Abortion in Western European Health Systems: Implications for U.S. Health Care Policy

The 2010 Affordable Health Care Act (ACA) extended the right to health care to millions of Americans. By mandating health insurance for most of its citizens, the United States joined other wealthy, industrialized countries which require that their populations receive basic health services. However, a major caveat of the ACA was to exclude abortion, one of the most common surgical procedures in the U.S., from public funding. Moreover, it requires special treatment within state health exchanges.

Abortion politics in the U.S. are notoriously vociferous, but is this caveat uniquely American? The purpose of this study is to examine how other wealthy industrialized countries in western Europe treat abortion within their health systems. In so doing, we consider access to abortion services (e.g. number of clinics providing services and their geographic distribution), financing (publicly or privately supported), abortion limitations (gestational age, mother's residence or citizenship), and integration with other health services. We employ a small N (3 case studies), large N (12 countries) to examine this phenomenon. We conclude by discussing the implications of our findings for abortion policy in the United States.