Opinion: Trump’s first blow against reproductive rights was in the developing world

In Kitengela, a poor neighborhood on the southern outskirts of Nairobi, Kenya, the Family Health Options Kenya clinic served as a beacon of hope for women and families with nowhere else to turn. It’s a small, unassuming stone building with a low-slung roof, but for patients in the surrounding area, it was everything. They filtered in and out of the clinic, receiving free HIV testing, anti-retroviral medication, family planning, and reproductive health care. Clinic staff often ventured out into the community, which is plagued with high rates of drug trafficking and rape, to inform locals about their free reproductive health services.

Until recently, that is. The Kitengela clinic was forced to shut down. All staff were served termination letters. The doors were closed and locked. The people who relied on it were left without alternatives. This disgraceful outcome is all thanks to United States President Donald Trump.

Trump’s first act as president was to sign his expanded “global gag rule,” which bans health care providers around the world that receive U.S. aid dollars from providing legal, safe abortions, or even discussing abortion as an option with patients. Trump’s gag rule puts providers such as FHOK in an impossible position: Either decline to sign the rule and risk losing desperately needed funding, or sign it, knowing that if they cannot provide abortion consultations to their patients, then those patients will seek abortions from dangerous “curtain clinics.” Those methods often involve inducing abortion by crochet needle. As one provider put it, signing Trump’s gag rule was akin to signing her patients’ death sentence.

To say these providers had a choice is to make a mockery of the word. They were essentially told that in order to help some, they’d have to abandon others.

FHOK, the oldest and largest sexual reproductive health organization in the nation, refused to sign. Now, as they are forced to shut down the Kitengela clinic for lack of funds due to Trump’s gag rule, their patients are paying the price. Left with no options, they may very well seek out those curtain clinics to terminate unwanted pregnancies. Some of them will die.

This policy was just the first in a long chain of dominoes. Trump kicked off his presidency by enacting the global gag rule, stripping reproductive rights from vulnerable people in developing countries. He then moved to defund the United Nations Population Fund, install anti-choice extremists to positions of power throughout the government and courts, and now impose a domestic gag rule on Title X funding in the U.S. 

It matters that Trump’s first blow against reproductive rights as president was struck overseas. It matters that his policy targeted the most vulnerable, people easily forgotten by the American voter. It matters that according to new data from PAI and the Center for Health and Gender Equity, the majority of American voters across the political spectrum oppose Trump’s global gag rule.

While Americans can take to the streets with signs and open up our checkbooks for 2020 candidates, the people in Kitengela have no recourse to fight back against the tragedy Trump has inflicted upon their community. It’s up to us to hold him accountable for what he’s done.

In the Senate, a bipartisan group of legislators has rallied behind Senator Jeanne Shaheen’s Global Health, Empowerment and Rights Act, which would permanently repeal the global gag rule. Representative Nita Lowey is leading a similar bill in the House.

If we do not stand up for reproductive rights everywhere, for all people, none of us will have any left when the final domino falls.