Federalism and the Implementation Problem
The implementation of abortion policy depends upon the health care community, largely private in the United States but more public in Canada, and upon subnational authorities through the funding powers of states and provinces in addition to whatever medical regulations those jurisdictions can impose on the abortion procedure. There has been comparative research on state abortion policies and implementation effects in the United States, but with one notable exception (Brodie 1994), Canadian academics have not focused on the implementation problem. Research on that aspect has been done mainly by official governmental bodies, reform groups, or feminist organizations seeking to show how unfair and uneven existing abortion policy has been. This chapter offers a departure. First it reviews the research on implementation in the United States, then gives a statistical comparison of abortion rates and services in the United States and Canada, and finally discusses the legal resistance by states that culminated in the Webster (1989) ruling and the policy reaction of provinces to the Morgentaler (1988) decision.
There was no national policy on abortion in the United States until 1973, when the Supreme Court nullified both the original and reformed abortion laws in forty-six states and thus constitutionalized a right of abortion during the first trimester of pregnancy. However, the Roe v. Wade ruling left many unanswered questions about the extent of state regulation, whether abortion funding was mandatory, and how economic and political forces might structure the delivery system for abortion services. Some of these legal issues