Of the many grave concerns held by millions of people about the new Trump Administration, one of the most pressing is what the new president will do to women’s reproductive freedom. Far from merely addressing a “social issue,” the restriction of reproductive rights can have dire impacts on the health, safety and economic security of women and families around the world.
Donald Trump has proven that he has some draconian positions and ideas on reproductive health, including supporting punishment for anyone who gets an abortion, as well as his appalling attitude about women’s bodies. But what will this rhetoric mean for policies on access to reproductive healthcare? We are starting to find out.
The first test is the Global Gag Rule. Reinstating this harmful and ineffective policy was one of the president’s initial actions on his first day in office. This Reagan-era policy followed the Helms Amendment of the 1970’s. Named for late North Carolina Senator Jesse Helms, a staunch opponent of reproductive freedom, the Helms Amendment prohibited the use of any U.S. funds for abortion-related activities. The Global Gag Rule goes further and prohibits organizations that receive U.S. aid from even talking to patients about the full range of family planning options by restricting their funding if they do so. The stated aim of this policy is to reduce the number of abortions abroad, but reports show that it does just the opposite. By suppressing a health professional’s ability to speak freely about all aspects of reproductive health, the restriction actually spurs more abortions because of decreased access to both birth control and comprehensive sex education.
Abortion-related deaths also increase. Without access to safe abortion care, women are forced to seek out unsafe and often deadly alternatives. They douse themselves with gasoline and light a match; they pay to have someone stomp on their stomach; or take traditional remedies to induce an abortion. According to the World Health Organization, 47,000 women die yearly from unsafe abortions.
Trump’s first act in reinstating the Global Gag Rule should be a warning sign for how he plans to handle abortion funding in the U.S. One restrictive rider that has been in place since 1977 is the so-called Hyde Amendment, a ban on public funding for abortion that is voted on in Congress every year. Recently, the House voted to make that annual ban into permanent law.
The Hyde Amendment bans Medicaid funding for abortion, restricting poor women from basic healthcare services. There are exceptions for rape, incest, and the life of the woman, but the vague language allows politicians to decide what constitutes rape or when these exceptions are allowed, meaning that the exceptions do little to help in practice.
What politicians don’t take into account is how much this law hurts poor women who rely on Medicaid for their healthcare. For example, many local retail workers are paid low wages and have no employer-sponsored health insurance. If one such worker becomes pregnant and chooses not to keep the pregnancy, they face a daunting process. Because of Hyde, they must pay for the entire procedure out of pocket: the cost of traveling to one of just a few abortion providers in North Carolina, the cost of the procedure itself (on average, about $500 during the first trimester), the aftercare visits, medication, and the lost income if they have no access to paid leave time. Unless you live in certain metropolitan areas, you typically must travel between 20 and 100 miles for an abortion  in North Carolina.
No one should be denied healthcare because of their inability to pay. When people seeking abortions do not have the money to pay for an abortion, they have stark choices: carry an unwanted pregnancy to term; take money needed elsewhere in their budget to find enough to cover the costs; or seek out a dangerous alternative.
More than 100 members of Congress — including North Carolina Representatives David Price and Alma Adams — sent a lette r to President Trump last December calling on him to repeal the Hyde Amendment and eliminate restrictions on abortion coverage and care in his budget request. Now, other members of Congress are asking him to sign the amendment into law.
While the new president has indicated he holds antiquated views on reproductive rights that are out of step with the majority of Americans, it’s not too late for him to learn and change and to consider what’s good for women and families. He has opportunities to ensure safe health care for women in the U.S. and abroad. He should eliminate these ineffective, damaging policies that merely play out dangerous ideological political battles at the expense of poor women’s health and safety in the U.S. and around the world.
Jina Dhillon is the Board Chair of NARAL Pro-Choice North Carolina .