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FEATURE| winter 2008

Are U.S. Policies Killing Women?In a word, yes. And what's Bush doing about it? These days, making it worse.

By Michele Kort

Even as we commemorate the landmark 35th anniversary of Roe v. Wadethis year, U.S.reproductive-health policies are having an inordinately negative effect outsideof our borders.Theyre causing women to die or be maimed. Harsh words, but true.

For the past 24 years, except during the Clinton presidency, U.S. administrations havemaintained a global gag rule against providing counseling or referrals for abortions at U.S.-funded clinics in developing nations. Its a rule that only thwarts safeabortions, while reducingthe already limited availability of other family-planning services. The global gag rule has alsoled to a pullback in overseas delivery of contraceptives, according to recent testimony by Rep.Nita M. Lowey (D-N.Y.) before the House Foreign Affairs Committee: U.S. shipments ofcontraceptives have ceased to 20 developing nations in Africa, Asia and the Middle East. Insome areas, the largest distribution centers for contraceptives have experienced decreasedaccess for over 50 percent of the women they serve.

Womens health and rights activists in the U.S. have spent the past two decades fightingagainst such actions, and advocating on behalf of global reproductive health issues. Butprogress has come slowly. While maternal mortality has been declining at 1 percent annually,it needs to decline by 5.5 percent a year in order to be three-quarters reduced by 2015 (one ofthe United Nations Millenium Development Goals). Sounds like a lotbut it would require justabout $6.1 billion more in annual fundingthe price of three weeks of the Iraq warto achievethat goal. Without that commitment, more than 500,000 women will still die annually from

childbirth and its complications, with an estimated 70,000 of those deaths due to unsafeabortions.

Take, for example, the situation of women in Kenya, where abortion remains illegal unless thepregnant womans life is in danger (a loophole some compassionate doctors interpret liberally,as they know that desperate women will risk their lives to abort anyway). An estimated250,000 to 320,000 abortions are carried out in the country each year, with unsafe procedurescausing a shocking toll: Globally, 13 percent of maternal deaths result from abortion-relatedcomplications, but in Kenya its as high as 40 percent.

In public hospitals such as Kenyatta National in Nairobi, about 20,000 Kenyan women aretreated each year for abortion-related complications. Nearly two-thirds of the beds in thenotorious gynecological sectionWard 1Dare occupied by those patients, who suffereverything from excessive bleeding to injured organs to sepsis. Those sufferers includewomen such as Wangui (not her real name), who drank a boiled concoction made from trees

and took several doses of an anti-malaria drug in order to abort because her impoverishedhousehold couldnt support a fifth child. She ended up in Ward 1D because she required anurgent blood transfusion to save her life.

Womens-rights groups in Kenya have been pushing for a new national law on reproductiverights, as well as supporting a continental protocol on the rights of African women and apatients bill of rights. But theyre not helped in their efforts to improve reproductive health careby the global gag rule, which has forced a number of clinics to turn down U.S. funds ratherthan stop discussing abortion. Three clinics of the Family Planning Association of Kenya (anaffiliate of the International Planned Parenthood Federation) and two clinics of Marie StopesInternational (the U.K.-based reproductive-health NGO) have been closed for loss of funds,according to a 2004 report from the Center for Reproductive Health Research and Policy inSan Francisco.

Maternity care in general is problematic in Kenyas public hospitals. The 2007 report Failure to

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Deliver, produced by the Federation of Women Lawyers-Kenya (FIDA Kenya) and the Centerfor Reproductive Rights in New York, pointed out that public health facilities often suffer fromlack of supplies and congestion. Claris Ogangah-Onyango, legal counsel for FIDA Kenya,points out the obvious: When the majority of beds in maternity hospitals are occupied bywomen with post-abortion complications, there is not enough space and care for other women.

The government is mostly concerned with post-abortion care, she says, and most of thefunding goes to that. But theyre not doing anything to stop [unsafe] abortions.

What has really affected our work in Kenya is that we have very few women in our parliament[just 18 of 222 members], says Ogandah-Onyango. When we take our issues to the

government, they are blocked. FIDA and other womens organizations have approached thecandidates for the next parliament to sign a document that they will support gender-friendlybills. Putting more women in government would make a big difference.

And what can women in the U.S. do to help their Kenyan sisters? Lobby for change in thepolicies that govern reproductive health, she says. U.S. women can also support the efforts ofgroups such as FIDA Kenya (www.fidakenya.org), which is now part of the ReproductiveHealth and Rights Alliance in Kenya.

Sisterhood is a global mission. Economics and politics and even social conscience aside, weknow that only by empowering allwomen can we ensure the future of the world.

--Michele Kort, with Mary Kathomi Riungu reporting from Nairobi

For the full article, see the Winter 2008 issue of Ms. magazine, now available on newsstandsand by subscription from http://www.msmagazine.com/.

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