Canadian aid agencies that offer health care to women in the developing world have no problem describing the condoms they distribute and education they provide as part of a family-planning program.

But ask if abortion services are included in their health-care repertoire, they clam up. It's a matter of don't ask, don't tell.

“There's a lot that's unspoken,” says a program manager with years of experience in several development organizations. “We have an extremely sympathetic officer who knows the realities in the field. It's not a subject I've raised. You dare not talk about it.”

The manager, who asked to speak without attribution, said a chill surrounds maternal health programs since the Conservative government declared in April that no foreign aid money will fund abortions.

“It's scary to articulate. Someone could overhear you and write down that you support a woman's right to choose and then funding could be cut to our partner agency,” the program manager said.

“This issue goes way beyond CIDA funding so we're trying to be very careful.”

Even though Prime Minister Stephen Harper says he has no wish to reopen the abortion debate in Canada, there are signs his government is on the road to an increasingly conservative social agenda. The International Planned Parenthood Federation hasn't heard whether its $18 million grant from Canada will be renewed — though the group applied nearly a year ago. Funding for Toronto's gay pride festival has been revoked. On Thursday, 15,000 pro-lifers rallied in Ottawa.

In interviews with workers for four aid organizations that receive about $6 million from the Canadian International Development Agency to provide maternal or reproductive health care, all said they did not provide abortion services in countries where it is illegal or allowed only in restricted circumstances.

“What we see in countries where abortion is forbidden, women keep having abortions — they put themselves in danger,” says Dr. Marc Paquette, a Montrealer who has been working in Haiti for Médecins du Monde Canada for the last 10 months. “We have reproductive health services, but we don't have abortion in our programs. We would never go against the law here.” If a woman who has attempted to abort comes for help, she is referred to a gynecologist.

In countries where access to abortion is permitted for a wide array of reasons, the procedure is generally safe. In South Africa, infection from abortion decreased by 52 per cent after the law was liberalized in 1996.

It is estimated 70,000 women die each year in botched abortions — most in sub-Saharan Africa. “Somewhere in the world a woman dies every eight minutes because of an unsafe abortion,” the British medical journal, The Lancet, commented in 2009 on data from the Guttmacher Institute, which does reproductive-health research.

More than 95 per cent of abortions in Africa and Latin America are performed under unsafe conditions.

Methods include drinking turpentine, bleach or tea made from livestock manure, and inserting sticks, knitting needles, or chicken bones into the uterus.

Another aid program manager who spoke to the Star on condition of anonymity, said, “If Canada wants to help women, they should probably not try to prevent abortion. ... The reality of women in the field is that they will abort any way they can.”

Harper has said that maternal and child health will be a focus of the G20 summit in Toronto next month, but has yet to announce his plan.

Some in the international aid business say the controversial issue of abortion funding threatens to overshadow all others relating to women's health and security.

“Poverty, violence against women, access to health education, access to financial services,” Laurie Cook, CEO of World Relief Canada, which has an infant and maternal health program in Sudan, cites as issues that risk being overlooked.

“We have the G20 here and so many issues for women and if abortion hijacks this, regardless of what side you're on, it's tragic.”

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For Canadian aid groups, there's fear the social conservative agenda may spread beyond abortion.

“We are flying below the radar,” said one aid worker.

“Family planning and condoms haven't come under fire — but nobody in the (aid) sector feels very safe. It's not difficult for us, yet, but the problem is the uncertainty.”