The practicalities of formulating regulatory policy associated with elective abortion often place public health officials at the center of political controversy. Resulting conflicts can inhibit a rational consideration of long-term objectives in implementing a national policy which assures legal accessibility to all who would select abortion as an alternative to term birth. Regulation which uses primarily structural criteria for monitoring and evaluating services tends to de-emphasize the importance of contraceptive counseling as a component of abortion services. Our process/outcome evaluation of abortion clinics located in Chicago suggests that contraceptive counseling provided at the time of the abortion procedure has a potential long-term impact in terms of reducing the need for elective abortion. We suggest that regulation policy should include process and outcome criteria which support the eventual reduction in need for abortion as a long-range policy goal and suggest key issues for consideration when such a policy is formulated.
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