For several decades, there were  major gains globally in access to family planning and reproductive health services.

The US Government contributed significantly to this progress through its Agency for International Development (USAID), the largest funding agency for humanitarian and development aid in the world. Indeed, USAID listed the benefits of family planning on its website. These included protecting women’s and children’s health by reducing high-risk pregnancies and allowing sufficient time between pregnancies, advancing individuals’ rights to decide their own family size, improving women’s opportunities for education, employment, and full participation in society, decreasing abortion and reducing poverty by contributing to economic growth at the family, community, and household levels.

All these factors are worthy in their own right, but are also integral in efforts to reduce population growth rates.

USAID proudly noted that it was involved in developing nearly every modern contraceptive method available today, benefitting both women abroad as well as those in the US. In the 41 countries it supported, modern contraceptive prevalence increased from less than 10% in 1965 to 34% in 2023 and family size fell from more than 6 to 3.9. USAID estimated that it would reach up to 24 million women and couples with contraceptive services and supplies, helping to prevent 14,000 maternal deaths and 8.1 million unintended pregnancies in 2023.

And then came Trump and the demolition of USAID. First, Elon Musk’s unofficial department of government efficiency (DOGE) erased 83% of USAID’s programs, and then, in June, Secretary of State Marco Rubio ordered the abolition of the agency’s entire international workforce.

In April, the International Planned Parenthood Federation responded to the initial cuts to USAID’s programs: “These funding cuts are expected to have severe consequences on people’s lives for the communities we serve. If all funding at risk is indeed cut, IPPF estimates this will result in an additional 3844 maternal deaths, over three million unintended pregnancies, and 756,010 unsafe abortions. These impacts will also place a heavy financial burden on national health systems.

“The impact of the Trump administration’s actions is particularly severe in Africa and South Asia, where many IPPF Member Associations depend on international funding to provide contraception, maternal healthcare, and HIV prevention services.

“In Malawi, US funding cuts will slash nearly half of the Family Planning Association of Malawi’s 2025 budget, jeopardising 27% of sexual and reproductive health services…

“In Afghanistan… the closure of 18 family health houses and 15 mobile clinics is already limiting access to maternal and reproductive healthcare, particularly for women in rural and conflict-affected areas who have no alternative options.

“In the US, independent reports… indicate the Trump administration intends to freeze funding for affordable contraception and reproductive healthcare for low-income individuals who rely on Planned Parenthood health centres.”

Earlier, on 6 March, a number of national organisations, including the Guttmacher Institute, Planned Parenthood Federation and the Population Institute, wrote a letter to Congress in which they urged Representatives and Senators to preserve foreign assistance for global health that includes investments in international family planning. “Family planning is fundamental, time sensitive, life-saving health care for millions of women and families,” they wrote.

“Congress must insist that the administration immediately release the funds they appropriated for international family planning and we urge you to continue appropriating funds for these important programs in all future spending bills,” the letter said.

It concluded: “It is imperative Congress … continue(s) to invest in comprehensive, evidence-informed family planning as part of foreign assistance appropriations. Congress has supported investments in international family planning — with bipartisan and bicameral support — for six decades and over 11 presidential administrations, recognising that this is lifesaving work. Don’t stop now.”

Trump’s latest attack on women in need came in mid-July. According to a report in the Guardian, his administration was planning to destroy US$9.7 million worth of contraceptives rather than send them abroad to women in need. The contraceptives were primarily long-acting, such as IUDs and birth-control implants, and were purchased to support women in crisis settings, including war zones and refugee camps, almost certainly in Africa.

Let us hope Congress finds a backbone and stops such egregious acts.

This article was first published in the August 2025 edition of the newsletter of Sustainable Population Australia.

The views expressed in this article may or may not reflect those of Pearls and Irritations.