Melinda Gates Can't Run From the Abortion Controversy

You might think that donating $1.5 billion to global maternal and infant health would beget global cheering. Perhaps a small island named after you. Children given your name. Songs sung in your honor.

But nothing is so easy and apolitical. Nothing, especially, in the world of women's health.

Last week, Melinda Gates promised that the Gates Foundation -- known for its work on vaccines, HIV/AIDs and malaria -- would be striding off into the future with a separate but related arm of work focusing on reducing maternal and infant mortality -- two of the Millennium Development Goals. Pledging $1.5 billion over the next four years, Gates promised the funds would go toward pre- and post-natal care, infant care and nutrition. Integrated programs that teach "front-line" practitioners how to address multiple issues was a focus.

But there was one thing she didn't touch on, and that silence has become the source of Internet musings, chatter, and even anger.

Abortion, and abortion-related services, were conspicuously absent. NPR's Michele Norris asked Gates why.

"The foundation specifically doesn't take a stance on abortion for exactly this reason, is we don't want to be part of the controversy . . ," said Gates. "We're much more trying to work upstream on reproductive health rights. If you work upstream on that, and you say to a woman today, you know, would you like to have an injection that you could come in once a month or an implant where you came in once every three years, and you give them the choices or the different tools, then you don't even have to get into the issue of abortion downstream. So we have 200 million women that can't even get the tools they need to plan their family. We have that problem to solve first."

In other words: fund the underlying issues that create the problem, and preempt the problem.

Sounds easy enough. But nothing in the entrenched 30 years war of abortion politics is easy. Unsurprisingly, neither side was mollified.

Abortion-rights advocates see the issues of maternal health and abortion as inseparable. That line of reasoning posits: if, as the United Nations Population Fund states, 68,000 women die every year from botched abortions, and 20 times that number are injured during the same, women's health must, necessarily, address the question of abortion. Providing funding without addressing this subject may be politically savvy, but practically impossible. Not to mention the fact that many women having abortions are already mothers.

Over the weekend, the bloggers pounced: Katherine Franke at Columbia's Gender and Sexuality Blog wrote: "Gates' riparian parry [on NPR] makes sense if and only if all sex that might result in a pregnancy takes place in contexts that are voluntary and planned for. But as we know, this is not always the case. It's fine to take the position that abortion should be an option not of first resort (as has been Hilary Clinton's position, for instance), but the need for safe and legal abortion is not obviated by accessible and affordable birth control technology as Gates maintains. Girls who do not plan on having sexual intercourse and thus are unlikely to have addressed their fertility in the structural ways Gates describes frequently find themselves pregnant either because they changed their minds and had sex with a boy or their pregnancies result from unconsented-to intercourse. So too, adult women who may want to have more control of their fertility than Depo Provera or Noristerat would allow (the former is administered every three months and the latter every eight weeks) may also have need for abortion services due to rape. Never mind the women who wish to terminate a pregnancy for reasons of their own health or the health of the fetus."

Wrote blogger Christine Bronstein: "No one mentions that the Gates and their prolific fortune are anti-choice. They are for maternal health as long as the A word is not in the initiatives being funded. You are probably thinking, 'That can't possibly be true! They seem so lefty, it would have come out before, they live in Washington, for Pete's sake . . . ' But it is true, and I know this because a good friend of mine tipped me off right before my husband interviewed Bill. And Bill confirmed that the Bill and Melinda Gates Foundation does not fund initiatives or programs that include abortion."

And yet pro-life groups are also deeply skeptical of the Gates Foundation. Google "Gates" and "Abortion" and you'll find dozens of critiques (and worse) accusing the Gates Foundation of funding abortion and pointing out the foundation's grants to the International Planned Parenthood Federation, which itself administers abortions and post-abortion care.

While ponying up such a tremendous chunk of change surely accords the giver the right to decide how it is administered (as opposed to all of us regular folks in the peanut gallery, hollering about how we'd like that money to be spent), it is naive to assume that an apolitical stance on anything having to do with childbearing will resist attack. Especially now, as we look forward to the G8/G20 meetings about to be held in Canada.

Canada has said that maternal and infant health are top on their agenda. But the Harper government has also turned away from funding abortion and abortion-related services overseas, prompting criticism from all corners, from the editors of the Lancet to Hillary Clinton.

A few applauded the Gates Foundation and the Women Deliver Conference for trying to focus attention on maternal and infant health, rather than getting bogged down in intractable controversy. The only way forward is through.