Foreign Policy, Akin-Style: How the U.S. Denies Abortions to Women Raped in War

When rape is used as a weapon of war in places like Congo or Bosnia, thousands of women and girls can become pregnant, but a piece of 39-year-old U.S. legislation means that few if any aid groups are allowed to provide or even discuss abortion services with them.

There's a 38 year-old Congolese woman named Josephine who has probably never heard of U.S. Representative and Senatorial candidate Todd Akin. But, if she had, Josephine would know all too well how wrong Akin was when he said that a woman's body can "shut the whole thing down" and prevent a pregnancy if she experiences a "legitimate rape." When Josephine was 29, she, like many of the estimated 1.8 million other women and girls who were raped during the Congo's series of conflicts, became pregnant. Akin's comments will never affect Josephine, so she has little reason to care. But she cares very much about the U.S. legislative efforts to restrict abortion access, because that decades-long campaign, of which Akin is only an example, has changed her life permanently.

Josephine carried her baby to term and raised him. It wasn't what she wanted. She wanted an abortion, but didn't know where to get one, despite the many health services NGOs that operated in and around Congo. "In the community, they made such fun of me that I had to leave the village and live in the forest," she told Amnesty International. "Today, the only thing that I can think about is that I want an abortion. I am hungry; I have no clothes and no soap. I don't have any money to pay for medical care. It would be better if I died with the baby in my womb." Unfortunately, Josephine's story is not unique. Thousands of girls and women raped and impregnated in armed conflict are routinely denied abortions with devastating consequences. Health experts say that about 5 percent of rapes lead to pregnancy, which suggests that the 1.8 million women and girls raped during the Congo's crisis may have led to as many as 90,000 unwanted pregnancies.

Though international humanitarian law provides a right to non-discriminatory medical care for rape victims in conflict, U.S. legislation forbids U.S. foreign assistance funds from being used to provide abortion services or information about abortion. This means that aid groups of the sort that might have helped Josephine are forced to choose between offering even basic information about abortion or accepting U.S. funding, which is often their largest source of funds. In effect, this pressures aid groups to deny a necessary medical service to pregnant women.

The U.S. restriction goes back to the 1973 Helms Amendment, which prohibits foreign assistance funding for "abortion as a method of family planning." That sounds straightforward enough, and "as a method of family planning" does not explicitly bar abortions for pregnancies resulting from rape. But it's more complicated. The 1976 Hyde Amendment, a similar piece of legislation that restricts federal funding for abortions domestically, does include a specific exception for cases of rape, which may help explain why the U.S. government currently interprets the Helms rule, which is habitually included in annual appropriations, as not providing an exception for cases of rape. Not only does this bar U.S. foreign aid recipients from offering abortion to victims of rape, it censors foreign assistance funding from being used even to speak about abortion to rape victims such as Josephine. U.S. foreign aid is often the greatest source of funding for humanitarian organizations, which is why many of them resign themselves to denying the abortion services that so many women and girls, especially those in conflict zones, need.

Many NGOs in conflict zones, as a result of this legislation, choose to follow the American requirement so that they can continue using American money. Without the provision of safe, legal abortion services, women and girls raped in conflict zones often have two options: turn to dangerous abortion methods provided in non-sterile conditions by people without medical training, or risk pregnancy. In a difficult conflict environment, where violence, malnutrition, and diseases such as malaria can all be more common, pregnancy can carry a greater risk of death for the mother or, ironically, her child. A rape-induced pregnancy can also function as a constant reminder of that original trauma, which can sometimes include gang rape, torture, or other forms of violence.

Humanitarian groups would likely be quite willing to provide abortion services, or at least offer counseling on it as an option. "For tens of thousands of women and girls who are raped in conflict zones, forced pregnancy poses life threatening risks, multiple layers of physical and mental trauma, and also contributes to the destruction of family and community," Susannah Sirkin, deputy director of Physicians for Human Rights, told me. "We believe that it is a medical imperative for survivors of sexual violence to have access to comprehensive reproductive health services without restrictions."

In places such as Rwanda, Congo, or Bosnia where rape has been used as a weapon, access to safe abortion services could help many women who become pregnant and unable to care for their children, or will may spend a lifetime disabled and traumatized. There have been reports in Darfur among other places, of men claiming that they are raping women in order to force the birth of "mixed" babies.However, even with this brutality -- violent rape used as a weapon, with pregnancy as the intended result -- women who have been raped in conflict in Sudan or otherwise rarely receive abortions, Human Rights Watch has found.

Representative Akin's comments were condemned by President Obama as well as by Mitt Romney and Paul Ryan, who now say that they would not oppose abortions for rape victims. But the Congressman's ideas, though extreme, are consistent with the same radical anti-abortion view behind the same, 39-year-old U.S. legislation and policy that effectively denies even minimal abortion services to rape victims in some of the world's ghastliest conflict zones.

Though this policy is the U.S.'s alone, humanitarian groups have little choice but to apply the anti-abortion standard applied to all of their sources of funding. Faced with the enormous logistical hurdles of separating U.S. aid from that of other donors, organizations are ultimately hamstrung into broad application of these restrictive abortion policies.

Some other major donors have expressed concern for the U.S. policy, such as the Norwegian government, which recommended that the U.S.remove these restrictions on rape victims, and the European Parliament, which recently passed a resolution urging EU member states to segregate their funding from U.S. funding due to the abortion restrictions.

Sopie in't Veld, a Dutch Member of the European Parliament who has been leading European efforts, told me, "The European Parliament has repeatedly taken a very firm stance on the right to a safe and legal abortion. It is a right for all women, but certainly for women who are pregnant as a result of rape as a weapon of war. It is unacceptable that EU policies and external relations are subject to the U.S. ban on abortion and the compulsory silence on the matter."

"Not allowing U.S. humanitarian aid to cover abortion services for women raped in conflict is adding insult to unimaginable levels of suffering," said Nobel Laureate Jody Williams, who is spearheading the Nobel Women's Initiative's new International Campaign to Stop Rape and Gender Violence in Conflict. "Lifting U.S. restrictions should be an immediate first step toward helping survivors of sexual violence. It would also help send a signal to women everywhere that they are not to blame and the ones who bear the shame are the rapists, not the women they rape."

In responding to Akin's comments, Obama stated, "What I think these comments do underscore is why we shouldn't have a bunch of politicians, a majority of whom are men, making health care decisions on behalf of women." He is exactly right. But the Helms Amendment and related legislation means that these men are still, indirectly, making health care decisions on behalf of tens of thousands of women in conflict zones. Hopefully, Obama will act on this commitment and work to lift the ban on abortion speech and services to women raped as a weapon of war. And perhaps Americas will take note of the ways that Akin's comments, however extreme, reflect the anti-abortion mission that lead the U.S. to effectively deny those services to the women and girls whose need is most particular and severe.