Two Women, Different Outcomes: How U.S. Foreign Assistance Policy Harms Women
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: ABORTION
Two Women, Different Outcomes: How U.S.
Foreign Assistance Policy Harms Women
by Elizabeth Maguire, Ipas
November 27, 2013 - 11:55 am
Consider the stories of two Ethiopian
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10
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women—Wubalem and Chaltu—who
found themselves in similar situations
that led to very different outcomes.
Both are young, married, and seeking
to create the best lives possible for
themselves and their families, and
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both wanted to terminate an
unwanted pregnancy.
Both Wubalem and Chaltu live only
five kilometers from the nearest public
health clinic. Under Ethiopian law,
both have the right to safe, legal
abortion. Yet, because of
unnecessarily broad interpretation of
How is it possible that U.S. foreign aid, which does so
much good around the world, can also prevent a woman
from receiving an abortion that is legal in her own country?
(spirit of america / Shutterstock.com)
U.S. government policy, one was denied this fundamental right.
Wubalem is 22 years old and lives in a rural area of southwest Ethiopia. Shortly after her
recent marriage, she was raped by a close relative and further traumatized when she
discovered she was pregnant. Desperate to end the pregnancy—and knowing she was legally
entitled to do so because it resulted from rape—she went to the nearest public health clinic
and requested an abortion.
Wubalem was shocked when health-care workers there told her that the clinic, which
receives support from the U.S. Agency for International Development (USAID), does not
provide abortions. She would need to travel over 60 kilometers to a facility that offers this
legal service. In desperation, she returned home and attempted to end the pregnancy on her
own, by inserting a large twig into her uterus.
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Two days later, hemorrhaging and with a high fever, Wubalem was rushed to the health
center. After almost dying from a severe infection, Wubalem learned that she had a ruptured
uterus and will never be able to bear children—a devastating and totally preventable
outcome.
Chaltu, also 22, lives in a coffee-growing region closer to the capital city of Addis Ababa. She
has two children, the youngest only 10 months old. When Chaltu learned she was pregnant,
she and her husband agreed that they could not have another child so soon, especially since
Chaltu had a very difficult delivery less than a year ago.
Chaltu traveled with her husband to the nearest public health clinic, which does not receive
USAID support, where she was able to obtain a safe, legal abortion on the grounds that
another pregnancy could endanger her health. Chaltu returned home the same day after a
http://rhrealitycheck.org/article/2013/11/27/two-women-different-outcomes-how-u-s-foreign-assistance-policy-harms-women/[12/2/2013 2:13:52 PM]
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U.S. foreign aid, which does so much good around the world, can also prevent a woman from
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The answer is overly restrictive interpretation of the Helms Amendment to the U.S. Foreign
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Assistance Act. In place since 1973, the Helms Amendment states that “none of the funds
made available [under the Foreign Assistance Act] shall be used to pay for the performance
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of abortions as a method of family planning or to motivate or coerce any person to practice
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abortions.” Legally, this restriction does not extend to abortions performed following rape or
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But for the past 40 years, USAID and its grantees have implemented the Helms Amendment
as a complete ban on abortion. This means that in Ethiopia and in many other developing
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countries, health-care facilities that receive U.S. government funds treat women only after
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For more than two decades I worked for USAID’s international family planning assistance
program, including leading the Office of Population from 1993 to 1999. I saw the significant
impact of U.S. government assistance on expanding the availability and use of modern
methods of contraception in Africa, Asia, and Latin America. But family planning alone will not
eliminate the high levels of unwanted pregnancy and unsafe abortion. Women also need
access to safe, legal abortion. This is an essential measure to reduce maternal deaths and
injuries in developing countries. For the past 14 years, I have been privileged to serve as
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president and CEO of Ipas, an international non-governmental organization dedicated to
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At the International Conference on Family Planning in Addis Ababa, Ethiopia, in midNovember, I chaired a session on “The Impact of Harmful Legal and Policy Requirements on
U.S. International Family Planning Assistance.” The session highlighted how women in
developing countries who rely on USAID-supported health-care facilities are denied access to
safe, legal abortion to which they are legally entitled—as well as counseling and referral to
these services—as part of comprehensive, integrated reproductive health care. Those who
are most affected by this denial of services and information are young, poor, and otherwise
vulnerable women.
The current restrictive interpretation of the Helms Amendment is at odds with U.S. domestic
policy on abortion, whose allowance of government funding for abortion in cases of rape,
incest, and life-endangerment is supported by even the most conservative members of
Congress.
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I call on the Obama administration to correctly implement the Helms Amendment now, by
allowing the U.S. Department of State and USAID to support abortion overseas in cases of
rape, incest, or to save the life of the woman. This simple act would enable millions of women
like Wubalem to gain access to safe abortion care that is legal in their own countries. It would
no longer deny the rights of women in other countries to make their own reproductive choices
freely and safely.
Failure to act perpetuates an unconscionable imposition of U.S. abortion politics on women in
developing countries who are least able to advocate for their own needs.
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http://rhrealitycheck.org/article/2013/11/27/two-women-different-outcomes-how-u-s-foreign-assistance-policy-harms-women/[12/2/2013 2:13:52 PM]