Maasai women participate in a rally against gender-based violence for International Women's Day. Photo by Thomson Safaris, via Flickr.   Horrific tales of gang rape— from India to South Africa to Egypt—have been in the news a lot lately.  It is beyond disturbing that such brutality continues, but the recent media attention combined with the theme of this year’s International Women’s Day, ending violence against women, serve as important reminders that this effort is far from over.   As we work to end violence against women, we must also think about how to protect the human rights of victims of violence.  For when the headlines fade, we hear little about what happens to the survivors, especially when they become pregnant as a result of rape—or how US foreign policy limits a woman’s options when she becomes pregnant following a sexual assault.

The Helms Amendment–a little known provision of the 1973 Foreign Assistance Act and a predecessor to the more familiar domestic policy called the Hyde Amendment, which bans Medicaid coverage of abortion in most instances—makes it impossible to ensure justice for victims of rape and incest.

The Helms Amendment forbids US foreign aid from being spent on abortion “as a method of family planning.” That phrasing is a problem in and of itself. But in practice, the amendment operates as a total ban on US funding for abortion care abroad—when it should be an integrated part of the reproductive health care programs supported by our humanitarian aid.  Instead, the U.S. Agency for International Development (USAID) has interpreted the Helms Amendment to deny funding for any abortions, including when a woman’s life is threatened by a pregnancy, when a pregnancy results from rape or incest, to preserve a woman’s health, or because of fetal anomalies—categories that most would agree do not qualify as methods of family planning.

The denial of abortion services to women is always a violation of human rights, but this denial is especially unjust in conflict ridden areas, such as the Democratic Republic of Congo, the Sudan, and Burma, where rape is routinely used as a weapon of war.  As victims of armed conflict, these women are entitled under the Geneva Convention to complete and nondiscriminatory medical care, which includes abortion care.  While foreign aid should not be limited to assisting only those raped in war, this is but one example of the extreme harms of the current policy.

The suffering that these women experience is severe.  Not only must they deal with the physical and emotional degradation of the rape itself, they often are left with permanent disabilities and they may contract HIV or other sexually transmitted infections.  If they become pregnant and are denied safe abortion services, their problems are only compounded.  Either they will pursue unsafe termination methods–a leading cause of maternal mortality where abortion is illegal–or they will be forced to bear and raise a child of rape.  In the latter case, too often they are abandoned by their spouse and family and subject to violence, stigma, and ostracism from their community. 

The misinterpretation of the Helms Amendment is in direct conflict with USAID’s own previous interpretation of “abortion as a method of family planning” that did allow exceptions for abortion for reasons of life, rape, or incest in the Mexico City Policy, also known as the Global Gag Rule. That policy prohibited grantees of U.S. family planning aid from using their own money to refer or counsel for abortion or advocate for changes in their home country’s abortion laws until it was rescinded by President Obama by executive order in 2009.  The Helms guidance is also inconsistent with the Hyde Amendment, which explicitly allows Medicaid coverage for abortion in cases of life endangerment, rape, and incest.

And until recently, a similarly draconian restriction was imposed on the military’s TRICARE insurance program, which only covered abortion for military servicewomen and dependents for life-threatening pregnancies.  But thanks to an amendment sponsored by Sen. Jeanne Shaheen (D-NH), exceptions for rape and incest were added to the National Defense Authorization Act and signed into law by the President this past December.

Yet the administration has failed to issue an interpretation of the Helms Amendment that would ensure that survivors of sexual violence receive the medical care they need, despite the fact that 83 percent of Americans support abortion following rape, including 76 percent of Republicans.  Ensuring that foreign aid can go toward abortion care in instances of life, rape, and incest should not be controversial.

While we work to end all forms of violence against women, the State Department and USAID can at least fulfill our promise to respect the human rights of survivors of sexual violence and ensure that they receive timely, complete, and unbiased medical care.

Ann Jones reports on the status of women in Afghanistan as US withdrawal nears.