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Good to Go: Permissible Abortion-Related Activities Under Current U.S. Law and Policy

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In response to an ongoing need for clarification and disinformation being spread by opponents to abortion rights, this publication provides an overview of what abortion-related activities are permissible under current U.S. law and policy – including activities that U.S. and non-U.S. government sources can fund. PAI created this resource to address persistent questions and concerns faced by advocates and implementers and share updated guidance on permissible activities. This resource is intended to counter misinterpretation and overapplication of policy restrictions that result from confusion about what is allowable. PAI strives to provide clear and simple policy guidance that enables advocates and implementers to offer the widest range of abortion information and services possible.

Although President Biden reversed the Trump administration’s dramatically expanded version of the Global Gag Rule (GGR) — known as Protecting Life in Global Health Assistance (PLGHA) — shortly after his inauguration in January 2021, there is some persistent confusion among advocates and implementers as to how U.S. government health assistance — including family planning and reproductive health assistance — may be used. In addition, many advocates and implementers have asked for clarification about if and how the U.S. Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization in June 2022 — which overturned the 1973 Roe v. Wade decision and ended the constitutional right to abortion in the United States — might impact foreign assistance programs funded by the U.S. government (USG). In particular, there is interest in what — if any — impact the Dobbs decision may have on USG-funded programs focused on expanding access to family planning and reproductive health care overseas, especially on abortion-related activities.

On the one-year anniversary of the Dobbs decision ending Roe, the U.S. Department of Health and Human Services released a statement re-affirming the Biden-Harris administration’s commitment to advancing sexual and reproductive health and rights (SRHR) globally and provided critical guidance on allowable abortion counseling and referral services that directly address the maternal health crisis related to unsafe abortion that persists around the world.

From a technical, legal standpoint, the Supreme Court decision in the Dobbs case does not affect the longstanding statutory restrictions on abortion contained in the legislation that governs U.S. foreign assistance. These remain in effect. The Dobbs decision also does not change the policies and programming of the U.S. Agency for International Development (USAID), State Department, or any other government agencies implementing global health programs. The U.S. government will continue to partner with other governments, NGOs, multilateral organizations, and the private sector to advance SRHR unabated.

As the chart indicates — with President Biden’s rescission of the Trump administration’s PLGHA — all organizations are currently free to use non-USG funds to perform abortion, counsel and refer for abortion, lobby for the liberalization of abortion laws, purchase and distribute manual vacuum aspiration (MVA) kits and engage in biomedical research on abortion. The chart also indicates the types of abortion-related activities that the NGO can or might be able to undertake with USG funding. A more detailed discussion of the permissibility of these types of activities, whether supported with USG or non-USG funding, is included, along with citations to official legal and policy authorities.

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