Explanation of Restrictions

Performance of Abortion for Life Endangerment, Rape or Incest

Foreign NGOs do not risk losing USAID assistance if they perform abortion in cases where “the life of the mother would be endangered if the fetus were carried to term” or “following rape or incest.” Under the terms of the policy, abortions performed for any other reason or circumstance would be forbidden.

The mere possession of equipment for vacuum aspiration or dilation and curettage (D&C) or of drugs for menses induction for use in cases of threat to life, rape or incest would not disqualify an organization for USAID support. However, no USAID family planning funds may be used to procure or distribute equipment for the purpose of inducing abortions in cases other than those listed above.

Counseling and Referral for Abortion

Counseling and referral for abortion in cases of threat to the life of the woman, rape or incest is permissible. In countries where abortion is legal for reasons broader than life endangerment, rape or incest, open communication between women and their health care providers is severely restricted by the Mexico City Policy. Counseling and referral for abortion is permitted in those countries only if all four of the following conditions are met:

• The woman is already pregnant;
• The woman “clearly states that she has already decided” to have an abortion;
• The woman “specifically asks” where a safe, legal abortion may be obtained; and
• The family planning counselor has reason to believe that the country’s medical ethics require him or her to provide a referral for a safe, legal abortion.

Training and Equipment to Treat Post-Abortion Complications

U.S. government policy, as reaffirmed by the presidential memorandum, encourages foreign NGOs to provide “treatment of injuries or illnesses caused by legal or illegal abortions, for example, post-abortion care.” Organizations are urged to provide treatment for post-abortion complications (e.g., septic or incomplete abortions) themselves or to assist clients in getting treatment (e.g., by accompanying a woman to a hospital). USAID considers such conditions potentially life-threatening.

USAID assistance may be used to support the training of health care workers in post-abortion care, the treatment itself, and other related technical assistance. But as a matter of agency policy, USAID funds may not be used to purchase manual vacuum aspiration (MVA) kits. However, there are no restrictions on using the matching funds many NGOs must raise and contribute to satisfy USAID cost-sharing requirements to purchase MVA kits or other supplies for the purpose of post-abortion care.

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