Where Do Refugee Women Turn for Abortions?

When refugee women are raped—something that happens with infuriating frequency—their options are dangerously limited.

Murad Sezer/Reuters

While Hillary Clinton and Bernie Sanders campaign to repeal the Hyde Amendment—a federal rider that bars Medicaid from funding abortion except in cases of rape, incest, or life endangerment—there’s an abortion law that has largely been left off the campaign trail and quietly ignored by the Obama administration.

It’s a law that, as it is being interpreted, refuses abortion funding to refugees who have been raped.

But the Helms Amendment, which was introduced by the notoriously conservative Sen. Jesse Helms in 1973 shortly after Roe v. Wade, doesn’t actually include that explicit prohibition. As an amendment to the Foreign Assistance Act (FAA), it specifies that no federal assistance funds “may be used to pay for the performance of abortions as a method of family planning or to motivate or coerce any person to practice abortions.”

Terminating a pregnancy resulting from rape, as abortion-rights advocates have repeatedly pointed out, is not really a matter of “family planning.”“When you look at our domestic laws, and even today with some of the most fierce advocates against legal abortion, the three exceptions [rape, incest, life endangerment] are consistently there,” Serra Sippel, president of the Center for Health and Gender Equity (CHANGE), told The Daily Beast. “That’s why it’s explicitly stated in the law: not ‘as a method of family planning.’”

CHANGE and other human-rights groups have long called on President Obama to interpret Helms as allowing abortion funding for women and girls who have been raped in conflict.But so far, the White House has stalled. Last June, when The New York Times highlighted the advocacy around Helms, White House officials deferred to the United States Agency for International Development (USAID). That agency did not address specific questions but said that the Obama administration took the issue “extremely seriously.”

Between last June and today, the sense of urgency around Helms has grown but no executive action has been taken. Last August, 81 House Democrats urged Obama to address the issue, saying that the current interpretation of Helms is “both overly restrictive and inconsistent with established legal precedent.” In October, Richard Blumenthal (D-CT), Claire McCaskill (D-MO), and 26 other senators sent a letter to the president asking him “to correct the overly constrained implementation of the Helms Amendment” and urging him to “ensure U.S. foreign aid does not stand in the way of women and girls fleeing conflict who seek abortion services.”

But when The Daily Beast asked the USAID for any updates, the agency did not answer specific questions, noting instead that it was taking the issue “extremely seriously”—the same response given to The New York Times eight months ago.

“I’m not surprised that that’s the answer they gave you,” Sippel told The Daily Beast. She suspects that the Obama administration may be reluctant to reinterpret the Helms Amendment because of the current state of domestic abortion politics.

If that’s the case, it’s a position that is strangely counterposed to current domestic policy and, perhaps, public opinion.

According to the latest Gallup data, 83 percent of Americans believe abortion should be legal in cases of life endangerment, and 75 percent agree in cases of rape or incest. Legality and federal funding are separate matters but the polling demonstrates a broad base of support for these three major exceptions. More convincing is that the Hyde Amendment, which both Democratic candidates for president have promised to ax, already contains those three exceptions in the case of domestic abortion funding.The double standard, advocates like Sippel say, is clear: A U.S. citizen who has been raped can secure Medicaid funding for an abortion in most states, but abroad, refugees who become pregnant as the result of rape cannot turn to the U.S. for aid.Given ISIS’s well-documented use of rape as an act of war, that contrast is only becoming sharper. But even when it comes to ISIS, politicians have been shy about reinterpreting Helms.During a November 2015 campaign stop in Iowa, Hillary Clinton was asked specifically about reinterpreting Helms but, as CNN reported, she stopped short of promising to do so, saying instead, “[I]f the United States government, because of our very strong feelings against it, maintains our prohibition, then we are going to have to work through nonprofit groups and work with other countries to…provide the support and medical care that a lot of these women need.”These nonprofit groups, however, are also constrained by the Helms Amendment. As The Atlantic noted in a 2012 feature on the legislation, NGOs in conflict zones often comply with the current interpretation of Helms in order to maintain access to U.S. foreign aid.How many women are affected by these restrictions? There are no precise statistics on the total number of rape-related pregnancies in conflict zones, but surrounding data paints a picture that is harrowing enough.One study in the American Journal of Public Health found that, in the Democratic Republic of Congo between 2006 and 2007, an average of 48 women and girls were raped every hour. Over 70 percent of victims of sexual violence in conflict zones are estimated to be children. In Syria, according to the International Rescue Committee (IRC), rape and sexual violence are “the most extensive form of violence faced by women and girls.”The stories of rape perpetrated by ISIS terrorists are indeed horrific. But they also tend not to include any mention of what might happen to victims if they become pregnant.And as The Atlantic reported in 2012—when former Missouri congressman Todd Akin made his infamous comments about rape-related pregnancy being “really rare” and “the female body” having “ways to try and shut that whole thing down”—becoming pregnant as the result of rape is more common than many might realize. In the U.S., women who have been raped once have about a 5 percent chance of becoming pregnant, according to a study in the American Journal of Obstetrics and Gynecology. Abroad and especially in conflict zones, that rate is believed to be higher.Without access to proper medical care, some refugees will die if they attempt to end a rape-related pregnancy on their own. According to the Guttmacher Institute, 47,000 women die from unsafe abortions every year, mostly in developing countries.

President Obama has publicly addressed the issue of rape in conflict several times; by Sippel’s count, five times in the last 18 months. But on Helms, the administration remains silent.

Sippel points to the positions that GOP candidates have taken on abortion as evidence that the White House may fear backlash if they reinterpret Helms. Ted Cruz, Marco Rubio, and Ben Carson have all expressed opposition to exceptions for rape and incest. As Paul Waldman observed on The Washington Post, those positions are more extreme than those of many Republican voters. Sippel agrees.

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“I think it’s a gross miscalculation on the part of the [Obama] administration to look at these reproductive politics and say that they would have some kind of bearing on the Helms conversation,” she told The Daily Beast.

For CHANGE and other groups who have been petitioning the administration to reinterpret Helms since Obama’s first term, the time for executive action is running out. After all, Cruz or Rubio could be president next January, virtually guaranteeing that the current interpretation of Helms remains in place until at least 2021.

“The thought of President Obama leaving office without so much as picking up a pen for women and girls raped in conflict is unconscionable,” Sippel said.