The NYRB has published a major investigation by Jill Filipovic about how American policy has contributed to preventing rape victims in war zones from getting access to abortion and other necessary health care. As is too often the case, Trump took an already bad bipartisan policy baseline and made it much worse:
The problem isn’t just that abortion laws in Uganda are conservative and contradictory (the law says abortion is legal only to save a woman’s health or life, while the Ugandan Ministry of Health’s national guidelines say abortion should be on offer for rape survivors). Rwenyawawa is in a refugee camp, which is subject to a combination of restrictive local laws, humanitarian timidity, and America’s abortion politics. This produces a singular result: even though everyone knows rape is endemic in conflict and that pregnancies from rape abound in refugee settings, terminating a pregnancy is stigmatized and almost universally out of reach for these women, some of the world’s most vulnerable.
This is despite the fact that most countries with large refugee populations officially permit abortions for rape survivors—and that US law, in theory, allows USAID dollars to fund them. The 1973 Helms Amendment to the Foreign Assistance Act came into force after the Roe v. Wade decision in the United States legalized abortion nationwide, and it bars US money from funding “abortion as a method of family planning [my emphasis].” That language leaves open the option for USAID to pay for abortions required for other reasons: to preserve a pregnant woman’s life or health, or to end a pregnancy caused by rape or incest. In practice, however, USAID does not fund abortions for rape survivors, or anyone. That is enormously influential, because the United States is the largest global health funder in the world.
All of these restrictions predate the presidency of Donald Trump, and they remained in place after he left office. Even under Democratic presidents, US backing for women’s reproductive health is tepid, and support for abortion virtually nonexistent. Yet Trump’s team made unprecedented attacks on women’s health, including basic care for rape victims. It was a disaster for the world’s women. But the administration’s aggressive stance highlighted the degree to which an overreliance on US largesse has made global health work a hostage to America’s deadlocked, antagonistic domestic politics of abortion. And it had one significant, if inadvertent, outcome: private philanthropists, innovative human rights lawyers, and more progressive nations are now taking a bolder stance—asking: Why shouldn’t refugee women raped in conflict be entitled to safe abortions?
This is one of the things the Biden administration can address despite the Manchin Gridlock, and he should.