The health of women and girls is closely tied to their right to make informed decisions about sexuality, marriage, and child-bearing, but the US is stepping back from leadership in this area. For the first time, the State Department has eliminated detailed information about contraception and maternal health care in its annual country reports on human rights. And the current Administration has reinstated and broadened the so-called “gag rule,” which prohibits foreign aid from going to any organization that discusses abortion as part of its family planning activities. What is the impact on reproductive health services and the organizations that provide them?