PORTLAND, Ore. (KOIN) — In one of his first executive orders on Monday, President Donald Trump reinstated and expanded a policy that threatens to cut all U.S. funding from any foreign health provider that discusses abortion as a family planning method, even though American dollars are not used for abortion services.

The Mexico City Policy, otherwise known as the global gag gule, was enacted by President Ronald Reagan in 1984. Since then, presidents have played political volleyball by reinstating and rescinding the policy early on in their terms. President Barack Obama most recently rescinded the global gag rule in 2009.

Trump is the first president to expand the policy, making it applicable to any foreign department or agency that receives U.S. health aid, not just family planning groups.

America is one of many developed nations that provides health assistance in the form of funding to some of the poorest countries in the world.

Some of that money goes to family planning groups that help increase access to information and services related to women’s health. Family planning services provide women around the world with access to a variety of contraceptive methods, helping to avoid unwanted pregnancies and offering protection from the spread of sexually transmitted diseases, among other things.

Although U.S. funding directly pays for these types of services, under the Helms Amendment of 1973, no U.S. dollars can be used to pay for abortion or abortion services in other countries. Taxpayer dollars also can’t be used to pay for abortion here in the U.S. under the Hyde Amendment of 1976.

That doesn’t change under the global gag rule — abortion services still cannot be funded using U.S. dollars both at home or abroad.

Before Trump reinstated the policy, health providers receiving U.S. aid were allowed to provide patients with information regarding safe abortion practices, or fund abortion services with money from other sources.

Now that the gag order has been reinstated and expanded, foreign health organizations are at risk of losing all U.S. aid if they provide abortion services using outside funds, or even consult patients on the option of abortion.

With the policy back in place, the Center for Health and Gender Equality says organizations that have been receiving U.S. family planning funds have 2 options:

  1. Accept U.S. family planning funds and be prohibited from providing abortion counseling, referrals, or even advocacy efforts and from providing abortions outside of the 3 exceptions (rape, incest and life endangerment).
  2. Refuse U.S. family planning funds and attempt to secure alternative sources of funding in order to keep health clinics open, continue providing a range of sexual and reproductive health services to clients, and continue advocating for law reforms to reduce unsafe abortion.

When George W. Bush became president in 2001, he stated that he was reviving the global gag rule in the belief that “it will make abortion more rare.”

But scientific studies on the impact of the policy actually suggest the opposite.

A Stanford University study showed abortion rates in sub-Saharan African countries increased significantly in the years after the global gag rule was reinstated in 2001.

“[The global gag rule’s] only impact on abortion has been to make the procedure more likely and unsafe,” according to a Guttmacher Institute policy review.

Center For Reproductive Rights: The Global Gag Rule’s Impact on Unsafe Abortion

A loss in U.S. funding can cause health clinics to close, leaving women and girls around the world without access to contraception and safe family planning services.

Many of these health organizations have said that their dependence on U.S. aid has forced them to accept the constraints of the gag rule, and in turn neglect the needs of women suffering as a result of unsafe abortions.

Unsafe abortions are the leading cause of pregnancy-related deaths and injuries in countries where access to abortion is restricted or unavailable. An estimated 70,000 women die every year due to complications resulting from unsafe abortions, and millions more are left seriously injured and permanently disabled.

Under Trump’s expansion, it’s not only family planning groups that are at risk of losing funding. Organizations that provide HIV/AIDS treatment, help prevent the spread of infectious diseases and consult women on the risks of the Zika virus are also in danger of losing vital funding.

Sen. Jeanne Shaheen, D-N.H., the only woman on the Senate Foreign Relations Committee, previously told Foreign Policy she has been planning a legislative response to the reinstatement of the global gag rule.

The National Right to Life Committee, on the other hand, applauded the decision.