The American government is once again stripping funding from non-governmental groups that discuss abortion.
U.S. President Donald Trump signed the executive order known as the "Mexico City Policy" on Monday morning.
The gag order prohibits USAID from funding any group operating internationally that promotes abortion, or tells a person that abortion is legal in their country.
The policy requires NGOs to "neither perform nor actively promote abortion as a method of family planning in other nations."
Its effects are widespread because USAID, the United States Agency for International Development, has a US$ 27 billion budget and often joins forces with other charity groups to offer aid.
Because it is almost impossible to discuss reproductive health without mentioning abortion, and often violates local law to refuse to tell a woman that abortion is legal, NGOs worldwide get stripped of their funding.
Many point out the move by Trump will appease right-wing groups in the U.S. but will actually lead to an increase in abortions worldwide.
That's because as NGOS lose funding, they scale back their efforts to educate men and women in foreign countries about reproductive health and can no longer provide contraceptives.
Political football
The global gag order has been a political football since Ronald Reagan first created the regulation in 1984.
Successive Democratic presidents have rescinded the order, while it was reinstated by their Republican counterparts.
Presidents usually deal with the order on Jan. 22, the day the U.S. Supreme Court issued the Roe v. Wade decision that legalized abortion in the United States.
Trump signed it one day after the 44th anniversary of Roe. v. Wade.
Republicans supported the move, with Senator Ben Sasse of Nebraska saying "the Mexico City Policy reflects our heartfelt compassion for both moms and babies."
The Centre for Health and Gender Equity said the policy will lead to the death of women.
"The global gag rule has been associated with an increase in unsafe abortions and we expect that Trump's global gag rule will cost women their lives," said Serra Sippel, the organization's president.
Marie Stopes International, a global charity that operates in 37 countries and gets funding in part from USAID, estimates the gag order signed by Trump will prevent it from offering contraception to 1.5 million women per year and lead to 2.1 million more abortions in the next three years.
A study by the World Health Organization found that while George W. Bush was in office the number of abortions in sub-Saharan Africa rose as a direct result of his implementation of the policy.
The WHO estimates that 56 million abortions are performed each year but the rate at which they take place is dropping, from 40 per 1,000 women of childbearing age in in 1990-1994 to 35 per 1,000 women of childbearing age in 2010-2014.
Most of the decline is in developed regions of the world, going from 46 to 27 per 1,000 in that timeframe.
Globally, 25 percent of pregnancies end in abortion.
