Donald Trump is in the White House because of abortion. Not solely that issue, of course, but it was his craven, calculated, and hypocritical embrace of the “pro-life” label just when he decided to run for office that pushed him over the edge with the many millions of evangelical Christians, Catholics, and other Americans for whom that is a single-issue deal-breaker. Added to the blue-collar discontent, racist backlash against the last president, and decades of anti-Hillary Clinton propaganda - OK, with her botched campaign too – and voila – here we are, where our whole beleaguered nation might be asked the classic Reaganite campaign question “Are you better off than you were four years ago?” Unless you are one of the fortunate 1% who got a tax cut, the question likely answers itself.
“I am strongly pro-choice” is what Trump said repeatedly prior to seeking office. He was likely telling the truth then, at a minimum for personal reasons (and what other motivations really fuel anything he does?). It’s pointless to speculate on how many unintended pregnancies he might have been personally party to, especially given his tendency to pay off anybody with compromising information on him, and/or to require nondisclosure agreements. He did say that avoiding sexually-transmitted diseases was his form of “service” during the Vietnam War he dodged. In any event those are private matters, and it’s his policies and their impacts that really matter. And with regard to those it is possible to propose what for some might be a startling hypothesis:
Donald Trump is responsible for more abortions than any person alive.
How could that be true? One of the very first things Trump did upon taking office was re-instating the “Global Gag Rule,” a Reagan-era ban on funding for any international aid programs that provide abortion that has been reversed by democratic presidents and reinstated by republicans since first instituted (again by a president who flip-flopped on abortion to serve his election purposes). Medical and public health experts and associations have always opposed it, even when they have no other position on abortion, for the seemingly obvious reason that in areas with few healthcare resources, those who provide abortion tend to also provide a wide range of women’s health services, including contraception and sex education. They also tend to deal with many unwanted pregnancies and serious complication of unprofessionally performed abortions, including self-induced ones – these being a widespread and tragic cause of much maiming and death among women, not to mention death of fetuses. Most anyone who has worked in or even just visited health clinics and providers in the developing world has likely witnessed the horrors women face in this regard.
Just last year, Stanford researchers published in the leading medical journal The Lancet some evaluation of the impact of the Gag Rule. Results showed a 40% increase in abortion rates in countries when the policy was active, as well as a drop in the use of modern contraceptives. The year before, a 100+ page report from African nations titled “Prescribing Chaos in Global Health: The Global Gag Rule From 1984-2018” detailed the many ways Trump’s expanded Gag Rule adversely impacted women and children. Similar research with similar results has been reported from Latin America and Asia. The Stanford researcher summarize the evidence thus: “Our findings suggest how a U.S. policy that aims to restrict federal funding for abortion services can lead, unintentionally, to more – and probably riskier – abortions in poor nations.” Given the populations in those regions, this likely means many thousands of abortions every year, and likely more than that.
What about here in the good ol’ USA? Abortion rates have been declining for decades, for various reasons including demographic trends (declining numbers of young people) and especially a wider use and availability of contraception. But Trump has worked hard to institute a domestic gag rule as well, blocking the use of Title X funds for the poor if any funded organization even talks about abortion, let alone refers for or provides it. These efforts have been opposed by the American Medical Association and American College of Obstetrics and Gynecology, who are hardly “liberal” organizations but know the real consequences of such policies.
What if abortion bans were instituted here? The real numbers on how many less a abortions might occur are fuzzy estimates. So are estimates on how many women would seek illegal ones. But we know from experience that would be many, with many tragic consequences. I learned this dramatically while still a student. Decades ago, medical and public health trainees at UCLA were sometimes taken on a tour of an old hospital ward, previously dedicated to women suffering the aftereffects of illegal abortions. I believe there had been something like 70 beds then and the veteran professor who guided us on the visit said that until 1970, when abortion was legalized in California, the ward was always full of suffering and dying women. “We used to have to mop their blood from the floors here – it reminded me of serving in World War II,” said the old doctor. After the laws changed, the ward quickly emptied out and was no longer needed.
This is what anti-choice activists, whatever their motivations, seek to bring back. They try any sneaky way to curtail abortion access, usually failing for legal reasons, but succeeding in some regions via harassment and even murder of doctors. But they are misguided. Most Americans support abortion, at least early in pregnancy when the vast majority of abortions occur and when the embryo or fetus looks nothing like what most people would consider a “baby.” But in fact virtually every “pro-choice” person shares their ostensible goal of reducing unwanted pregnancy and abortion, and we know how to do that. Endless arguments about “when life begins” or what Jesus did or didn’t say about abortion (he didn’t) don’t solve anything. Focusing on what works – widely-available low-cost or free contraception, fact-based sex education, economic support and equality for poor women, adoption where desired, and more are what work. Preaching about being “pro-life” and seeking to deny access to abortion does not. That only makes the activists feel more, well, “holy,” while in fact adding to the problem they say they seek to solve. So the uncomfortable truths are that Planned Parenthood and similar organizations prevent more abortions than any amount of ‘pro-life’ advocacy ever has. And let’s not forget that Donald Trump, again, is most likely responsible for more abortions around the world than any other human alive.