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MARTY MEEHAN AND GLORIA FELDT

Lift the family planning gag

THIS WEEK marks the 20th anniversary of a profound and misguided change in US foreign policy: the Reagan administration's "global gag rule," which was first announced at an international family planning conference in Mexico City in August 1984.

The "Mexico City" policy prohibits US dollars and contraceptive supplies from going to any international family planning program that provides abortions or counsels women about their reproductive health options. The policy isn't about money going to pay for abortions. Even those groups that use only private funds for abortion services -- where abortion is legal -- are barred from assistance. This is money going to family planning programs.

President Clinton rescinded the Mexico City policy in 1993. But President Bush reinstated and expanded it on his first day in office. Now not only are organizations that provide or counsel about abortion services affected; those that dare to take part in a public discussion about legalizing abortion are also affected (hence the name "global gag rule"). Of course, those that call for restricting abortion rights are not affected.

This policy has nothing to do with government-sponsored abortions overseas. Ten years before the gag rule was in place the law strictly prohibited that. This policy is about disqualifying prochoice organizations from receiving US international family planning funding.

Under Bush's policy, organizations that play a vital role in women's health are forced to make an impossible choice. If they refuse to be "gagged," they lose the funding that enables them to help women and families who are cut off from basic health care and family planning. But if they accept funding, they must accept restrictions that jeopardize the health of the women they serve.

The most tragic ramifications have been felt in the developing world. In Kenya, for example, two of the leading family planning organizations have been forced to shut down five clinics dispensing aid from prenatal care and vaccinations to malaria screening and AIDS prevention. Kenya's experience is common, according to "Access Denied," a report on the impact of the global gag rule on developing nations. Researchers found that programs for rural communities and urban slums have been scaled back by as much as 50 percent. As a result more women are turning to unsafe abortion -- a leading cause of death for young women in much of Africa -- because they lack access to family planning information and essential contraceptive supplies.

International family planning programs work. For more than 30 years, the United States has supported programs in some of the poorest regions of the world to deliver voluntary family planning and reproductive health services. These programs help educate and empower women to take better care of themselves, their families, and their communities. Every day, international family planning services save lives, reduce the number of unintended pregnancies, combat the scourge of global HIV/AIDS, and promote sustainable development worldwide.

Consider the facts. More than 500,000 women die annually from pregnancy-related causes. Babies of women who die in childbirth are unlikely to survive one year. Family planning can cut maternal mortality rates by 25 percent and infant mortality rates even further.

More than 38 million people live with HIV/AIDS worldwide. Family planning programs provide education and contraceptives that play an important role in curbing the spread of the pandemic.

More than 80 million unintended pregnancies occur annually worldwide, and more than half of them result in abortion (78,000 women die every year from unsafe abortions). Family planning reduces the need for abortion.

These are not new issues. A decade ago, the nations of the world came together in Cairo at the International Conference on Population and Development with a unified vision of improving the quality of life for women, families, and the environment. They made a promise to commit moral and financial resources to ensuring that all people have access to information and services that include health care, family planning, and a basic education.

The United States was a leader in that effort. But with the advent of the current global gag rule, this work is threatened. It is the tragic outcome of a decision-making process that puts blind ideology before sound public health practice and global cooperation.

Thousands of Americans have joined together in the campaign "A Mother's Promise the World Must Keep" to call on our government to cooperate with other nations to meet our promise. We must restore common sense and America's leadership role by reversing this misguided policy.

So many lives are at stake. We can't afford to exclude any family planning organization that can safely and effectively provide comprehensive reproductive health services. America should be leading -- not gagging -- global efforts to improve women's health.

US Representative Marty Meehan represents the Fifth Congressional District of Massachusetts. Gloria Feldt is president of the Planned Parenthood Federation of America. 

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