NAF was established in 1977 with the merger of the National Association of Abortion Facilities (NAAF) and the National Abortion Council (NAC). They participate in a variety of activities, including lobbying efforts, public outreach campaigns, and a helpline referral service to member practitioners, giving accurate medical information about abortion, non-biased options counseling and post-abortion counseling, as well as helping to fundraise for women who cannot afford the full cost of an abortion due to Medicaid restrictions. The organization annually holds a meeting to address areas of concern to abortion facilities such as political challenges, staffing, and legal issues. Since 1981 NAF has also held an annual Risk Management Seminar to address clinical aspects of abortion practice. They also publish clinical guidelines for practitioners.
NAF indicates that "In order to become a member, a clinic must complete a rigorous application process. Member clinics have agreed to comply with our standards for quality and care, updated annually in our Clinical Policy Guidelines, which set the evidence-based standards for abortion care in North America. NAF periodically conducts site visits to confirm that our clinics are in compliance with our guidelines."
NAF is particularly controversial to pro-life organizations because a small number of member doctors and facilities have been involved with legal troubles such as malpractice, illegal abortions, patient death, and loss of licensure.
NAF launched a Canadian Public Policy and Outreach Program on May 16th, 2006 with the support of Senator Lucie Pépin, Federal MP and former Minister of State for Health Carolyn Bennett and NDP Status of Women Critic Irene Mathyssen. The program offers Canadian women abortion referrals, options counseling and post-abortion counseling through the NAF toll-free helpline, and French language website support .
Canada is unique among nations in being without an enforceable criminal abortion law. The 1988 Supreme Court ruling R. v. Morgentaler found the 1969 criminal code provisions unconstitutional with the majority decision turning on s. 7 (life, liberty and security of the person) of the Canadian Charter of Rights and Freedoms (Judge Wilson's decision was based on s. 15). To date, the Canadian Federal Parliament has not been successful in enacting replacement abortion legislation nor has it repealed criminal code sections 287 and 288. Provinces govern how abortion service is delivered and though they don't have authority to criminalize abortion and may face penalties if they contravene the Canada Health Act they still enjoy considerable political latitude on the abortion issue. This grey area of law and health policy has led to some provinces enacting their own legislation to control access and service delivery. Further evidence of provincial claims to autonomy are seen in the variance that exists throughout Canada in availability of abortion service and in how components of care are delivered (facility, counseling, timeliness of care, referral process, cost, quality of provider care). The NAF Canadian Public Policy and Outreach Program seeks to address this variance through working to promote compliance with its Clinical Policy Guidelines.. Their efforts in this regard can be seen by some to compete unfavourably with policy standards of the Canadian Medical Association (CMA) and provincial Colleges of Physicians and Surgeons.
NAF has taken issue with the Canadian Medical Association's (CMA) abortion referral policy which allows physicians to refuse to refer women to abortion providers in accordance with their conscience and CMA Policy - Induced Abortion. If pressed, a physician must indicate alternative sources where a woman might obtain a referral.. NAF has lobbied to force Canadian physicians to opt out of provincial healthcare plans entirely if they do not refer for abortion . According to those opposed to abortion, this does not respect the grey area of law and policy which leave abortion as a free decision of each individual Canadian. They believe that there is no legal obligation to provide elective abortion, nor is there any law compelling a person to participate in abortion.
Some people in some regions of Canada do not like the policy of abortion-on-request and do not approve of clinic abortion. New Brunswick is one province with restrictive abortion regulations. New Brunswick Regulation 84-20 under the Medical Services Payment Act only funds abortions performed by a specialist in the field of obstetrics and gynaecology in a hospital facility approved by the jurisdiction in which the hospital facility is located and two medical practitioners certify in writing that the abortion was medically required. . New Brunswick does not fund clinic abortion at all and so far no citizen of New Brunswick has ever challenged their government to do so, though pro-choice groups have continually lobbied against the strict regulations. In 2001, the federal government began insisting that New Brunswick fully fund abortion services, but was slow to take official steps toward remedying the situation. It has never withheld transfer payments from New Brunswick for its violation of the Act (Abortion Rights Coalition of Canada, 2005. Clinic Funding—Overview of Political Situation. Position Paper 3. www.arcc-cdac.ca). In April 2005, then-Federal Health Minister Ujjal Dosanjh began a dispute avoidance resolution process with the government of New Brunswick, but it lost momentum with the election of a Conservative government, and Federal Health Minister Tony Clement has decided not to pursue it (Morrison, Campbell. 2006. N. B. Opposition MP’s Urge Minister to Enforce Canada Health Act, The Daily Gleaner, 20 May, A5). Currently NAF member Henry Morgentaler is appealing a decision in New Brunswick but the chance of his success is not assured. On the other hand, there are signs that provinces are indeed required to fund abortions in private clinics, for in August 2006 a court judgment ordered the government of Quebec to refund 13 million dollars to the approximately 45,000 women who had paid some fees for their abortions in women’s health centres and private clinics between 1999 and 2006 (Carroll, Ann and Dougherty, Kevin. 2006. Province to Refund Abortions. Montreal Gazette, 19 August. www.canada.com/montrealgazette/news/story.html?id=e1708b6f-76f7-4595-b1a2-328807b72485).
Contrasting NAF standards of care against those of New Brunswick it is apparent that New Brunwsick does not meet NAF policy standards. It provides a handful of abortions per month through only two hospitals (one in Bathurst and one in Moncton), and over 600 women per year pay for their abortions at the Morgentaler Clinic in Fredericton. Some doctors claim that a woman seeking an abortion within the New Brunswick system has several options, but members of NAF would disagree, based on the number of women forced to pay for their abortions.
NAF exists by donation only and is a registered charity.
In conclusion, the Canada Health Act guarantees Canadians access to necessary healthcare services, but provinces have autonomy in the delivery of healthcare service and some think they can decide whether abortion is medically necessary. The Federal Government has disagreed with this position in the past, as indicated by the multiple demands that New Brunswick fully fund abortion services. The debate about this issue continues, but no where moreso than in New Brunswick, which arguably has some of the most restrictive abortion regulations in the country.