One of the greatest public health achievements of modern medicine was the legalization of abortion, which resulted in at least a 90% reduction in abortion-related deaths. Today women can be assured that abortion is one of the safest and most commonly provided medical procedures in the United States.
But the medical community did not step forward to accept abortion practice when it was legalized by the Roe v. Wade decision in 1973. Instead, the National Abortion Federation has filled this gap by providing standards of care, protocols, and clinical education to health care professionals.
NAF is the professional association of abortion providers in North America. We are unique among pro-choice organizations because we represent the providers who make reproductive choice a reality. Our members include private and non-profit clinics, Planned Parenthood affiliates, women’s health centers, physicians’ offices, and hospitals who together care for more than half the women who choose abortion in the U.S. and Canada each year. Our members also include public hospitals and both public and private clinics in Mexico City and private clinics in Colombia.
NAF was established when an abortion provider service organization, the National Association of Abortion Facilities (NAAF), and a professional association dedicated to standards of care and access for women, the National Abortion Council (NAC), merged in 1977. The two independent groups were formed to serve the needs of abortion providers and women seeking abortion care following the first national symposium on abortion after Roe v. Wade, held in March 1975 in Knoxville, TN.
It was around the time of NAF’s founding that the rise of active opposition to legal abortion became evident. Abortion providers recognized the need for a national professional organization to set standards, increase access, and give support to the pioneers of this new branch of medicine. Our groundbreaking founders included providers from across the country, faculty from medical schools, and abortion advocates.
Over time, NAF has expanded our programs to address the growing needs of abortion providers and patients. Throughout our history, we have made a difference by:
- providing resources for women seeking abortion care;
- initiating groundbreaking educational programs for health care professionals;
- protecting providers and patients from anti-abortion violence; and
- developing a pivotal, pro-choice advocacy role to represent the voices of abortion providers and women who have chosen this care.
We began providing direct services for women in 1979 when we established our national, toll-free, multilingual Hotline (1-800-772-9100). Ours is the only hotline that provides personal and confidential information about abortion, referrals, and case management support for women with special needs.
In 1981, NAF was among the first organizations accredited by the Accreditation Council for Continuing Medical Education (ACCME) to deliver continuing medical education in abortion practice. For over 25 years, our educational programs have played a critical role in the dissemination of research findings and new abortion procedures and technology.
We were among the first medical organizations to adopt the new evidence-based model of practicing medicine with publication of the first Clinical Policy Guidelines (CPGs) on abortion care in 1996. Our CPGs set the standard for abortion care in North America, and help ensure that abortion patients receive the highest quality care. In 1999 we expanded our Quality Assurance and Improvement Program to include site visits to NAF facilities to evaluate their compliance with the CPGs.
Since 1990, we have convened four national symposia on critical abortion issues, including the shortage of abortion providers, the role of advanced practice clinicians in abortion care, bridging the gap between abortion training and abortion provision (PDF file, 283K), increasing access to abortion for women in diverse communities, and overcoming barriers to access. The recommendations from these symposia guided NAF in developing new program initiatives to address abortion access barriers. In 1993, for example, we organized Medical Students for Choice (MSFC), which works to increase abortion training opportunities. We formed three advanced practice clinician organizations in 1997: Midwives for Choice, Nurse Practitioners for Choice, and Physician Assistants for Choice, which are now combined as Clinicians in Abortion Care (CIAC).
NAF took the lead in introducing mifepristone (RU-486) in the U.S., and educating providers in its use for early abortions. We have conducted national, regional, and inservice training to help our members and other health care professionals integrate mifepristone into their practices.
Our members often work in a hostile environment with challenges that few other medical professionals face. They are often targeted for aggressive harassment from anti-abortion protesters, and many have experienced acts of violence carried out by extremists. NAF offers abortion providers the professional support they need to help them deal with security threats and the isolation they often experience in their field of medicine. In order to help protect patients and providers, NAF tirelessly advocated for the passage of the Freedom of Access to Clinic Entrances (FACE) Act. FACE helps ensure that women are able to access reproductive health care services and providers are able to offer these services without the threat of violence and clinic blockades. NAF also successfully advocated for the creation of the Department of Justice’s National Task Force on Violence Against Reproductive Health Care Providers in 1998. Our work with the Task Force has resulted in improved law enforcement response, which has led to a significant decrease in extreme forms of violence against abortion providers.
NAF opposes restrictions on abortion access at both the federal and state levels. The history of such anti-choice legislation demonstrates that the voices of abortion providers and patients, and factual medical and scientific information, must be heard in public policy debates about abortion, and in the media. Because our membership includes the leading researchers, clinicians, and experts in the field of abortion, we are able to provide the medical and clinical case for reproductive choice. We are able to share the personal stories of abortion providers and patients in order to demonstrate the real-life impact of anti-choice policies.
The Board of the National Abortion Federation has developed a document of ethical principles as a guide for practitioners involved in abortion care. These ethical principles provide a common ethical framework for abortion providers, and are intended to guide decision making in the challenging situations abortion providers face when providing health care or interacting with the broader medical or non-medical community.
These principles should serve providers in conjunction with NAF’s Clinical Policy Guidelines (CPGs) as a guide for providing the highest standard of care.