24 November 2014
Canada: New study finds variation in abortion access and method
The early findings of a 2012 survey, presented in Quebec City and published in the Canadian Medical Association Journal, suggests access to abortion services vary widely depending on province, and whether a woman resides in a rural or urban area.
“With the differences in access to abortion, time is really a big factor. The further along [a pregnancy is] more compelling it is, not only because an unwanted pregnancy can complicate a personal and social life, but also because a [later] abortion is also medically complex,” said Dr Wendy Norman, who holds the chair in applied public health research at the Canadian Institutes of Health Research/Public Health Agency of Canada.
The research also suggests that women have very little choice when it comes to method. Though medical abortions are widely used in other developed countries, virtually all of abortions performed in Canada are surgical, the National Post reports.
On access, two provinces provided notable exceptions. Quebec, for example, is home to 46 of the country’s 94 abortion facilities, with at least half in rural areas. And the province’s health policy, which has directed funds specifically to providing abortion in underserved areas since the 1970s, has dictated that every health region have at least one abortion facility.
British Columbia, which legislated access requirements in the 1990s, has 16 facilities, half in rural areas. The province has also established a hotline.
By comparison, there are only four abortion facilities in all of Atlantic Canada — in P.E.I., there are are none at all. Women there must travel off island to terminate a pregnancy.
Sixteen locations will perform abortions in Ontario. In the prairies, there are eight facilities.
There is currently no federal law governing abortion in Canada. The Supreme Court of Canada struck down the country’s previous abortion law as unconstitutional in 1988.
Abortion is governed by guidelines adopted by professional associations. The vast majority of elective abortions happen before 12 weeks, according to data collated by the Canadian Institute for Health Information. It’s virtually impossible for women to access the procedure past 24 weeks without a compelling medical reason.
Abortion law is decided at the federal level, but it’s up to the provinces to provide and fund abortion services.
In stark contrast to other developed nations, Dr. Norman’s study found that upwards of 95% of all abortions conducted in Canada were completed using a surgical method. In other nations, such as the U.S., and in Europe, between 30% and 40% of abortions are induced in the early stages using mifepristone and misoprostol. The medication, which can terminate pregnancies up to nine weeks, has been pending Health Canada’s approval since 2012.
“Few women have any real alternative at all. And even when that’s the case, it’s only available in cities. We urgently need approval of mifepristone so we can offer women a choice, and offer women more timely services,” Dr. Norman said.
However, Stephanie Gray, a Canadian pro-life activist known for spearheading campaigns that targeted MPs in graphic mail-out campaigns, was not moved by Dr. Norman’s findings, the National Post reports. Ms. Gray believes that there is no moral distinction between abortion in the first and second trimester and, thus, that all access should be prohibited.
“Where you have public opinion largely in favour of abortion, you’re going to to see more of it and, therefore, more access to it,” she said. “I do think that it’s important to remind people that even though they work at the federal level through legislation, certainly much can be done at the provincial level, particularly funding to abortion and lack thereof.”