UNITED NATIONS — President Donald Trump reinstated a policy Monday that originated in the Reagan era, prohibiting the use of U.S. foreign aid to health providers abroad who discuss abortion as a family planning option.
U.S. law already prohibits the use of U.S. taxpayer dollars for abortion services anywhere, including in countries where the procedure is legal. But this order takes it further. It freezes U.S. funding to health care providers in poor countries if they include abortion counseling or if they advocate the right to seek abortion in their countries.
Trump and Vice President Mike Pence had stated their opposition to abortion during the presidential campaign. Trump had signaled his intent to make the order one of his first acts as president, which pleased the anti-abortion lobby at home.
"We applaud President Trump for putting an end to taxpayer funding of groups that promote the killing of unborn children in developing nations," Carol Tobias, president of the National Right to Life Committee in Washington, the nation's largest anti-abortion organization, said in a statement.
Critics said the order reflected what they regarded as the new administration's defiance of women's reproductive health rights, whose advocates were an important force in the weekend protest marches in Washington and other cities after Trump's inauguration.
The order revives what is known as the Mexico City policy, so named because President Ronald Reagan announced it in 1984 during a U.N. population conference in Mexico City. Critics call it the Global Gag Rule.
As for the order's practical effects, health policy experts say restrictions on abortion services in the past have not led to a decline in abortion rates in countries that receive U.S. funding for reproductive health services, and they warn that those restrictions only heighten the chances of illegal, often unsafe, abortions.
The United States is the largest bilateral donor of reproductive health services abroad, according to the United Nations Foundation, which advocates greater support from the United States for the world body.
In recent decades, abortion rates have declined sharply in the richest countries, including the United States, where the rate has fallen to its lowest since the Supreme Court legalized abortion in 1973, according to the Guttmacher Institute, a research group that supports women's right to have an abortion. It has remained steady in the developing world since the early 1990s.
The impact of the order is likely to be felt beyond abortion services, which cannot be carried out with any federal funding, under a 1973 law known as the Helms Amendment and named after former North Carolina Sen. Jesse Helms.
Critics say the order would hinder the ability of women in poor countries to access reproductive health services, including family planning, by severing U.S. funding to health clinics that offer a variety of services, including abortion counseling.
A study of 20 sub-Saharan African countries by Stanford University researchers, for instance, found that in countries that relied heavily on U.S. funding for reproductive health services, abortion rates rose when the Reagan-era policy was in place.
The World Health Organization says 225 million women in the developing world would like to delay childbearing but are not using contraception for a variety of reasons, including a lack of access.
"President Trump's reinstatement of the Global Gag Rule ignores decades of research, instead favoring ideological politics over women and families," Sen. Jeanne Shaheen, D-N.H., said Monday. "We know that when family planning services and contraceptives are easily accessible, there are fewer unplanned pregnancies, maternal deaths and abortions."
Vicki Saporta, president and chief executive of the National Abortion Federation, a Washington-based advocacy group for abortion rights, said in a statement that "President Trump's decision to reinstate the Global Gag Rule will endanger already vulnerable women by further curtailing their access to accurate information and safe reproductive health care services."
The policy has been suspended by every Democratic president since then and reinstated by every Republican. Democrats in Congress have tried — unsuccessfully — to pass legislation that would scrap the policy. Shaheen said she intended to introduce similar legislation. With Republicans controlling both houses, it is unlikely to pass.
Trump's pick for ambassador to the United Nations, Nikki R. Haley, made clear in her confirmation hearing last week that she opposed abortion, even as she said she backed support for contraceptive services in U.S. foreign aid programs.
Rick Gladstone contributed reporting from New York.