The Supreme Court's recent decision on contraception coverage and the Affordable Care Act may make it harder for some American women to control their reproductive choices. In most other developed countries, contraception is provided through national health systems as a matter of course. But the difficulties here of getting birth control, especially for low-income women, make the United States more akin to many developing countries.
This helps explain why many of the top global foundations working on reproductive rights don't fund in places like Germany and Denmark, concentrating instead on the developing world and also the United States.
Here's a quick look at five foundations that focus on strengthening reproductive rights, both globally and in the United States:
The Susan Thomas Buffett Foundation is among the biggest philanthropic funders of reproductive health work in the United States. To be sure, STBF invests in family planning progams internationally; it awards ten of millions in reproductive rights initiatives in other countries on an annual basis. But the foundation also remains heavily invested in protecting reproductive freedoms in its country of incorporation.
STBF gives its largest grants, which can range into the millions, to abortion rights advocates and reproductive healthcare providers with strong institutional capacity, like Planned Parenthood and the Guttmacher Institute. And though it is one of the biggest supporters of reproductive rights advocacy on the ground in the entire country—or more likely, because it is—STBF keeps a surprisingly low public profile. Its website is basically useless for grantseekers. Check out IP's look at who's who at STBF here.
The Packard Foundation funds reproductive rights work in three areas of the world: Sub-Saharan Africa, South Asia, and the United States. Packard hightlights the fact that more than half of all U.S. women of reproductive age (15–44) live in a state that is hostile to abortion rights, a statistic the foundation (correctly) considers problematic. To address the proliferation of laws intended to undercut women's reproductive rights around the country, Packard funds domestic organizations working on comprehensive sexuality education, voluntary family planning and contraception services, and safe abortion care.
Packard is also big on policy advocacy. The foundation gives to organizations that work toward changing national abortion laws. And at the state level, Packard is especially interested in policy in Louisiana and Mississippi, where reproductive freedoms are particularly restricted.
In explaining why it works on reproductive health, the Hewlett foundation notes that unplanned pregnancy rates in the United States are among the highest in the industrialized world. And while more than 3 million women in the U.S., particularly low-income and teenaged women, become unexpectedly pregnant every year, safe abortion has become difficult to access in various regions throughout the country. Fundamentally, American women are losing the ability to decide when and how to have children, which raises exacerbates existing cycles of poverty and oppression.
Hewlett addresses preventative and treatment aspects of reproductive rights gaps in the United States. The foundation funds programs on sex education for youth, reproductive health services for low-income women, and teen pregnancy prevention. Based in California, the foundation does a lot of work in the Central Valley, where teen pregnancy is more common than in other parts of the state. And Hewlett is also behind the National Campaign to Prevent Teen and Unplanned Pregnancy, an initiative to reduce teen pregnancy by 20 percent by 2020.
Merck for Mothers
Sometime around Mothers Day, I found myself reading about Merck for Mothers, an initiative of the multinational pharmaceutical company to assist women in the United States who are quite literally dying due to failures in public policy surrounding reproductive health. In a PR piece published in the Huffington Post, the Merck for Mothers lead, Dr. Naveen Rao, noted some alarming statistics about how women are faring in America's brave new era of austerity.
A couple of the cheerful stats he shared: The rate of maternal deaths in the United States has nearly doubled in the last 20 years and is currently worse than pretty much every other industrialized country. By way of context, the United States is among eight countries (including Afghanistan and Sudan) where the percentage of women dying in childbirth actually rose from 2003 to 2013. America also has the highest rate of first-day infant mortality in the developed world.
So in addition to funding advocacy, service, and medical initiatives especially in Brazil, India, Uganda, and Zambia, Merck has decided to make the United States an "important part of our global initiative to reduce maternal mortality" (per the HuffPo piece). Merck for Mothers funds work in other countries, too. But the United States is now on the foundation's top-five country priority list.
Merck for Mothers has made an initial commitment of $6 million toward programs to improve maternal health in the United States. Considering the magnitude of the problem Merck is addressing, its budget for U.S. projects can only go so far, so its funding is rather focused. Merck for Mothers invests in community-based programs addressing the needs of "high risk" women, such as a mobile, medical home-visiting program for pregnant women in Philadelphia. And Merck also funds data collection projects on maternal outcomes and medical groups working to standardize and improve care for pregnant women around the country.
The Hyde Amendment prevents federal tax revenues from subsidizing abortions. But Washington, D.C.'s non-state status allows Congress to block the city (which, incidentally, has no voting representation in Congress) from using its local tax dollars on abortions for low-income women just about every year. So what of D.C. women whose health or life is as risk but who cannot afford the necessary medical care? Enter the Moriah Fund.
Among other things, Moriah supports the D.C. Abortion Fund, which essentially fills in to pay for the abortions that federal law prevents the city government from funding. Moriah also gives to local social justice groups advocating for (among other things) the rights of women and children, like Empower DC, Jews United for Justice, and Metro TeenAIDS. The foundation supports women's advocacy groups based in D.C. but with a national focus, such as the National Black Women's Health Project and the National Partnership for Women and Families. Moriah's grants don't usually exceed $100,00 each (though there are exceptions), so it makes a lot of them. And while D.C. organizations might show up with disproportionate frequency on Moriah's list of grantees, it funds reproductive rights initiatives in other parts of the country as well, though to a less concentrated extent.
No other wealthy country invests so little in resources for women's health or creates so many obstacles to managing reproductive choices. Philanthropy is hardly adequate in filling the gap, but it's something. And after the Supreme Court's recent decision on the ACA, it may well become more important.