “about 15 times as much money as the United States spends on family planning, which was the core program affected across all three previous Republican administrations.”

While foreign organizations could agree to drop any activities related to abortion in order to continue to receive U.S. funding, the integrated nature of health services, particularly in rural areas, makes this especially difficult.

A broad coalition of organizations, including several GlobalWA members, have publicly opposed the expanded policy, saying that it “interferes with the doctor-patient relationship by restricting medical information healthcare providers may offer, limits free speech by prohibiting local citizens from participating in public policy debates, and impedes women’s access to family planning by cutting off funding for many of the most experienced health care providers who chose to prioritize quality reproductive-health services and counseling over funding that restricts care and censors information.”

Despite the contraction of U.S. funding for family planning globally, European governments and others continue to invest in this important area. Organized by the U.K. Department for International Development, the United Nations Population Fund and the Bill & Melinda Gates Foundation, the upcoming 2017 London Summit on Family Planning in July will focus on ways to continue making progress toward the Sustainable Development Goal of achieving universal access to sexual and reproductive healthcare services by 2030.

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The following Global Washington members are working to save and improve lives in developing regions through their work on reproductive health:

ACT for Congo

ACT for Congo improves health for women and their communities through partnership, capacity building and advocacy. We identify change-agents and help them identify opportunities and resources which empower them as they change the future of DR Congo. Our partner’s peer educators create music, drama and use their own stories to teach reproductive health and rights in schools, faith communities, marketplaces and by radio and local television.

Adara Development

Adara Development is focused on improving health and education for women, children and communities living in poverty. Its expertise is in maternal, infant and child health; and remote community development. Adara’s work reaches tens of thousands of people living in poverty each year through service delivery, and countless more through its knowledge sharing program. Adara is in the process of scaling its global health work in order to contribute to the end of preventable deaths of women, children, adolescents and particularly newborns.

Bill & Melinda Gates Foundation

The Foundation aspires to help all people lead healthy, productive lives and is dedicated to discovering and disseminating innovative approaches to addressing extreme poverty and poor health in developing countries. It is working to bring access to high-quality contraceptive information, services, and supplies to an additional 120 million women and girls in the poorest countries by 2020 without coercion or discrimination, with the longer-term goal of universal access to voluntary family planning.

Days for Girls International

Days for Girls creates a more dignified, free and educated world through access to lasting feminine hygiene solutions. Through volunteers, through enterprises, and through public and private partnerships, Days for Girls is working to shift how women and girls see themselves and are seen by their communities. The organization offers girls and women new life choices and spurs narrative change, by providing sustainable hygiene solutions, health education, and income-generation opportunities.

One By One

One By One is a Seattle-based non-profit organization dedicated to the elimination of obstetric fistula worldwide. The organization partners with communities to develop and support holistic fistula treatment and to increase access to safe childbirth for all women.

OutRight Action International

OutRight works to bring visibility to the struggles and expose discrimination and violence against the LGBTIQ community. For example, the organization brings the voices of the LGBTIQ community to the United Nations and helps advocates build networks that empower lesbian, bisexual, trans and intersex women to ensure that they are not excluded from broader discussions around global health.


PATH is an international organization that accelerates innovation to save lives and improve health, especially among women and children. PATH’s health solutions reach an average of 150 million people per year in more than 70 countries, addressing a range of global health challenges from malaria to diabetes to reproductive health. For 40 years, the organization has mobilized thousands of cross-sector partners to help countries tackle their greatest health needs, empowering people to transform their own health and futures.

Planned Parenthood of the Pacific Northwest and the Hawaiian Islands (PPGNHI)

PPGNHI draws upon its expertise as a leading provider of sexual and reproductive health services and comprehensive sexuality education to build the capacity of partner organizations around the world. PPGNHI believes that sexual and reproductive rights are basic human rights and that everyone should have access to quality health care and education.