President Trump campaigned on a pledge to “make America great again,” but instead launched an attack on health care for women worldwide. Alongside a suit-clad, nearly all-male cadre of White House insiders, Trump signed a new global gag rule designed to silence doctors and disrupt reproductive health care for some of the world’s poorest women.

Under Trump’s global gag rule, non-governmental groups working overseas to promote global health must now agree not to provide safe and legal abortion services and related information, or provide referrals for abortion — even using their own, non-U.S., funds — as a condition of U.S. support.

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Trump’s heavy-handed political coercion puts a terrible choice to groups struggling to save lives and promote public health.

These groups can either submit to Trump’s demands, forcing healthcare providers to withhold information from patients and cutting off access to essential reproductive health services. Or they can resist Trump’s demands and lose vital funding for essential programs like contraception and preventative health screenings.

Either way, vulnerable women around the world will pay the price.

Forcing health care providers to stop providing abortions and abortion-related information and referrals will invariably lead to more injuries and deaths. We know that making safe abortions harder to obtain leads many women to attempt to self-induce an abortion or seek an abortion from unskilled providers.

Unsafe abortions already cost tens of thousands of women their lives, and lead to countless injuries and hospitalizations. Trump’s global gag rule will only exacerbate this unnecessary tragedy.

Trump reinstates ban on US funds to international groups that provide abortions: https://t.co/AvxvLDu8jX pic.twitter.com/1PEwg7TE0D — The Hill (@thehill) January 24, 2017

On the other hand, defunding providers who remain committed to providing patients with the full range of reproductive-health options means reducing access to family planning at a time when 225 million women in the developing world want to avoid pregnancy but are not using modern (and reliable) contraception.

An unwanted pregnancy can mean intense personal hardship, adverse health outcomes, and even death — 830 women die each day from pregnancy or child-birth-related complications, the vast majority of whom live in the developing world.

Trump’s global gag rule, which Republican presidents put into effect, means more unsafe abortions and suffering for women across the globe. And these are not “alternative facts.” We know the impact of similar policies that have been implemented.

Dr. Eunice Brookman-Amissah, the former Minister of Health in Ghana, explained in 2003, after President George W. Bush implemented the global gag rule, that:

“Contrary to its stated intentions, the global gag rule results in more unwanted pregnancies, more unsafe abortions, and more deaths of women and girls. We who have seen those effects first-hand can no longer tolerate silence about the gag rule’s tragic effects.”

Brookman-Amissah’s conviction is backed up by empirical studies.

A 2011 Stanford University study, published in the Bulletin of the World Health Organization, examined the impact of a previous iteration of the Trump global gag rule in 20 African countries. It found that the policy was strongly “associated with increases in abortion rates in sub-Saharan African countries.”

Another 2011 study, published by the International Food Policy Research Institute, found that the policy reduced access to modern contraceptives, leading to an increase in unintended pregnancies, especially among rural women.

In addition to increasing unintended pregnancies and unsafe abortions, Trump’s gag rule is also a profound betrayal of American values, violating principles of free speech and democracy.

Many countries around the world apparently recognize that laws criminalizing abortion put women’s health and lives at risk. Since 1994 over 30 countries worldwide have liberalized their abortion laws to promote women’s health and safeguard their rights.

By prohibiting the provision of safe abortion services, or even abortion-related information or referrals, the Trump global gag rule runs roughshod over other nations’ laws and instead imposes rigid prohibitions based on the Trump-Pence anti-choice, anti-woman agenda. And by forcing clinicians to withhold information about legal health services, it violates the trusted relationship between a woman and her healthcare provider.

The notion that a billionaire president’s first order of business is to bully some of the world’s poorest women by stripping them of healthcare is as dangerous as it is perverse. Ultimately, the Trump’s global gag rule is a political gift to opponents of legal abortion that will hurt women, cost lives, and undermine American values.

Aram Schvey is senior policy counsel and manager of special projects at the Center for Reproductive Rights.

The views of contributors are their own and not the views of The Hill.