Abortion access not equal for all
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There are no federal laws restricting abortion in Canada. The procedure was decriminalized in 1988 and — like other forms of medical care — is publicly funded through provincial and territorial health insurance programs. Funding and legality, however, does not equal accessibility.
In the wake of the leaked U.S. Court draft opinion to overturn Roe v. Wade (the landmark decision that legalized abortions south of the border), Prime Minister Justin Trudeau has made a point of reinforcing Canada’s reputation as an abortion-friendly country. This week, Health Minister Jean-Yves Duclos announced $3.5 million in funding for two projects aimed at improving abortion access nationally.
Action Canada, a sexual health and reproductive rights advocacy group, will use the money to expand its education programs and bolster its travel and accommodation fund for those seeking abortions outside of their home community. The National Abortion Federation has, likewise, earmarked the cash for financial, referral and logistic supports as well as health-care staff training.
While these are important initiatives that deserve funding, Wednesday’s announcement is also an acknowledgement that Canada’s abortion system isn’t working for everyone.
As of 2019, there were 148 hospitals and specialized clinics providing abortions in Canada — only 22 of which were operating in rural areas. For a woman living outside of an urban centre, getting an abortion can be a long and costly process. The medical procedure may be free, but travelling to an appointment is not.
In Manitoba, there is nowhere to get a surgical abortion outside of Winnipeg and Brandon. This means a woman with an unwanted pregnancy in, say, Churchill, would have to fly (at a cost of around $1,600 round-trip) or take a train (for two days and two nights) south to receive care. Factor in the cost of missed work, lodging, transportation and food during her stay in Winnipeg and abortion becomes out of reach for many people.
In 2019, the provincial government moved to include Mifegymiso, the pill used in medical abortions, in universal health coverage. While this helps make reproductive health care more accessible for rural residents, the pill is only suitable for women who are up to nine weeks pregnant. Surgical abortion is required for those who are further along — up to 19 weeks and six weeks in Manitoba.
Following the Roe v. Wade news, the Women’s Health Clinic — which oversees the province’s abortion program — launched an online intake form to make scheduling appointments easier for clients seeking an abortion. It’s a small step in the grand scheme of things, but one that will make the process less daunting for local women.
It also streamlines the workflow for staff, who are bracing for an influx of requests from women south of the border if abortion rights are indeed overturned in the coming months. Out-of-country clients will put pressure on the Winnipeg clinic, which often struggles to meet local demand.
A few million dollars and some enterprising advocates can create incremental improvements in abortion care, but they will not fix a flawed system. If Canada truly wants to set itself apart from its U.S. neighbours, federal and provincial governments need to provide permanent increased funding for existing providers while allowing for abortions to be performed in a wider array of health-care settings. This can include training more doctors to administer the abortion pill. Enshrining the medical procedure in the constitution would not hurt either.
Updated on Thursday, May 12, 2022 7:41 PM CDT: hyphenates health-care