Proponents of abortion warn that the recent U.S. Supreme Court ruling overturning Roe v. Wade will allow anti-election groups in Canada to push for restricted access, making a resolved issue seem controversial in a country where almost 80% of people are in favor of choice.
A key anti-election strategy in Canada revolves around the enactment of abortion legislation, an idea that has been gaining momentum amid the aftermath of the U.S. court ruling. There is currently no abortion law in Canada, making it the only country in the world where the procedure is completely free of legal restrictions.
“There’s a lot of talk right now about whether or not the Canadian government should pass a proactive law that protects our right to abortion: a preventive strike, if you will. It would be a big mistake,” said Daphne Gilbert, a professor. of Law at the University of Ottawa.
Gilbert and other advocates of abortion say that while the enshrinement of the right to abortion may seem progressive, the opposite is true: the consolidation of rules will make it easier for anti-election lawmakers to retract their rights to abortion. abortion if they are never in the majority. Last year, 81 Conservative MPs (and one independent) voted against anti-election legislation.
And while Prime Minister Justin Trudeau promised Canadians after Roe that his government “would always defend your right to choose,” advocates argue that it may not always be true.
That’s why the country should focus on consolidating people’s rights by expanding access to abortion, Gilbert said.
Since it became legal in a 1988 Supreme Court ruling, abortion in Canada has been designated as a medical service like any other, as are procedures such as X-rays and blood tests. But this does not make it easy to achieve, especially in remote, religious or conservative parts of the country.
In 2014, Sarah (who asked to remain anonymous) requested an abortion on Prince Edward Island (PEI), a province of 160,000 people that, at the time, had no public abortion provider.
It took Sarah a month to finally get a provider – five hours away, in another province. The trip involved travel and accommodation expenses, but the procedure itself was covered by the health authority.
“The idea that someone has to travel to take care of something that you should be able to do near home, is not good,” Sarah said. Attention to abortion only reached the PEI in 2017, after activists called on the provincial government to act unconstitutionally.
Although there is no federal law, each province’s medical school sets its own guidelines on abortion, including gestational age limits for the use of the abortion pill.
These guidelines are modeled on the skills and training available in each province, said Martha Paynter, an abortion care provider in Nova Scotia and author of the new book Abortion to Abolition: Reproductive Health and Justice in Canada.
But there is also a political dimension to providing care for abortion that prevents some doctors and nurses from doing so.
“More people might be doing it than they are doing,” Paynter said. “We, as educators, am a teacher in a nursing school, we have a responsibility to teach all medical and nursing programs how to do these cares, and almost not. [any school] it does.”
Paynter is the creator of the country’s first university abortion course at Dalhousie University, which is open to students of medical, nursing and other health programs with the goal of inspiring future health workers to integrate access to abortion in primary care.
The Society of Obstetricians and Gynecologists offers an online course to teach professionals how to prescribe and manage medical abortion.
But most students and health professionals are not required to know how medications and surgical abortion work, and many choose to abstain because they are afraid to get into the political struggle around abortion.
According to Gilbert, this means that many primary care providers remain deliberately misinformed.
“Many doctors are simply not politicians. They’re scientists and they don’t see the politics behind any of their care, ”he said.
Further complicating access is the fact that many Canadians are unaware that the country’s professional nurses are allowed to prescribe the abortion pill and refer patients to surgical abortion providers, or that most patients can self-refer directly. to an abortion provider.
Addressing these issues is critical to expanding existing access to medication and surgical abortion, Paynter and Gilbert said.
In 2017, Natalie (also a pseudonym) discovered she was pregnant while visiting her parents in a small town in northern Alberta. After a doctor at a local clinic said the abortion was a murder, he asked for an appointment with a different doctor.
That doctor told her there was no such thing as a medical abortion. “He looked me in the face and said,‘ This doesn’t exist, ’” he said.
Mifegymiso, also known as the abortion pill, was approved by Health Canada in 2015, but had recently hit the market when Natalie was in the doctor’s office.
“I know it exists. It’s literally the front page of the news, “he said.
Still, he left empty-handed. She was only able to have an abortion after returning to her home province of New Brunswick, where only three hospitals and a clinic offer abortions. Natalie went to the clinic, where she paid $ 800 for a surgical abortion, a cost incurred because the province refuses to pay for abortions performed outside of hospitals.
New Brunswick is currently being sued for its abortion restriction.
Stories like those of Sarah and Natalie show how abortion remains inaccessible in Canada, despite its federal legal position.
“Our biggest problems really come in terms of provinces and what they can do to restrict access to abortion in light of what I think will now be a really emboldened anti-election movement,” Gilbert said.