(CNN) The US successfully used the threat of its veto power on the UN Security Council to demand significant changes to a resolution on sexual violence.

The altered resolution passed on Tuesday following major changes granted by Germany in the face of demands from the US, sources told CNN.

CNN previously reported on the threat of a US veto over simple references to "health services" and "sexual and reproductive health" in a UN Security Council resolution targeting rape as a weapon of war and reaffirming the UN's opposition to sexual violence.

CNN obtained a draft of the resolution ahead of the vote that showed potential changes marked in the margins by a member of the German delegation to satisfy what multiple sources said were US issues with the language of the proposal.

While a source told CNN ahead of the vote that the hope was the changes, including making a reference to a past resolution that did mention reproductive health, would be enough to solidify support, the later iteration of the resolution obtained by CNN saw Germany ceding further ground to the US demands on the issue.

The final draft obtained by CNN contained no reference to sexual or reproductive health. The changes from the previous draft indicated the US had successfully forced changes to sexual health language, the training of journalists on the issue of sexual violence and struck the suggested reference to a prior resolution that mentioned sexual and reproductive health.

Language chipped away through drafts

The Trump administration has taken measures to avoid supporting efforts and organizations that provide abortion services to women, including victims of rape, and sources say such language is now viewed by the US as a veiled reference to that.

As an example, the original draft contained this paragraph: "Recognizing the importance of providing timely assistance to survivors of sexual violence, urges United Nations entities and donors to provide non-discriminatory and comprehensive health services, including sexual and reproductive health, psychosocial, legal, and livelihood support and other multi-sectoral services for survivors of sexual violence, taking into account the specific needs of persons with disabilities."

On Monday, a compromise version from the German UN delegation offered this instead: "Recognizing the importance of providing timely assistance to survivors of sexual violence, urges United Nations entities and donors to provide non-discriminatory and comprehensive health services, in line with Resolution 2106."

But on Tuesday, in the final copy, the US demanded that paragraph be eliminated entirely.

Although the vote passed with 13 nations in favor and two, Russia and China, abstaining, several traditional US allies on the top UN panel voiced major dissatisfaction with the changes, including France, Belgium and the United Kingdom, whose representatives all made reference to the behind-the-scenes talks.

French ambassador to the UN François Delattre noted after the vote that previous resolutions had indicated support for sexual and reproductive health and the move otherwise on Tuesday undermined the dignity of women, according to a translation of Delattre's remarks at the UN.

Despite the changes, the German mission to the UN touted the passage of its resolution and called it "a resounding expression of our will to strengthen the international response to sexual violence."

Results of the vote on Germany's #UNSC Resolution against #SexualViolence in conflict:



✅ 13 in favor

2 abstentions



The adoption is a resounding expression of our will to strengthen the international response to sexual violence. pic.twitter.com/9xJB1u07rL — German Mission to UN (@GermanyUN) April 23, 2019

But activists were angry at the US move.

"It is unthinkable and bizarre to see the US lining up with Russia and China to block efforts to strengthen the UN's ability to effectively address rape in conflict and to provide sexual violence survivors with sexual and reproductive health services," read a statement from Jessica Neuwirth of the Sisterhood Is Global Institute.

A statement from the group attributed to Dr. Denis Mukwege and Nadia Murad, who won the Nobel Peace Prize last year for their efforts to combat sexual violence, said that "there is simply no excuse for continuing to fail those who have already been victimized -- as well as those who continue to be at risk of -- devastating levels of sexual violence in conflict."

The US move against the UN resolution is "just another expression of the contempt that this administration has for women's rights and reproductive health and rights," said Stacie Murphy, Director of Congressional Relations at Population Connection Action Fund. "It's certainly typical of this administration when it comes to anything having to do with reproductive rights, sexual assault," Murphy said.

Part of broader Trump administration shift

Tuesday's resolution was in line with other moves by the Trump administration, which has targeted UN resolutions and other international health programs that conservative Christians argue promote abortion and sexual activity, focusing in particular on language that relates to reproductive health and sexual harassment.

One of the most visible examples is the White House decision to expand the "Mexico City policy," a US mandate that requires foreign organizations to pledge that they will not perform or promote abortion as a condition of receiving US funding for family planning and maternal and child health programs. Typically imposed during Republican administrations and lifted during Democratic ones, the Trump White House reapplied and dramatically expanded the Mexico City policy in January 2017.

Under this policy, if foreign aid and medical groups promote or perform abortions, the US is cutting off funding for nearly all health assistance programs, including nutrition, malaria, tuberculosis, tropical diseases and maternal and child health, including water, sanitation and hygiene programs.

Aid groups and lawmakers have said the move is undermining global health programs, maternal and child health and will likely lead to more, not fewer abortions, an argument backed by long term independent studies.