Women’s reproductive health should be a priority

Views of the President


I have written and spoken many times about the growing sense that obstacles, difficulties and challenges are making it increasingly difficult for many of our dedicated and talented colleagues to remain in the service and continue to serve our country as our first line of defense at home and abroad .

It was never easy to serve, and the Foreign Service never wanted it to be. Indeed, what we hear more and more from our members is their hope that they will be allowed to take more reasonable, pragmatic risk in their efforts to serve effectively and fulfill the mission they have undertaken for our country.

Our colleagues need to know that someone has their back as they serve overseas on difficult and sometimes dangerous assignments, and that someone understands what it’s like to deal with the challenges of the service. That “someone” should be the U.S. government agencies that employ Foreign Service members: their leadership and our fellow employees who provide support and protection.

So it was with great concern and, frankly, sadness The Foreign Service Journal published a Speaking Out column in May by an active duty member representing more than 200 Foreign Service personnel who signed a letter calling on the State Department to ensure equal access to essential reproductive health services for women overseas.

The letter and column detailed examples of the State Department’s failures to help officials facing medical emergencies, from one who “suffered a near-fatal ectopic pregnancy” to another who “suffered a miscarriage at one of the world’s most polluted posts.” Another FSO serving in a country where abortion is illegal was “directed by the medical unit to illegal local providers.”

The authors say the State Bureau of Medical Services “actively and repeatedly forced patients into impossible decisions and significant financial burdens and placed them in life-threatening situations.” They state: “Diplomats representing America in countries around the world are denied access to the same services that are legal and readily available in the country we represent, and told, ‘You’re on your own.’ We will not tolerate this any longer.”

It was also very troubling that the 200-plus members who signed the letter to state leadership did not receive even a courtesy response for over four months—not, in fact, until we sent an advance copy to the state board of medicine and published the column.

AFSA does not interfere in political matters. We recognize that our agencies are bound by the restrictions of the Hyde Amendment (prohibiting the use of federal funds to pay for abortions except in certain circumstances) and other applicable laws. However, we expect our agencies to do everything possible within the law to support, protect and care for colleagues who face health problems and dangers.

The state MED promised an expeditious review of the situation and improvements in areas that can be addressed under the law. This is good, but late. When more than 200 colleagues write to the leadership of our agencies expressing alarm and concern and asking for a change in the way they are treated, there is clearly a problem that needs to be addressed.

FS members posted to developed countries with excellent health care can turn to local resources for care, while members serving in countries without adequate medical services cannot. They all need to know that our government supports them and will help them get the care they need.

Money can’t be an excuse. Women’s health is a human right and a Foreign Service right. “In the Biden-Harris administration, the empowerment and protection of women and girls, including the promotion of their sexual and reproductive health and rights, is a central part of US foreign policy and national security,” US Secretary of State Anthony Blinken said in a statement in the first administration week 2021

We expect the Biden administration to follow through on its public commitments and the law and take care of our colleagues who put their lives and health at risk in the service of our country.

Ambassador Eric Rubin is president of the American Foreign Service Association.

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