Equal access, equal rights: the state of abortion access in Canada

VANCOUVER, B.C. (CUP) — In 1988, Henry Morgentaler, an active pro-choice doctor, challenged Canada’s abortion restrictions in the Supreme Court of Canada, where they were found to be unconstitutional.

A year later, another case was brought to the Supreme Court in regards to fetal rights after a man tried to get an injunction to stop his ex-girlfriend from getting an abortion (Tremblay v. Daigle). The ruling declared that a fetus has no legal status in Canada as a person, in both Canadian common law and Quebec civil law.

Since then, Canada has had no laws regulating or restricting abortion access. However, there continue to be multiple barriers for Canadian women faced with unwanted pregnancies, ranging from the stigma associated with abortion to lack of access in rural and remote areas.

Doctors who provide abortions also face risks. Dr. Garson Romalis, a provider from Vancouver, was shot and seriously wounded in 1994, and then attacked again and stabbed in 2000; the Toronto Morgentaler clinic was fire-bombed in 1992; and two other Canadian doctors were shot between 1995 and 1997.

Although the current federal government has no plans to change the abortion status-quo in Canada, some members of the Conservative party — like Saskatoon’s own Brad Trost — are still pushing to re-open the issue. The debate on abortion, it seems, is far from over.

Stigma and access still issues

A 2003 study by the Canadian Abortion Rights Access League found that fewer than one in five Canadian hospitals provide abortion services, and those hospitals are located only in larger communities.

New Brunswick and Prince Edward Island do not fund abortions unless they are performed at a hospital. Furthermore, there is no place in P.E.I. that handles abortions, and residents have to travel off-island to obtain them. There are only two hospitals that can perform abortions in New Brunswick, and the demand is higher than can be met, so the rest of the abortions are performed at the Morgentaler Clinic in Fredericton, where women must pay for the procedure themselves.

The preliminary findings of a federally funded study by Christabelle Sethna and Marion Doull indicated that “nearly 23 per cent of women who have obtained abortions in a freestanding clinic had to pay for it up front” and that “15 per cent travelled more than 100 kilometres from home.”

Clinics perform roughly 45 per cent of all abortions in Canada. The main difference between clinic and hospital abortions is that one does not need to obtain a doctor’s referral in order to receive an abortion at a clinic. Hospitals also offer sedation for surgical abortions, while clinics use only local anaesthetic.

Manitoba did not fund abortions done at clinics until 2004, when a non-profit clinic successfully sued the provincial government to pay for abortion procedures. Quebec had similar restrictions, but in 2008 ruled that all abortions would be funded, without any limitations. In the Yukon, the Northwest Territories and Nunavut, abortions are accessible only in the capitals, but the territorial governments do pay travel costs for women from remote areas.

Women in Saskatchewan receive full medical coverage for abortions in hospitals. Saskatoon providers offer abortions up to the 12th week of pregnancy, while those in Regina offer abortions up to 16 weeks and six days. If a woman travels to Alberta for an abortion in a clinic, the Saskatchewan government will pay for the abortion itself but the woman may have to cover the travel costs.

In Regina, wait times for abortions are a bit longer than in Saskatoon. Planned Parenthood Regina estimates that the waiting list is about three to four weeks in Regina and two to three weeks in Saskatoon. The longer the wait list, the more difficult it could potentially be for women who discover their pregnancy late to book an abortion.

British Columbia offers and funds abortions up to 20 weeks. Although access in British Columbia is better than in other provinces, the public stigma regarding abortion continues to make the process difficult, and services are still limited to larger communities.

When Mary Scott tried to get an abortion in Penticton, B.C., she faced both geographical and societal barriers: “There’s no actual place in Penticton to get one, so if you lived in Penticton, Summerland, etc., you had to go out to the one clinic in Kelowna,” Scott explained. Penticton is a one-hour drive from Kelowna. “They only do abortions on Tuesdays and are incredibly hard to get a hold of.”

Kelowna is well-known for its active anti-abortion groups. A doctor has to be flown in from Vancouver to perform the abortions, wading through the weekly vigils staged by protesters outside the Kelowna General Hospital.

Scott says that due to protesters, the clinic did not have an answering machine, and every time she went past the clinic she was yelled at and called “a murderer.” When she went in for her ultrasound, Scott says that the nurse told her she was “wasting taxpayer dollars,” and she was given very little advice or guidance.

Not a settled issue for some

Prime Minister Stephen Harper has said he has no interest in re-opening the debate on abortion in Canada. However, some Conservative backbenchers continue to go against their party leadership. In February, Ontatrio MP Stephen Woodworth introduced a private member’s bill that sought to redefine personhood under the law, with the possibility of expanding the law to fetuses. During the last federal election, Saskatoon-Humboldt MP Brad Trost boasted of having defunded the International Planned Parenthood Federation, which provides maternal and sexual health services abroad, of $18 million in federal dollars.

Later in the year, the Canadian International Development Agency did grant IPPF $6 million over three years. The renewed funding has been criticized by pro-life advocates.

Medically necessary?

John Hof is the president of the Campaign Life Coalition of British Columbia, which he describes as “the political activist arm of the pro-life movement in B.C.” The CLC puts on various campaigns both nationally and in individual provinces, including the 40 Days for Life campaign, the Defund Abortion Rally and the Pro-Life Day of Silent Solidarity.

“Planned Parenthood,” Hof has said, “should not receive a penny of federal funding.”

In 1995, under pressure from the Committee to End Taxpayer-Funded Abortions, the Alberta government attempted to define “medically required” abortions in an effort to fund only those deemed absolutely necessary. The Alberta Medical Association and the College of Physicians and Surgeons were asked to clarify the distinction, but they refused.

“You have to leave it up to the doctor to decide, based on the patient’s best interest,” said Joyce Arthur, executive director of the Abortion Rights Coalition of Canada. “We can’t distinguish between different types of abortion as to whether they are medically necessary or not, because that would require women having to state their reason and then someone having to decide whether their reasons are legitimate or not, and it just won’t work.”

Arthur also notes that not funding abortion would be discriminatory, as women who are well off could still easily get an abortion, “but it’s the poor women and the disadvantaged women who are stuck, and that’s unjust.”

The ARCC also emphasizes that defunding abortion or imposing restrictions would be a violation of women’s rights to life, liberty and security of person under the Charter of Rights and Freedoms.

“Abortion must be funded because it is not an elective procedure any more than childbirth is,” Arthur writes. “Pregnancy outcomes are inescapable, meaning that a pregnant woman cannot simply cancel the outcome — once she is pregnant, she must decide to either give birth or have an abortion. To protect her health and rights, both outcomes need to be recognized as medically necessary and fully funded.”

According to Hof, “Eliminating the child should never be suggested as a solution with total disregard for subsequent effects on the mother and the child.” He claims that “in a civilized society [abortion] should not be tolerated.”

In a 2010 online Angus Reid poll, 39 per cent of respondents agreed with the statement, “The health care system should only fund abortions in the event of medical emergencies.” Another poll reported that 27 per cent of Canadians describe themselves as “pro-life.”

However, the ARCC warns that popular opinion polls are not a good way to make decisions regarding women’s health. “Voter opinion on this issue has been shaped by anti-choice misinformation, as well as lingering prejudice about women who have abortions,” they say.

Arthur also said that 90 per cent of abortions happen within the first 12 weeks, the other eight per cent happen by 16 weeks, and one to two per cent are done by 20 weeks. Only 0.3 per cent of abortions happen after 20 weeks. In many third-trimester abortions, major health complications such as serious fetal abnormalities are often considered.

“Late-term abortions are the ones that are the most desperately needed of all, done for medical reasons, and so it’s ridiculous to criminalize those,” said Arthur. “The idea of criminalizing abortion would just be from the myth of women having a lot of abortions, but that doesn’t happen.”

Coercive forces

Hof explains that another goal of the CLC is to ensure “protection for women being coerced into abortion.”

In 2010, Bill C-510 was put forward in order to amend the Criminal Code to make it illegal to coerce a woman into having an abortion. It was put forward by Conservative MP Rod Bruinooge and was not supported by Stephen Harper. Threats and illegal acts, such as coercion, are already illegal under the Criminal Code, and the bill did not pass; but it did spark conversation regarding various influences over women’s reproductive rights.

A 2010 study by the Guttmacher Institute found that women in abusive relationships were often coerced into childbirth: “Pregnancy promotion involves male partner attempts to impregnate a woman, including verbal threats about getting her pregnant, unprotected forced sex, and contraceptive sabotage,” the study read. Seventy-four per cent of respondents reported experiencing this kind of coercion.

The concern over coercion regarding pregnancy and abortion is evident from both pro-life and pro-choice groups. Crisis pregnancy centres such as Birthright International advertise that they are “here to help you in making a decision about your pregnancy,” but critics suggest that they mislead women and exist in order to coerce them out of having abortions.

“I have nothing against anti-choice places if they want to help women… [and] give them resources and support to have their babies,” said Arthur. “The problem with these hotlines and these crisis pregnancy centres is that they are very deceptive…. They engage in all the standard misinformation tactics, and scare [women] and confuse them with really unprofessional counselling techniques.”

Prevention

A 2010 report by the Sex Information and Education Council of Canada showed that there was a 36.9 per cent decline in Canada’s teen birth and abortion rate between 1996 and 2006 due to an increase in contraception and birth control use.

Globally, countries with the best access to contraceptives and sex education have the lowest abortion rates. The Netherlands, for example, has fully funded birth control and they have one of the lowest abortion rates in the world.

The Canadian Medical Services Plan does not universally fund birth control or contraceptives.

Hof does not believe the Canadian government should add more costs to the health care system by mandating full birth control coverage. “Birth control and contraception are lifestyle choices. In no other situation do we facilitate choices by financially supporting them with tax dollars,” he said. “We don’t buy people cigarettes if they choose to smoke.”

However, Arthur counters that we give people free health care, regardless of why they need it, including smokers with lung cancer and people with addictions.

“Ninety-eight per cent of women have used contraception at some point,” she said. “The main cause of abortion is unattended pregnancy, and the main cause of unattended pregnancy is no use or improper use of contraception.

“Women still have to pay for that, in most cases, and it’s expensive,” she said. “Contraception is essential preventive health care for women — and all of society.”


Graphics: Kira Campbell/Capilano Courier