NGOs, Abortion, and Federal Money: The Truth About The Mexico City Policy

The Mexico City policy (so named because it was announced at the United Nations International Conference on Population in Mexico City) has been implemented or suspended on strict partisan lines since the Reagan administration. All Republican Presidents implement it; all Democratic ones suspend it. The fact that President Trump has reimplemented it should surprise no one. However, now that it's getting either wildly applauded or criticized, it's worth looking at the reality of the policy.

Let’s begin by looking at the facts. First, from usaid.gov:

USAID'S FAMILY PLANNING GUIDING PRINCIPLES AND U.S. LEGISLATIVE AND POLICY REQUIREMENTS

Restrictions on Support for Abortions

Since the enactment of legislation in 1973, recipients of U.S. family planning assistance have been legally prohibited from supporting abortion as a method of family planning using U.S. funds. USAID is committed to expanding access to voluntary family planning and reducing unintended pregnancies which saves lives and reduces reliance on abortion. USAID continues to support post-abortion care, which includes emergency treatment, counseling on and provision of family planning options, and community mobilization.  

The Helms Amendment: No foreign assistance funds may be used to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortions. Under the Helms Amendment, post-abortion care is permitted. USAID post-abortion care programs include emergency treatment for complications of induced or spontaneous abortion, counseling on and provision of family planning options, and community mobilization. 

The Leahy Amendment: The term "motivate," as it relates to family planning assistance, shall not be construed to prohibit the provision, consistent with local law, of information or counseling about all pregnancy options. 

The Siljander Amendment: No foreign assistance funds may be used to lobby for or against abortion. {Note: later amended to add ‘or against.’) 

The Biden Amendment: No foreign assistance funds may be used to pay for any biomedical research which relates, in whole or in part, to methods of, or the performance of, abortions or involuntary sterilization as a means of family planning.

Second, here are the high points from a summary by the United States Conference of Catholic Bishops (and which is consistent with other summaries I have read):

• The MCP does not apply to abortions or abortion referrals in cases of rape, incest, or danger to the life of the mother.
• The MCP places no restrictions on lobbying for legalized abortion in cases of rape, incest, or danger to the life of the mother.
• The MCP allows passive abortion referrals when women may otherwise seek an ‘unsafe’ abortion.
• The MCP explicitly allows treatment for women who have complications from abortion.
• The MCP does not increase ‘unsafe’ abortions.
• The MCP does not reduce the amount of family planning funds by one penny.
• People in developing nations support the MCP because it respects their sovereignty and their values.
• The [MCP] has been supported by the great majority of developing nations.

* * * * *

If I am understanding the Mexico City policy correctly - and I'm admittedly finding it very difficult to find all the stats I would like to find - here’s the change that the Mexico City policy forces: NGO’s must stop actively promoting abortion as a “method of family planning when it is for the purpose of spacing births” if they want to continue receiving money from the United States government.

However, there is an exception for the ‘hard cases’ of rape, incest, and danger to the life of the mother. Also, if the woman states she wants an abortion, the NGO can provide, consistent with local law, information or counseling about all pregnancy options. “Passive” responses by family planning counselors to questions about abortion from pregnant women who have already decided to have a legal abortion is not considered an act of promoting abortion."

Frankly, both the pro-life and pro-choice responses often fail to account for the big picture. There are so many loopholes (or at least there have been historically) that most NGOs, if they read the cheat sheet, can easily get around these restrictions. In addition, abortions don't necessarily decline when this policy is implemented. This is neither the robust pro-life win nor the women’s health apocalypse I’ve been reading about in the news. 

I believe implementing the Mexico City policy is the right thing to do on deontological grounds, not consequentialist ones. We have a duty to protect life; that includes unborn life, and any measure taken to preserve the unborn is laudable. If NGOs choose to respond in a way that increases abortions, that's on them. If it's true that the rise of abortions correlates with the drop in contraception (a statistic which is contested), the NGOs could stay and continue to hand out contraception. They don't. 

If I am understanding my research correctly, the NGOs can continue to do everything they did before the Mexico City policy except offer a surgical abortion, ‘motivate’ unmotivated women to get an abortion, or lobby/counsel in opposition to a nation's laws.

• If the woman comes in stating she wants an abortion, they can counsel her along those lines if abortion is legal in that country. 
• If a woman is pregnant because of rape or incest, they can counsel for an abortion if abortion is legal in that country.
• If a woman’s life is in danger, they can counsel her to get an abortion if abortion is legal in that country.
• They can hand out all the contraception they did previously. As far as I can tell, they can even hand out the 'morning after' pill. I've seen multiple article pointing out how contraceptive shipments drop when the Mexico City Policy is implemented. But the Mexico City policy has nothing to with contraception. The U.S. would keep sending just as much contraception as it always did.
• They can provide every other service to women they previously offered. They can do cancer screenings, mammograms, and other life-saving services.

Being able to do literally everything expect perform, 'motivate,' and lobby for surgical abortion as a form of family planning is apparently a bridge too far. Some NGOs refuse to provide any of their other very important services if they cannot do those things, so they leave. Specifically,  International Planned Parenthood and Family Planning International Assistance refuse the money, while most other NGOs generally accept the terms. 

If this were all about women’s health, NGOs would adjust. Plenty of them do. IPP and FPIA don’t. They would rather not help at all if they can’t help on their terms. That’s not pro-women. That's pro-abortion. 

The good news is that, based on the information I have been able to find, the money earmarked for women will simply go to the NGOs that continue to do good things for women. If you are opposed to the Mexico City policy, and you want to be channel your anger constructively, contact IPP and FPIA and ask them why they have abandoned the women they claim they want so desperately to help.