Did the Mexico City Policy lead to a reduction in abortions?

Yesterday President Joe Biden rescinded the so-called “Mexico City” rule. For those unfamiliar with this policy, here is some background from the Kaiser Family Foundation:

The Mexico City Policy is a U.S. government policy that – when in effect – has required foreign NGOs to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S. funds) as a condition of receiving U.S. global family planning assistance and, when in place under the Trump administration, most other U.S. global health assistance.

The policy was first announced by the Reagan administration at the 2nd International Conference on Population, which was held in Mexico City, Mexico, on August 6-14, 1984 (hence its name; see Box 1).  Under the Trump administration, the policy was renamed “Protecting Life in Global Health Assistance” (PLGHA). Among opponents, it is also known as the “Global Gag Rule,” because among other activities, it prohibits foreign NGOs from using any funds (including non-U.S. funds) to provide information about abortion as a method of family planning and to lobby a foreign government to legalize abortion.

When first instituted in 1984, the Mexico City Policy marked an expansion of existing legislative restrictions that already prohibited U.S. funding for abortion internationally, with some exceptions (see below). Prior to the policy, foreign NGOs could use non-U.S. funds to engage in certain voluntary abortion-related activities as long as they maintained segregated accounts for any U.S. money received, but after the Mexico City Policy was in place, they were no longer permitted to do so if they wanted to receive U.S. family planning assistance.

The Trump administration’s application of the policy to the vast majority of U.S. bilateral global health assistance, including funding for HIV under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), maternal and child health, malaria, nutrition, and other programs, marked a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020 alone, to the extent that such funding was ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounted for approximately $600 million of that total). The Trump administration also moved to further tighten restrictions, reaching other areas of U.S. development assistance beyond global health and other non-U.S. funding streams. See “What is the definition of ‘financial support’?” below.

Conservative evangelicals are very upset.

Here is pastor Jack Hibbs at his Facebook page: “

The God of heaven has seen today what Joe Biden has done.Jesus said that “it would be better for a person to have never been born then for that person in the day of judgment to face the wrath of God for having offended a child.” God‘s wrath is coming and his judgment will not sleep forever. Joe Biden will face the God of all eternity an answer for the lives that he has condemned to death.

Here is Liberty University Falkirk Center fellow Jenna Ellis:

Robert Jeffress is fired-up:

Albert Mohler is not happy:

But does the Mexico City Policy really result in more abortions around the world? The jury is still out. We do know, for example, that in sub-Saharan Africa, the Mexico City Policy resulted in a 40% increase in abortion rates. A study by Lancet Global Health concluded that “curbing US assistance to family planning organisations, especially those that consider abortion as a method of family planning, increases abortion prevalence in sub-Saharan African countries most affected by the policy.”

Here is the Kaiser Family Foundation again:

Several studies have looked at the impact of the policy. A 2011 quantitative analysis by Bendavid, et. al, found a strong association between the Mexico City Policy and abortion rates in sub-Saharan Africa. This study was recently updated to include several more years of data, again identifying a strong association. Specifically, the updated study found that during periods when the policy was in place, abortion rates rose by 40% in countries with high exposure to the Mexico City Policy compared to those with low exposure, while the use of modern contraceptives declined by 14% and pregnancies increased by 12% in high exposure compared to low exposure countries. In other words, it found patterns that “strengthen the case for the role played by the policy” in “a substantial increase in abortions across sub-Saharan Africa among women affected by the U.S. Mexico City Policy … [and] a corresponding decline in the use of modern contraception and increase in pregnancies,” likely because foreign NGOs that declined U.S. funding as a result of the Mexico City Policy – often key providers of women’s health services in these areas – had fewer resources to support family planning services, particularly contraceptives. Increased access to and use of contraception have been shown to be key to preventing unintended pregnancies and thereby reducing abortion, including unsafe abortion. The study also found patterns that “suggest that the effects of the policy are reversible” when the policy is not in place.

Read the entire report, complete with footnotes, here.

If Biden wants to be a unifier, he can frame his rescinding of the Mexico City Policy as a way of both protecting women’s health and reducing the global abortion rate.