NEW YORK (Thomson Reuters Foundation) – U.S. President Donald Trump on Monday reinstated a global gag rule that bans U.S.-funded groups around the world from discussing abortion, a move that was widely expected but nonetheless dismayed women’s rights advocates.

The rule, which affects American non-governmental organizations working abroad, is one that incoming presidents have used to signal their positions on abortion rights. It was created under U.S. President Ronald Reagan in 1984.

Trump, an abortion opponent, signed the reinstatement directive at a ceremony in the White House on his fourth day in office. Former President Barack Obama had lifted the gag rule in 2009, when he took office.

“Women’s health and rights are now one of the first casualties of the Trump administration,” said Serra Sippel, president of the Center for Health and Gender Equity in Washington.

“The global gag rule has been associated with an increase in unsafe abortions and we expect that Trump’s global gag rule will cost women their lives,” she said.

Reinstatement of the gag rule, formally the Mexico City policy, comes just two days after hundreds of thousands of people marched in cities across the United States and around the world in a show of unity for women’s rights, among them abortion access.

The far-reaching gag rule affects groups getting funding from the U.S. Agency for International Development, even if they use separate money for abortion services, counseling or referrals, advocates note.

“It is appalling to dictate to civil society groups and health care providers how they can spend their own money and force them to withhold from women critical information about and access to the full range of reproductive health care,” said Nancy Northup, president of the U.S.-based Center for Reproductive Rights.

The policy puts groups that provide women’s health care in an “untenable position,” said Brian Dixon of Population Connection Action Fund.

They can either accept the restriction to keep their funding or they can reject the restriction and lose their funding, Dixon said. “Either choice hurts the women that rely on them.”

Following the rule’s inception in 1984, former President Bill Clinton revoked it when he took office in 1993 and former President George W. Bush reinstated it in 2001.

(Reporting by Ellen Wulfhorst, additional reporting by Steve Holland. Editing by Ros Russell; Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s rights, trafficking, property rights, climate change and resilience. Visit http://news.trust.org)

IMAGE: U.S. President Donald Trump holds up his executive order on the reinstatement of the Mexico City Policy after signing it in the Oval Office of the White House in Washington January 23, 2017. REUTERS/Kevin Lamarque