Helms Hurts: How the US Prevents Thousands of Women from Accessing Safe Abortions Each Year

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William Murphy
Activists call for safe abortion options for women at a rally in Dublin in 2011.

During a visit to Kenya in the summer of 2015, President Barack Obama gave a rousing speech to a crowd of Kenyan youth at a soccer stadium in Nairobi, citing the advancement of women’s rights as a major factor in the country’s progress.

“Treating women as second-class citizens is a bad tradition,” said Obama. “It holds you back. There’s no excuse for sexual assault or domestic violence… These traditions may go back centu-ries; they have no place in the 21st century. They are issues of right or wrong in any culture.”1

The speech was well received by many of the young Kenyans in attendance, but for all of its gender equality rhetoric, drew severe criticism from several Kenyan women’s rights organiza-tions. The reason? Obama failed to address the controversial US foreign aid policy, the Helms Amendment, which precludes the use of any US aid dollars to fund abortions in other countries. As it is currently enforced, the policy acts as a blanket ban for the use of foreign aid funds for abortions under any circumstances, including rape, incest, and endangerment of the mother’s life.

“In Kenya, maternal deaths and injuries can and must be prevented,” says Evelyne Opondo, Nai-robi-based regional director for Africa at the Center for Reproductive Rights (CRR). “President Obama has been a champion for women’s health in the United States, so we now call on him to take a stand for women worldwide and fix the Helms Amendment.” President Obama has re-mained consistent throughout his presidency on the right of a woman to choose when to termi-nate a pregnancy, even as abortion access has become increasingly limited for many women due to bills introduced by Republican lawmakers, and in the face of domestic terrorist attacks, such as the shooting at a Colorado Planned Parenthood clinic in November 2015 which killed three people and wounded nine. Reproductive health activists like Opondo are calling for Obama to defend the same right for women abroad.

Introduced in 1973 by Republican US senator Jesse Helms, the Helms Amendment states that, “No foreign assistance funds may be used to pay for abortion as a method of family planning or to motivate or coerce any person to practice abortions.” The policy was enacted in the same year as Roe v. Wade, and exists as a living relic of the conservative reaction to the introduction of le-gal abortion domestically. The restrictions outlined in the amendment are unique to the United States, the largest supplier of foreign aid globally. “The United States is the only major donor to have any kind of restrictions” for funding abortions, says Aram Schvey, senior policy counsel at the CRR. “Other countries simply don’t.” The United Kingdom, the second largest donor, con-tends that abortion procedures may be covered under foreign aid funds, citing the fact that girls and women raped in armed conflict are entitled to abortions when medically necessary under Ar-ticle 3 of the Geneva Convention, and has called upon the United States to repeal the Helms Amendment. Norway, also citing international law, has similarly challenged the policy.

Given varying infrastructure, political circumstances, and the status of women’s rights in aid-receiving countries, some women are left more vulnerable by the Helms Amendment than others. “In Kenya in particular, there’s evidence that US influence has been particularly noxious,” says Schvey. The USAID Global Health Initiative’s Kenya strategy acknowledges that, “maternal mortality levels in Kenya remain unacceptably high at 488 per 100,000 live births,” and cites the United Nations estimate that one in every 39 Kenyan women dies in childbirth. Kenya’s Ministry of Health states that unsafe abortions, often coupled with side effects like sepsis, ruptured uter-us, and postpartum hemorrhage, is one of the top causes of maternal death.

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Heinrich Böll Stiftung East & Horn of Africa
A woman poses a question at an event titled “Unsafe Abortion: Is Kenya Brave Enough to Take a Stand?” as part of the May 2014 Gender Forum, a monthly public dialogue in Nairobi.

The Ministry of Health’s National Reproductive Health Policy goes on to say that adolescents aged 10 to 19 are the group most at risk of unplanned pregnancy and unsafe abortions. These un-der-the-table abortions have had devastating effects for women and girls in Kenya, with those who survive the practice often experiencing appalling health complications. In Failure to Deliver, the CRR’s report on women’s health rights in Kenya, a nurse administrator describing her experi-ence treating women who received unsafe abortions recalled that, “One woman’s infection was so bad that we could smell her while she was outside approaching the building, and flies were fol-lowing her. She had … an abortion about a week ago, and everything was toxic.”2 Laura Bassett, writing for The Huffington Post, documented cases of women who “insert poisonous herbs into their vaginas, drink crushed glass,” and who have been forced to have their “stomachs stomped on by village elders until they miscarry.”3

Access to medical abortions is highly restricted in Kenya, though the Constitution does allow for the procedure to be legally performed in cases of physical or mental health emergencies, if the life of the mother is in danger, or where abortion is permitted “by any other written law.” Despite these provisions, which would allow for life-saving abortions to be legally performed, the Helms Amendment nonetheless bars the use of any funds for the procedure. Given this, reproductive health groups claim that there is a need for a reinterpretation of the policy.

The Helms Amendment stipulates that USAID, “cannot pay for the performance of abortions as a method of family planning. It is not an outright ban,” says Schvey. Situations which fall outside of the definition of family planning, he says, “would include rape, life endangerment, incest, [and] health endangerment.”

The CRR is not alone in calling for a reinterpretation of the policy. In 2015, a coalition letter ad-dressed to President Obama consisting of 71 organizations, including Planned Parenthood, the American Civil Liberties Union, and a number of faith-based groups, called for a reconsideration of the current implementation of the Helms Amendment, while 81 Democrats in Congress have urged that Obama proclaim that the policy allow for aid to go to abortions in cases of rape, in-cest, and life endangerment.

In the 47 years since the Helms Amendment has been implemented, hundreds of thousands of women have died as a result of unsafe abortions. As the death toll continues to climb, it is with a sense of urgency that civil society organizations and politicians seek a reinterpretation of the poli-cy. Addressing the Planned Parenthood National Conference, President Obama stated that ef-forts to defund the organization are an attempt by Republican lawmakers to tell women, “You’re on your own. They’re talking about shutting those women out at a time when they may need it most—shutting off communities that need more health options for women, not less.” Until he chooses to engage with those calling for a reinterpretation of the Helms Amendment, it remains to be seen if President Obama is willing to extend the same concern to women abroad.