Today, Donald Trump is inaugurated as the 47th US President, ushering in renewed threats to reproductive rights. As part of Population Matters’ Welcome to Gilead campaign, Madeleine Hewitt interviews Olivia Nater from Population Connection to explore the challenges ahead and the fight for women’s rights.

Q: In the first few days after Donald Trump’s election in November 2024, purchases of emergency contraceptives spiked. Planned Parenthood reported a 760% increase in appointments for IUDs the day after his win. What do you think this says about the anxieties of many American women in their daily lives? 

A second Trump term poses a real threat to US women’s reproductive health and rights, which is why many are seeking out emergency and long-acting contraception ahead of his inauguration. During his previous presidency (2017-2021), Trump appointed three anti-abortion justices to the US Supreme Court, resulting in the overturning of Roe v. Wade in June 2022, which effectively ended the constitutional right to abortion in the United States. Since then, fourteen states have enacted total abortion bans, with 12 in effect today. Under an anti-choice president, more states may feel emboldened to aggressively pursue abortion restrictions. 

During his first term, Trump also blocked clinics that received grants from Title X (ten), the domestic family planning program for low-income Americans, from providing patients with abortion services, referrals, or information. As a result, many clinics were forced to leave the program, resulting in financial losses and millions of low-income patients losing access to health services. Trump is expected to reinstate this “domestic gag rule” when he takes office in January.

Project 2025, an extreme right-wing plan co-developed by people who served in Trump’s previous administration and intended as a presidential agenda for when he retakes office, is further cause for concern. Among countless other terrible things, Project 2025 lays out plans to ban medication abortion and block its delivery by mail (which is currently of vital importance for those living in abortion ban states), make it easier for employers to exclude contraceptive coverage from their employees’ health plans, enable hospitals to deny emergency abortion care when the patient’s life is at risk, establish an abortion surveillance system, and replace comprehensive sex education with abstinence-only curricula. 

Q: Vice President JD Vance has made several derogatory comments directed at women who have not had any biological children, including his infamous “childless cat ladies” remark. He has also expressed a view that people without biological children do not have a “direct stake” in society. How do you respond to these comments?  

Vance’s ridiculous comments were motivated by his misogynistic beliefs that women should return to traditional domestic and childbearing roles. He, like other conservative pronatalists, has repeatedly expressed alarm over the declining US birth rate. Vance believes a steady supply of American babies is needed for a strong country, while at the same time opposing immigration, which aligns with the racist “Great Replacement” conspiracy theory motivated by the fear that “traditional” white Americans will be replaced by foreigners with higher fertility rates. 

Every person, regardless of whether they have biological children or not, has a stake in the future and is affected by the policies implemented by elected officials. Suggesting that non-parents should have less of a voting right (which Elon Musk has done too) is obviously absurd and deeply undemocratic.  

Q: Elon Musk has positioned himself as a figure close to the Trump administration. He has made several comments on X (formerly Twitter), stating “population collapse due to low birth rates is a much bigger risk to civilization than global warming”. How do you respond to these comments? 

Musk’s comments are so detached from reality that they are hard to take seriously, but a lot of people sadly do. As the richest man on Earth, Musk has enormous power and influence, and his newly acquired role in the upcoming US presidential administration gives him even more of that, which is deeply concerning.  

First of all, our global population is still very much growing, and according to UN projections, is not expected to peak until the 2080s, at over 10 billion. It is projected to stay at this level until the end of the century. There’s no chance of a “population collapse” driven by low fertility. There is, however, a real chance of collapse driven by our escalating environmental crises, including climate change. Our failure to tackle overconsumption and overpopulation means we are facing an increasingly uncertain future marked by worsening natural disasters, extreme heat, resource depletion, and biodiversity loss. 

Declining fertility is actually one of the few global trends that are moving in the right direction. Ending human population growth is a prerequisite to a more sustainable future, and low birth rates are a result of women gaining more choices over their bodies and lives – definitely not something to lament.  

Megalomaniac billionaires like Musk benefit from propping up our unsustainable economic systems with an endless supply of babies. His priority is to become as rich and powerful as possible, with no regard to what the world needs.  

Q: There has been concern in the sexual and reproductive health (SRHR) sector, that the Trump administration will reintroduce the Global Gag Rule, could you explain what this policy is? And how will it impact communities, especially women, in other areas of the world? 

The Global Gag Rule is officially known as the Mexico City Policy and was first introduced by President Ronald Reagan in 1984. It blocks US federal funding for foreign non-governmental organizations (NGOs) that provide abortion services, counseling, or referrals, or that advocate to decriminalize abortion, even when those activities are paid for with their own money. This puts organizations in a position where they either lose existing funding for not complying with the heinous policy or are able to keep US funding but are forced to stop providing comprehensive reproductive health care.  

Since its introduction, the Global Gag Rule has been repealed by every Democratic president, and reinstated by every Republican one. The Gag Rule’s worst iteration was under Trump’s first presidency because he expanded it twice to encompass the vast majority of U.S. bilateral global health assistance. President Biden rescinded the policy in January 2021, and Trump is expected to reinstate it as soon as he takes office. 

The Global Gag Rule is devastating because it causes the most vulnerable women and girls to lose access to vital sexual and reproductive health services – not just abortion care but also access to contraception, cancer screenings, etc. While the policy is intended to decrease abortions, there is no evidence that it actually does so. In fact, evidence suggests that it increases the number of unwanted pregnancies and forces more women to seek out unsafe abortions. 

Q: The next four years of the Trump administration are likely to be a difficult period for Population Connection, due to the policies of the administration being counter-productive and hostile to your work. That said, Population Connection has already been through a previous Trump administration and been resilient to it. To end on a more optimistic note, what gives you hope for the oncoming 4 years? 

We are certainly facing a tough four years. What gives us hope is that the reproductive health and rights community is bigger and more determined than ever before, and surveys continue to show that the majority of Americans are pro-choice. We will do everything we can to fight Trump’s harmful policies.  

During his last administration, we established our far-reaching #Fight4HER campaign to pass the Global Health, Empowerment, and Rights (HER) Act, which would permanently end the Global Gag Rule. Right now, the Global Gag Rule is an executive action, unilaterally imposed by the President. The Global HER Act would make its imposition an act of Congress, and getting legislation passed is a much more arduous task than one person taking pen to paper. The hope is that having the Global HER Act in place would protect US foreign assistance from future hostile presidents. Our #Fight4HER campaign resumed activity in the lead-up to the 2024 election and will continue to engage activists in the coming months and years.  

Ironically, not everything is more difficult for our organization when there’s a hostile presidential administration. It’s easier to organize people when there’s a common enemy and an urgent battle to fight. As we learned all too well when Roe v. Wade was overturned in 2022, complacency can be the enemy of progress. When people perceive that things are going along just fine, they let their guards down, and that’s when our opponents can make inroads with their regressive agenda. Adversity inspires vigilance, which is what’s needed now. Population Connection will make sure Americans know exactly how terrible Trump’s actions are during the next four years. We’re confident that our supporters will heed the call to action.