There is no gender equality without access to reproductive health services, including access to contraceptives and safe abortions. In fact, economists are paying increasing attention to the economic benefits of investing in women’s reproductive health and finding gains not only for women but also for their families and for the economy at large. Yet several governments around the world, including the United States, are restricting women’s access to contraception and safe abortion services. The International Day of Action for Women’s Health on May 28 marks a particularly good time to recognize that investing in women’s reproductive health is smart economics at home and abroad.
Since January 2017, the Trump administration has enacted a set of policies that have restricted women’s access to reproductive health care. On his third day in office, President Donald Trump reinstated and expanded the Global Gag Rule. First implemented by Ronald Reagan in 1984, the Global Gag Rule cuts U.S. foreign aid for family planning and reproductive health to foreign nongovernmental organizations that perform abortions or discuss the option of abortion with patients. Over the last 35 years, every Democratic president has rescinded the policy and every Republican president has reinstated it. Not only did President Trump reinstate this restrictive policy, he expanded it to cover all global health funding. The policy puts $8.8 billion in global health funding at risk.
The Global Gag Rule and other policies that restrict funding for women’s reproductive health are ineffective and costly. It turns out that the Global Gag Rule causes more rather than fewer abortions. Data from 51 developing countries, covering about 6.3 million women per year, indicates that women in Latin America and Sub-Saharan Africa were at least twice as likely to have an abortion when the policy is effect. This policy – renamed by the Trump administration as “Protecting Life in Global Health Assistance” – does not achieve its objectives in the majority of countries that receive U.S. assistance. This is cutting U.S. foreign aid for family planning and reproductive health reduces women’s access to contraception and leads to more unwanted pregnancies. And women will find a way to have an abortion if they need to, even if it is illegal and in unsafe conditions.
Investing in women’s reproductive health is good for women. It also makes good economic sense for a number of reasons. Access to comprehensive reproductive services improves women’s health. Women’s ability to control the timing and number of births is linked to higher maternal age at first birth, fewer children, and longer birth intervals. These factors are all linked to improved maternal health, which not only helps women but also has repercussions for healthcare costs and the overall macroeconomy.
Women’s ability to control fertility is linked to increased educational attainment, higher labor force participation rates, and greater lifetime earnings for women. Providing birth control to young women leads to a substantial increase in age at first marriage and higher enrollment in in professional and graduate schools. A recent study suggests that abortion law liberalization in the United States had an even stronger effect than the introduction of the birth control pill on women’s decisions to delay marriage and childbirth.
Investing in women’s reproductive health improves children’s wellbeing. In developing countries with high fertility rates, greater spacing between births and smaller family size both benefit children’s nutritional status, body mass index, development, and survival chances. Smaller family size increases the resources available for each child, which contributes to improved child health and greater educational attainment. Some of these effects can result simply from contraceptive access, not necessarily contraceptive use. For example, evidence for Malaysia indicates that parents may invest more in their daughters’ education if they know that their daughters will have access to contraception later in life.
Integrating family planning and safe abortion into a full range of reproductive health services will go a long way to promoting health equity and improving women’s economic opportunities. When women control their reproductive health, they have more control over their economic health and well-being. Research shows that it makes sense for US policy to support this agenda rather than marginalize women and their reproductive health with ideologically-based funding restrictions such as the Global Gag Rule. It is time for policy makers to embrace the fact that women’s reproductive health rights are intricately linked with their economic empowerment.
Featured image credit: #Fight4HER Rally to End Trump’s Global Gag Rule Lafayette Square, Washington, DC by Bill Petros. Public Domain via Flickr.