In the Wake of Roe v. Wade: The Helms Amendment

USAID is essential in reducing infant and maternal mortality in the developing world.

This Sunday, December 17, is the 44th anniversary of the Helms Amendment.

What is the Helms Amendment and why should we care about it?

The simple answer to the first part of that question is that it is language added to the 1973 foreign aid bill. It reads:

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.

The Helms Amendment was the first federal legislative attack on abortion rights in the post-Roe era.

But of course nothing to do with abortion is ever simple. Think of the Senate in December 1973, just 11 months after the Roe v. Wade decision made abortion legal. In the intervening months the war in Vietnam ended; Henry Kissinger visited China; the Watergate hearings and the first trials of the conspirators began; Vice President Spiro Agnew resigned after being convicted of accepting bribes; President Nixon named Gerald Ford to replace Agnew; there were bloody coups in Greece and Chile; the Yom Kippur War was fought in the Middle East; Saudi Arabia led the oil embargo against the United States, raising gasoline prices from 25 cents per gallon to more than a dollar; Nixon tried to stop the Watergate investigation by firing the special prosecutor, Archibald Cox; the top two people in the Justice Department resigned rather than do so, leaving Robert Bork to carry out that order, in what became known as the Saturday Night Massacre; eventually Nixon was compelled to turn over his tapes after fighting the order in court.

In other words, 1973 was a turbulent year, a time of great change and political turmoil in Washington.

American politics were already undergoing a seismic shift. The “solid South,” the southern Democrats who had kept civil rights legislation from being passed for almost a century, had lost that battle when Lyndon Johnson got the Civil Rights Act and Voting Rights Act passed in 1964 and 1965. The movement of this voting bloc to the Republican party began with these laws, and was well underway when Jesse Helms of North Carolina took his place in the Senate in 1973 as a Republican. He would prove to be one of the most conservative members of Congress for 30 years, and became an early leader of the religious right. Helms opposed civil rights, feminism, immigration, social welfare programs, and, of course, abortion.

He and other abortion opponents in the Senate looked for ways to overturn Roe; a Constitutional amendment was proposed, but that idea got nowhere, and they decided that if they couldn’t ban abortion, they could at least refuse to have the government pay for it. The Helms Amendment was born, and was the foot in the door for federal anti-abortion legislation after Roe. (The Hyde Amendment, restricting use of federal funds for abortion in this country, was not passed until 1976.)

The Foreign Assistance Act of 1961, which separated military aid from economic assistance to developing nations, established the United States Agency for International Development (USAID) to administer nonmilitary assistance to government and nongovernmental programs whose goals included reducing infant mortality and regulating population growth. The mission was to provide training and program development support as well as financial assistance.

When the Helms Amendment was being debated in Congress, USAID submitted a statement in opposition. The availability of safe abortion is a necessary component of comprehensive family planning policy, it said.

The agency also implied that the effect of removing safe abortion from the range of options provided to women with unintended pregnancies — an option just legalized for U.S. women nationwide —  could amount to a form of coercion. The Foreign Assistance Act, USAID wrote, “explicitly acknowledges that every nation is and should be free to determine its own policies and procedures with respect to population growth and family planning. In contradiction of this principle, the amendment would place U.S. restrictions on both developing country governments and individuals in the matter of free choice among the means of fertility control … that are legal in the U.S.”

But the Helms Amendment — the first federal legislative attack on abortion rights passed, and has remained part of our foreign aid ever since. Programs in developing countries had to maintain separate accounts for U.S. funds so they would not be used for abortions — and it was just a beginning. Early in the Reagan administration, there was an attempt to stop all foreign aid for family planning, which Reagan himself refused to approve, although he tried to lower the appropriation over the next few years. James Buckley, undersecretary of state for security assistance and a devout Catholic, tried to get USAID to stop all family planning assistance, without success.

Then in 1984 the National Security Council proposed a change in this policy, which could then be passed by executive order, bypassing Congress, and which was formally announced by Buckley at the UN International Conference on World Population in Mexico City. It became known as the Mexico City policy, or the global gag rule. The relevant passage in the U.S. statement to the conference is this:

U.S. support for family planning programs is based on respect for human life, enhancement of human dignity, and strengthening of the family.

The United Nations Declaration of the Rights of the Child (1959) calls for legal protection for children before birth as well as after birth. In keeping with this obligation, the United States does not consider abortion an acceptable element of family planning programs and will no longer contribute to those of which it is a part.

In her autobiography Life on the Line, former Planned Parenthood Federation of America President Faye Wattleton describes her feelings as an observer at the conference and her disappointment as conference participants, in desperate need of U.S. financial help, signed on.

I left the meeting frustrated and disgusted that my colleagues could not see that this policy was one more step toward disenfranchising all women from their reproductive rights. This time around, the stakes were international.

In practice, this meant USAID would not contribute to programs in developing countries that performed abortions or even counseled about abortion as part of their women’s health programs, even though U.S. funds already could not finance abortions under the Helms Amendment. Health agencies in these countries would now have to choose between providing the full range of women’s health services available under their country’s laws (or even providing information or referrals to other doctors or programs that did provide abortions), or receiving much needed U.S. financial assistance.

Since 1984, all Republican presidents have instituted the Mexico City policy, and all Democratic presidents have rescinded it. Coming into office after the first eight years of this policy, the Clinton administration clarified the Helms Amendment as permitting U.S. funds to be used for counseling about abortion. In its latest incarnation, the gag rule is even more dire:

Trump’s policy extends restrictions to an estimated $8.8 billion in U.S. global health assistance, including funding support for family planning and reproductive health, maternal and child health, nutrition, HIV/AIDS – including The President’s Plan for Emergency Relief for AIDS, prevention and treatment of tuberculosis, malaria (including the President’s Malaria Initiative), infectious diseases, neglected tropical diseases, and even to water, sanitation, and hygiene programs.

Because of the uncertainty of overall U.S. family planning assistance policy, USAID and affected health care providers use the strictest possible interpretation of the Helms Amendment, and don’t allow use of U.S. funds for abortions under any circumstances. In Congress and groups including Planned Parenthood, advocates have focused on the phrase “as a method of family planning” in the amendment, and worked to allow USAID assistance to pay for abortions in cases of rape, incest, and to save the life of the mother, the same exceptions that pertain in this country. In countries where violence against women and girls is especially frequent, in war-torn countries in which rape is often used as a weapon of war, and in countries where child marriage is still frequent, such exceptions could be a matter of life and death. In its list of the Top 10 health issues that affect women worldwide, the World Health Organization names three on which the Helms Amendment has a negative impact — reproductive health, maternal health, violence against women — and a fourth, being young, since the first three issues are worse for adolescent girls.

And unsafe abortions are a major cause of maternal deaths:

Based on data from 2010–2014 there are approximately 25 million unsafe abortions annually. Of these one third or approximately 8 million were performed under the least safe conditions by untrained persons using dangerous and invasive methods. Unsafe abortions lead to an estimated 7 million complications.

In developed regions, it is estimated that 30 women die for every 100,000 unsafe abortions. That number rises to 220 deaths per 100,000 unsafe abortions in developing regions and 520 deaths per 100,000 unsafe abortions in sub-Saharan Africa.

Mortality from unsafe abortion disproportionately affects women in Africa. While the continent accounts for 29% of all unsafe abortions, it sees 62% of unsafe abortion-related deaths.

I can only wonder, with Faye Wattleton, whether the men who make laws like the Helms Amendment ever think of the women’s lives they impact, while they self-righteously talk about family values and call themselves pro-life.