When the G8 Summit begins today in Ontario, the Obama administration may be pressed to clarify its position on support for abortion services abroad. While Secretary of State Hillary Clinton has unequivocally stated that all women must have access to a full range of reproductive health services, President Barack Obama has been relatively silent. But he now has the opportunity to speak out.
In anticipation of hosting this year’s summit, conservative Canadian Prime Minister Stephen Harper launched a new international campaign for maternal and child health, the two Millenium Development Goals for which progress has been slowest. When unveiling the initiative, Harper called for increased funding and resources from governments, non-governmental organizations, and private foundations for a range of interventions, with an emphasis on nutrition, vaccines and clean water. He pointedly excluded both abortion and contraception from this effort.
This move provoked a strong rebuke from Secretary Clinton, who stated at a meeting of G8 foreign ministers in March: "You cannot have maternal health without reproductive health. And reproductive health includes contraception and family planning and access to legal, safe abortion." In response to Clinton and public pressure, Harper said that he would consider adding family planning to his initiative. But he refused to compromise on abortion, echoing the “no public funding for abortion” mantra.
Clinton’s statement was both welcome and quite accurate—13 percent of maternal deaths each year are attributed to illegal and unsafe abortion. However, her comments came less than a week after the ink had dried on an executive order President Obama had agreed to sign in a last-minute effort to secure votes for the health reform bill from antiabortion Democrats. The order simply reiterated the abortion restrictions already in the bill—which cemented a ban on public funding for the foreseeable future but did not prohibit private insurance coverage of abortion—but signing it put Obama in a tight spot: how can he now speak out for abortion services abroad when he has agreed to restrictions at home?
In fact, their positions are not as inconsistent as they may appear at first blush.
One of Obama’s first acts in office was to remove a ban on US funding, known as the "global gag rule," to foreign organizations that used their own money to provide, counsel or refer for abortions or to advocate for a change in their country’s abortion laws. The reversal of the rule did not, however—and could not—change the Helms Amendment, a statutory ban on direct payment for abortion services with US foreign assistance funds that remains in full force today.
Similarly, Obama’s executive order and the health reform law he signed require that private premiums be segregated from government subsidies and only private money be used to pay for abortion coverage in private insurance plans. What the president would not and did not agree to was the Stupak Amendment, which would have prevented any government money from going to an insurance plan that included abortion coverage, even if abortion care would be paid for separately with private funds.
Thus in both the international and domestic context, Obama has drawn a distinction between direct and indirect funding. While he has declined to fight Congress on statutory restrictions on public funding for abortion itself, he has rejected claims by abortion opponents that funding for other services (e.g., prenatal care, contraception, HIV prevention and treatment) provided by entities that also provide access to abortion “subsidizes” abortion and therefore should be prohibited as well.
Ideally, the administration would recognize that the United States and its partners cannot achieve maternal and child health goals without being willing to directly fund safe abortion services. Indeed, Clinton’s position implies that a repeal of the Helms Amendment (and similar domestic restrictions) is necessary—both in order to accomplish real progress on maternal and child health measures and to avoid charges of US hypocrisy. But at the very least, the president can stand solidly behind Clinton’s statement and reaffirm that women need to have access to safe and legal abortion, both because it is a basic human right and because it is a necessary component of a comprehensive and effective approach to achieving maternal and child well-being.
Canada’s stance on abortion at the G8 will require countervailing pressure from global supporters of reproductive rights. With financial pressures and conservative forces rising in Europe and the British government having shifted to the Conservative party, that pressure will need to come from the United States. Secretary Clinton has set the stage for President Obama to take this leading role.