Ethiopia: U.S. foreign policy and unsafe abortion in Africa

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United States foreign policy abortion restrictions have often hampered African NGOs’ efforts to reduce deaths and disabilities associated with unsafe abortion procedures. In a positive recent development, however, the fight for African women’s access to safe abortion services took a small but important step forward.

On July 29th 2010 the United States Senate Appropriations Committee passed an amendment to the State and Foreign Operations bill authored by New Jersey Democratic Senator Frank Lautenberg that would permanently ban the Global Gag Rule, a U.S. foreign policy restriction that has haunted reproductive rights organizations in Africa and other parts of the Global South on and off for over two decades.

The Global Gag Rule prohibited NGOs receiving any U.S. foreign assistance from engaging in abortion-related activities, including the distribution of information regarding safe abortion, even if the NGOs used their non-U.S. funds for the forbidden services. Now that the Senate committee has passed the Lautenberg amendment, the United States Congress should act quickly to forever eliminate the Global Gag Rule. Women’s lives in Africa and throughout the Global South are at stake.

One of U.S. President Barack Obama’s first actions upon taking office in January 2009 was to repeal the Global Gag Rule through an executive order. However, only a law passed by the United States Congress can make the repeal permanent. A permanent ban of the Global Gag Rule would allow U.S. foreign aid recipients in Africa and elsewhere to invest resources for safe abortion care without fearing a potential change in U.S. foreign policy with each new administration.

The fate of the Global Gag Rule and African women’s access to safe abortion services has long been subject to the vagaries of U.S. political winds. President Ronald Reagan first introduced the Global Gag Rule, also known as the Mexico City Policy, in 1984. Subsequent Republican U.S. presidents including George H. W. Bush and George W. Bush upheld or reinstated the Global Gag Rule during their tenures. Democratic Presidents Bill Clinton and Barack Obama signed executive orders rescinding the rule.

Reproductive rights advocates have long lobbied the U.S. Congress to pass a law that would permanently repeal the Global Gag Rule and forever remove it from the political whims of each successive administration. A U.S. Senate vote in favor of a permanent ban on the Global Gag Rule would help eliminate once and for all the corrosive effects of the gag rule in African countries and throughout the world.


According to the World Health Organization, 5.5 million African women undergo unsafe abortions each year, often resulting in death or short- or long-term disability. East Africa in particular has one of the world’s highest rates of maternal deaths linked to complications from unsafe abortions. During recent research and fieldwork in Ethiopia, where each year unsafe abortion accounts for 50% of the 20,000 maternal deaths, I observed how the uncertain future of the Global Gag Rule could affect women’s access to safe abortion services that can save their lives.

Unsafe abortion remains the leading cause of death among Ethiopian women of childbearing age, surpassed only by HIV/AIDS. Many Ethiopian women have little or no choice over when or how they become pregnant. Lack of female control over contraceptive use, domestic and sexual violence, early marriage, forced abductions, and poverty often strip Ethiopian women of control over their reproductive lives and lead to unwanted pregnancies. Over 50% of all women seeking abortions in Ethiopia do so outside the reach of trained medical professionals.

In 2005, Ethiopia courageously liberalized its national abortion law in order to address the public health crisis resulting from the high incidence of unsafe abortion. However, U.S. foreign policy remained a hurdle to the successful implementation of the law. Eight long years of the Bush administration’s enforcement of the gag rule eroded the strength of well-known and respected abortion service providers in Ethiopia including Marie Stopes International Ethiopia (MSIE) and the Family Guidance Association of Ethiopia (FGAE).

MSIE and FGAE had long been dedicated to providing safe abortion services that often meant the difference between life and death for Ethiopian women. During MSIE and FGAE’s years roaming the Global Gag Rule wilderness they lost all U.S. funding and Ethiopian women suffered as a result. Organizations that continued to receive U.S. funding were forbidden from even presenting Ethiopian women with information about safe abortion. Thus, U.S. foreign policy undermined Ethiopia’s attempt to address a public health crisis affecting countless Ethiopian women.

Although Ethiopian reproductive healthcare providers cheered President Obama’s repeal of the Global Gag Rule on 23 January 2009, confidence that a future U.S. administration will not resurrect the gag rule remains low. Ethiopian local NGOs link the policy change with the domestic abortion debate between Democrats and Republicans in the U.S. and fear that a subsequent administration may reinstate the gag rule.

The uncertain political fate of the Global Gag Rule may cause organizations in Ethiopia and elsewhere in Africa and the Global South to refrain from investing necessary resources to increase access to safe abortion fearing that a change in U.S. foreign policy may cause them to lose U.S. funding altogether. Absent a permanent repeal of the Global Gag Rule, women’s access to safe abortion services in the Global South will remain tenuous.

To avoid this devastating result, the United States Congress should permanently repeal the Global Gag Rule by passing the Lautenberg amendment to the State and Foreign Operations bill. A permanent repeal of the Global Gag Rule would ensure that organizations receiving U.S. foreign aid in Ethiopia, throughout Africa, and elsewhere in the world can tackle the problem of unsafe abortion which claims the lives of countless women – often poor and marginalized –without fear of the harsh ramifications of uncertain U.S. political currents.

Also read: Manipulating the memory of the Rwandan genocide

Chi Mgbako is clinical associate professor of law and director of the Walter Leitner International Human Rights Clinic at Fordham Law School in New York City. She is co-author of the report “Exporting Confusion: U.S. Foreign Policy as an Obstacle to the Implementation of Ethiopia’s Liberalized Abortion Law.”

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Chi Mgbako
Chi Mgbako is a Nigerian-American human rights professor, lawyer, and writer based in New York City. A graduate of Harvard Law School and Columbia University, she has conducted human rights fieldwork, advocacy, and teaching in Ghana, Ethiopia, Liberia, Malawi, Nigeria, Rwanda, Sierra Leone, and Uganda. She has published in the areas of women’s rights, justice sector reform, and contemporary politics. She is currently clinical associate professor of law at Fordham Law School in New York City where she directs the Walter Leitner International Human Rights Clinic.
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