If a Republican becomes president, says Michelle Goldberg, say goodbye to international programs providing birth control to women in desperately poor countries such as Liberia.
Gertrude Gorma Cole, a midwife in Liberia’s Bong County, is almost universally known as “Mother Dear.” A warm, grandmotherly presence in a traditional lappa dress, she has been practicing at least since the 1970s. In some ways, she is conservative. Speaking of Liberia’s disastrous teenage pregnancy rate—which is high even by West African standards—she blames both the social breakdown caused by the country’s savage civil war and the lax ideas of the international NGOs that swept into the country in its wake. “After the war, the NGO people came in and they brought ‘child rights,’ so the children became so loose, and even to discipline them, they will take you to the police,” she says. Western aid workers dispute this, insisting that the idea of Liberian kids informing on their parents is an urban legend. Still, her views speak to a level of distrust toward the humanitarian agencies that play an outsized role in governing the decimated nation.
Yet there is one thing Mother Dear does not distrust: the programs to provide birth control, which are largely supplied by USAID. In addition to being a midwife, Mother Dear is the county’s reproductive-health supervisor. When I tell her that support for international family planning is controversial in the U.S., and that some candidates for president would like to end it, she is shocked. “If they cut off funding for family planning, more mothers are going to die,” she says.
She’s worth listening to, because whatever effect the upcoming election has on the reproductive health of American women, the effect on women worldwide is likely to be even greater. I was in Liberia recently as part of a World Health Organization-sponsored trip to look at the future of funding for AIDS, TB, and malaria in an age of global austerity. But the country is also an object lesson in the potential global impact of our interminable culture wars.
If Romney is willing to scrap the only federal program to provide birth control to low-income women in the United States, programs to do the same thing abroad certainly aren’t safe.
Finbarr O'Reilly / Reuters
Those culture wars have turned birth control into a significant issue in the U.S. presidential campaign. All of the Republican candidates have slammed the administration’s refusal to give religious institutions a broad exemption from the mandate that insurance cover family planning. One of them, Rick Santorum, has promised to use the presidency to speak out about “the dangers of contraception in this country,” and has said he believes states should have the right to ban it. Mitt Romney, the likely nominee, has laughed off threats to birth control as an absurd nonissue, but even he has pledged to eliminate Title X, the federal family-planning program founded under Richard Nixon.
To understand how radical that is, consider that Mike Pence, one of Congress’s leading crusaders against Planned Parenthood, has never gone that far. “I’ve never advocated reducing funding for Title X,” he told an Indiana radio station last year. “Title X clinics do important work in our inner cities. They provide health services for women and children that might not otherwise have access to them.”
If Romney is willing to scrap the only federal program to provide birth control to low-income women in the United States, programs to do the same thing abroad certainly aren’t safe. We already know that, like every Republican since Ronald Reagan, he’ll impose the global gag rule, preventing any American money from going to organizations that perform or even counsel about abortions. He will likely follow George W. Bush in withholding money from the United Nations Population Fund, or UNFPA, an agency that promotes reproductive health worldwide, on the demonstrably false grounds that it supports coerced abortion in China. (Restore Our Future, the pro-Romney Super PAC, has tried to tie Newt Gingrich to China’s one-child policy because he co-sponsored a 1989 bill that included a UNFPA appropriation.)
There’s reason to believe Romney would go even further than Bush did. He’s already signaled a desire to cut some of the international HIV/AIDS prevention and treatment programs that Bush championed. At a New Hampshire town hall in October, he was asked if he would “continue the tradition that was laid forth by the Bush administration” of funding global health. “I am very reluctant to borrow lots more money to be able to do wonderful things if those things can be done by people making charitable contributions or other countries that are wealthy,” he responded.