A recently published article exposes how abortion practitioners used U.S. foreign aid and the guise of “post-abortion care” to increase the number of abortions in Zambia.
Activists use Zambia as a model for how to impose their agenda on sub-Saharan Africa, a region known for its pro-life laws. A recent article in Reproductive Health details how abortion groups used Zambia’s relatively liberal abortion law to increase the provision of abortifacient drugs.
The article credits U.S. foreign aid with supporting “limited training for legal terminations” in the early 1990s and with “material support” from non-governmental organizations. Current U.S. law prohibits direct funding for overseas abortion provision or advocacy. The Mexico City Policy prohibits funding to foreign groups that promote abortion, but it was not in effect during the Clinton presidency when this training occurred. Recently however, President Trump reinstated this policy.
Abortion training occurred under the guise of “post-abortion care…using manual vacuum aspiration, which requires the same skill set as the provision of induced abortion.” Since the early 1990s, post-abortion care has been promoted as a non-controversial way to address the complications of “unsafe” abortion.
Members of Ipas, which raises more than $30 million each year and specializes in promoting abortion in pro-life countries, coauthored the article. Ipas distributes manual vacuum aspirators, provides abortion training to health workers, and lobbies governments to expand access to abortion.
In 2008, Ipas collaborated with Zambia’s health ministry and the University Teaching Hospital in Lusaka to introduce medical abortion with the drugs misoprostol and mifepristone as a way to “scale up safe abortion services to the extent allowed by the law.”
“Meanwhile,” the article notes, “another international NGO began quietly providing induced abortions to Zambian women who could afford them” in violation of the law, which requires at least a purported threat to the health of the mother. When British NGO Marie Stopes International was found performing illegal abortions, the Zambian government suspended its work in their country.
Behind the scenes, Ipas worked to register abortion drugs and train pharmacists to respond to crisis pregnancies “in a more compassionate manner” by providing drugs or abortion referrals. Ipas gave community health care workers their “values clarification exercises” designed to wear-down their objections to providing abortions. More than fifty local journalists were trained in “abortion and [sexual and reproductive health] issues.”
According to the article, four hospitals and one hundred other facilities now provide more than ten thousand legal abortions in Zambia every year.
The article claims that the impetus to address abortion “stemmed from national-level awareness of the impact of unsafe abortion on the maternal mortality rate” despite Zambia’s declining maternal mortality ratio. While the University Teaching Hospital estimated that thirty percent of maternal deaths were abortion-related, data from the Global Burden of Disease study attributes less than seven percent of Zambia’s maternal mortality rate to abortion-related causes including miscarriages.
Zambia reported improvements in maternal and child health, particularly by treating malaria and increasing availability of skilled birth attendants. In contrast, Ipas’ article declines to estimate whether the scaling up of abortion in Zambia reduced maternal deaths, or if it is merely a success story for activism.