Illegal abortions are killing women in developing countries and restrictions demanded by the USA make it worse

In developing countries, the maternal mortality rate is a staggering 239 per 100,000 women, with an estimated 303,000 women dying in 2015. One in 10 of all maternal deaths are caused by unsafe abortions; an estimated 20 million unsafe abortions are performed every year.

We know that providing access to legal terminations would stop women dying, but this remains an issue that provokes huge debate. Women who can’t access them legally still have abortions, but they have to pay bankrupting sums, often risking their lives.

Backstreet abortions are usually done in an unclean and unsafe environment. If they don’t kill women, they often put them in hospital with horrific complications, leaving them infertile, facing major abdominal surgery and enormous medical bills.

What is stopping women from accessing safe abortions? The first is restrictive laws in their own countries, which can extend to a ban…Ludicrously, this problem is compounded by the fact that countries with the most restrictive abortion laws often have the poorest family planning provision.

The second barrier is the tight regulation governing donor aid. The US has a ban on any of its funding being spent on terminations for women. The Helms amendment, a 43-year-old law, stipulates that abortions cannot be funded as a method of family planning. This means that no US foreign aid is spent on the provision of abortions or even advising or promoting abortion services for women. Recent headlines suggest that the US will not even allow its funds to be used to provide terminations for women who have been raped by Isis fighters…

We know that abortions, when performed legally, are cheap and safe. Yet the grim reality is that tens of thousands of women who die in the developing world each year from unsafe abortions do so because policymakers have decided their lives are not worth saving.

With changes in this policy, maternal mortality could be reduced for a low cost. The technology exists and is affordable. A misoprostol pill that induces an early stage abortion costs less than a dollar. This is not an issue of resources and funding, but a value judgment on what women may or may not do with their lives.

Another look back to the world of the Republican Party and the ideology of patriarchal religion held dear to the heart of 19th Century conservatives.

The United States still relies on a model generated by a religious bigot who hated equal rights for non-white Americans as much as he opposed reproductive rights for women. Jesse Helms was a racist thug kept in office beyond any reasonable function except to stand in opposition to the concept of equal opportunity for class after class of Americans. The Republican Party still honors his memory.

Jesse Helms bones are the foreign policy skeleton in the closet

What US elected officials are doing to reproductive rights in the US is outrageous, but at least we have some recourse as voters and advocates. What US elected officials are doing to the reproductive rights of women in developing countries – through foreign policy that exports our own abortion hang-ups – is reproductive colonialism.

The Helms Amendment was enacted in 1973 and bars US aid recipients from using funds for abortion services, even in countries where it is legal. However, funding can support abortion referrals and even the procedure itself in cases of rape and incest. But it rarely or never does.

The language of the policy is vague and confusing, prohibiting “abortion as a method of family planning” and the “motivation or coercion” of anyone to perform the procedure. The US Agency for International Development (USAID) (and one presidential administration after the next) has continually neglected to provide sufficient guidance on how to implement the policy.

This has left ample room for misinterpretation by aid recipients and USAID staff, which is further fostered by the US’ long history of politicising and stigmatising abortion combined with the undue power of a wealthy donor country. The result is that Helms is being implemented as if it were a total abortion ban.

Seeds of stigma and censorship have been sewn into already-struggling health systems of poor countries, hampering meagre efforts to address unwieldy maternal mortality rates. It is poor women who suffer, unable to access the safe, legal abortion services they deserve…

Reproductive rights groups have raised the alarm, continuing to push the Obama administration to issue clarifying guidelines. Last year, 12 members of US Congress publicly called on President Obama to even reviewthe policy – the first time it would have received such close attention in decades…

Ideally, the Helms Amendment should be repealed. It is archaic and over-reaching, a relic of paternalistic aid that we should have long moved beyond. It was authored by the late Republican Senator Jess Helms, a well-known racist and homophobe, and is shameful as global reproductive health legacy.

But barring repeal, at the very least the policy should be implemented properly. This is not about personal opinion on the morality of abortion, but rather the principles of good, fair and effective foreign policy. Abortion counselling and referral as well as services in cases of rape and incest should be fully funded, and USAID should take active steps to ensure everyone – grantees, employees and government officials – knows this is so.

In his second term, President Obama can lead the United States away from racist and anti-human policies established within our foreign policy by one of the worst bigots in the history of Congress. So far, he ain’t making a peep. So far, he has done little or nothing to counter the so-called gift of Christian guidance provided to poor women around the world.

Jessica Mack reminds us that decades of hatefilled ideology and just plain stupidity are cast into iron bars defining the policies of the American government. Some of these are more than a little fragile – not needing much more than a hammer blow from someone with courage and a fist to hold that hammer. Ain’t seen it happen, yet.