Global Gag Rule: How Trump’S Second Term Could Threaten Reproductive Health Worldwide

Ahead of his anticipated second term, former President Donald Trump is set to reinstate the global gag rule, a policy that bans foreign organizations receiving U.S. global health aid from discussing or providing abortion services. This rule, first introduced by President Ronald Reagan in 1984, has been repeatedly reinstated and repealed depending on the U.S. administration’s party affiliation. Now, activists and more than 100 international civil society organizations are calling for its permanent repeal due to its devastating effects on global health and reproductive rights.

On the anniversary of the Dobbs decision, which overturned Roe v. Wade, Trump praised himself for his efforts in restricting abortion rights in the U.S., calling himself the “most pro-life president in U.S. history.” This rhetoric is tied to his broader anti-abortion agenda, which, if pursued globally, could cause significant harm to sexual and reproductive healthcare worldwide.

The global gag rule, which Trump reinstated during his first term, prohibits foreign NGOs from promoting or performing abortions as a condition for receiving U.S. family planning funds. This sweeping policy extends to advising, referring, or even discussing abortion with patients where legal. It also limits lobbying for changes in abortion laws and conducting public campaigns on abortion services.

Before the global gag rule was reintroduced, organizations receiving U.S. aid were allowed to use non-U.S. funds for abortion-related activities, as long as U.S. funds were kept separate. The rule’s re-imposition under Trump was coupled with an expansion of its scope. The policy was renamed the Protecting Life in Global Health Assistance and extended to include U.S. health grants for issues unrelated to family planning, such as sanitation and disease prevention. The Trump administration also added new restrictions, targeting sub-recipients of organizations that had been “gagged,” even if they did not receive U.S. aid themselves.

In response to these developments, over 100 civil society groups worldwide are calling for the permanent repeal of the global gag rule, highlighting the harm it has caused in countries with limited access to healthcare. These groups argue that the gag rule has led to clinic closures, reduced access to contraception, and worsened health outcomes, particularly in underserved communities. The policy’s impact has been especially harmful in areas with already existing barriers to care, resulting in more unintended pregnancies, unsafe abortions, and preventable deaths.

In addition to the global gag rule, Project 2025—an initiative linked to Trump’s policy vision—proposes expanding the rule to cover all foreign assistance, including humanitarian aid. This change could increase the affected funding from $7.3 billion to $51 billion, further restricting reproductive health services globally. The policy could even extend to foreign governments, not just NGOs, intensifying its global reach.

Experts like Beth Tully from the Guttmacher Institute warn that the global gag rule undermines countries’ health systems and obstructs progress toward Universal Health Coverage. They argue that this anti-abortion policy, driven by Trump’s ideology, would hinder essential services like antenatal care and overall healthcare access.

As Trump prepares for his second term, the global community faces the potential return of a policy that has already caused widespread harm to reproductive rights. Only the permanent removal of the global gag rule can prevent further damage to sexual and reproductive health worldwide, but with Trump’s firm stance against abortion, that outcome remains uncertain.