Bush urged to lift cash ban to groups offering abortionBMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7287.636/c (Published 17 March 2001) Cite this as: BMJ 2001;322:636
Family planning organisations are calling on the US president, George Bush, to lift his “global gag rule” restricting reproductive health services in developing countries; this call comes after a study found that women run a 1 in 65 risk of dying in pregnancy and childbirth.
The report, released on International Women's Day, shows that women in developing countries are 33 times more likely to die of reproductive, health related causes than women in industrialised nations.
The study's findings fuelled protests last week by agencies threatened with cutbacks to their activities after President Bush reinstated a rule prohibiting the use of US funds by any organisation offering abortion related services overseas (27 January, p 193).
Known as the “global gag rule” for the restrictions it places on family planning organisations with regard to the spending of their own funds as well as US donations, the “Mexico City policy” was originally enacted by President Reagan in 1984 and later rescinded by President Clinton in 1993.
“We cannot accept this diktat,” said Dr Mohammed Bouzidi, spokesman for the International Planned Parenthood Federation, which stands to lose $8m (£5.3m) in US aid even though the money from the United States is not actually spent on any abortion related activity. “Depriving family planning organisations from providing contraceptive services will only increase unsafe abortion,” said Mr Bouzidi.
According to the report, compiled by Population Action International, Washington, DC, 1 in 150 abortions leads to death in Africa compared with 1 in 85 000 procedures in the developed world. “This high risk means that nearly 70,000 women die each year—one every 7 minutes—from botched abortions,” said the document, launched jointly by the parenthood federation and Population Concern.
Although nearly 80 million unintended pregnancies occur each year, with more than half of these ending in abortion, over 350 million couples still have no access to family planning, said the report. In addition, more than a quarter of women in developing countries receive no antenatal care, and almost half deliver their babies with no help from skilled staff. In total, 98% of the 3.43 million adult deaths related to poor reproductive health occur in the developing world, the study found.
“President Bush's decision has exacerbated an already dangerous situation that can only lead to more women dying simply because they have no access to safe, reliable, informed health services and provision,” said Population Concern's spokeswoman, Sandra Kabir.
The study found, however, that some progress had been made, with contraceptive use increasing more than 10-fold in developing countries and women having on average half as many children as they did 35 years ago.
The report, which ranks 133 countries on a “Reproductive risk index” composed of 10 indicators, found Italy to have the lowest overall risk and the United Kingdom to have the eleventh lowest risk. Although 80% of UK women use contraception—second only to Italy—the figure is at odds with the United Kingdom's high teenage pregnancy rate, concluded the study.
A World of Difference: Sexual and Reproductive Health Risks is available on http://www.populationaction.org/worldofdifference