President Donald Trump has directed his administration to block global aid recipients from telling patients about abortion — a move that could weaken reproductive health care worldwide.

The move, announced in a presidential memorandum Friday, revives a policy known as the “global gag rule” that Trump and many other Republican presidents have implemented. Already, contractors that receive U.S. foreign aid money cannot use it to directly support abortion services. But they can tell people the option is available.

Trump is not the first GOP president to implement this policy, but his interpretation of it, which matches an approach he took in his previous term, is the most expansive. Other Republicans have only applied the gag rule to foreign aid that is specific to family planning services. But Trump’s rule affects any global health funding distributed by the United States. 

The gag rule’s wide reach means that its implementation could weaken global efforts to prevent the spread of HIV, to promote contraception, and to fight diseases such as malaria and tuberculosis. 

In the past, similar gag rules have resulted in family planning clinics in other countries shutting down and fewer people receiving contraception. Some health centers have dropped contraception offerings in response to the policy, leaving people with no local options for birth control. The rule has also been associated with a higher rate of unintended pregnancy and abortion, including in countries where the procedure is not legal.

Also on Friday, Trump issued an executive order that further strengthens the Hyde Amendment, which bars federal dollars from being used to fund abortion. The order rescinds two Biden administration executive actions, one compelling the government to expand abortion access and the other defining abortion as health care.  

The moves come as speculation mounted about why the president had failed to make abortion policy moves in his first days back in office. Earlier Friday, Trump addressed the annual March for Life via video, but did not mention either of these moves of commit to the specific abortion policies the groups have been pushing him to enact.