Last updated: March 4, 2012 1:44 pm
Equal access, equal rights
The state of abortion access in Canada
VANCOUVER, B.C. (CUP) — In 1988, Dr. Henry Morgentaler challenged Canada’s abortion regulations in the Supreme Court of Canada, where they were struck down and found to be in violation of the Canadian Charter of Rights and Freedoms.
A year later, another case was brought to the Supreme Court in regards to fetal rights, after a man tried to get an injunction so that his ex-girlfriend could not have an abortion (Tremblay v. Daigle). The final ruling declared that a fetus has no legal status in Canada as a person, both in Canadian common law and Quebec civil law.
Since then, Canada has had no laws regulating abortion access. However, there continue to be multiple barriers for Canadian women faced with unwanted pregnancies, including societal perceptions and stigma and lack of access in rural and remote areas.
In Prince Edward Island, the government does not provide any abortions at all on the island.
“P.E.I. does send some women to Halifax,” explains Joyce Arthur, executive director of the Abortion Rights Coalition of Canada. “They will pay for their abortion in Halifax, but it’s an onerous process for women to go through. Confidentiality is lost because of the paperwork, and they have to get approval from a doctor there, which adds to the delay.”
Women are required to travel off-island at their own expense, and the only other option for women facing an unwanted pregnancy in P.E.I. is to travel to the clinic in Fredericton and pay around $800 for the procedure. “So [abortion is] really just an option for women who can afford it,” says Arthur. “Which is discriminatory, because young women, or low-income women, can’t even afford to get off the island.”
The P.E.I government will only fund abortions that happen in a hospital, not a clinic, and the woman must have a referral from two doctors. In 2011, only 49 women from P.E.I. received an abortion at the hospital in Halifax, while 73 women went to the clinic in Fredericton and paid for the procedure themselves.
According to Arthur, this has resulted in women attempting self-administered abortions in P.E.I. Psychologist Colleen MacQuarrie, as reported by the CBC, conducted interviews with women in PEI regarding abortion. She recalls talking to a “14-year-old who found herself pregnant and was desperate to not even tell anyone she was pregnant, and so engaged in two weeks of intense self-harm, ingesting different chemicals, just doing anything she could to bring on a period.”
The Health Minister in P.E.I., Doug Currie, says the status quo is acceptable and abortions are just one of a number of health services that the Island has chosen not to perform in order to save resources. "To me, it’s not about the political discussion, it’s more about another service," he told the Charlottetown Guardian.
Arthur argues that this is a weak excuse and notes that all hospitals have the equipment to perform a miscarriage and other standard procedures. “So, it’s all set up and ready to go, they can do abortions. It’s a bad excuse, except they don’t have a doctor there to do it. The anti-choice movement in P.E.I is strong, and no doctor there is going to do abortions because of the harassment they would get,” says Arthur.
There are reportedly eight obstetricians in P.E.I., a profession in which abortion training is part of their instruction; however, the government claims that no doctor has ever applied for privileges to perform abortions on the Island and been refused.
“Keeping P.E.I. ‘Canada’s Own Life Sanctuary,’” reads an advertisement by the Right to Life Association in P.E.I. The organization is one of many groups who disagree that abortion should be made available on the Island.
“We certainly made it clear to the minister that we’re really just beginning our campaign,” association spokeswoman Anne Marie Tomlins told the National Post. “It’ll get as big as it has to get to make things go away.”
With no intention of implicating the Right to Life Association, it is worth mentioning that doctors do have reason to be nervous when deciding whether to become an abortion provider or not: 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 1995–97.
Globally, abortion providers have been the victims of escalating acts of violence, including harassment, stalking and kidnapping, and even arson and murder. In the United States, the Christian terrorist anti-abortion group, called Army of God, are responsible for many of the above-mentioned acts, as well as bombings, the assassination of providers and anthrax threats.
Stigma and distance
Prince Edward Island is not the only province limiting abortion access. A 2003 study by the Canadian Abortion Rights Access League found that fewer than one in five Canadian hospitals provide abortion services, nationally, and those hospitals are located only in larger communities.
New Brunswick, like P.E.I., does not fund abortions unless they are performed at a hospital. As there are only two hospitals that can perform abortions in N.B., the demand is higher than can be met, so the rest of the abortions are performed at the unfunded Morgentaler clinic in Fredericton. This means 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; 15 per cent travelled more than 100 kilometres from home.” Clinics perform roughly 45 per cent of all abortions in Canada.
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 capital cities, but the territorial governments do pay travel costs for women from remote areas.
Although access in B.C. 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 [an abortion], so if you lived in Penticton, Summerland, etc., you had to go out to the one clinic in Kelowna," Scott explains. 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 being a community with active anti-abortion groups. As reported in the Globe and Mail, “protesters stage weekly vigils outside the Kelowna General Hospital, [and] a doctor has to be flown in from Vancouver to perform abortions.”
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.
While Stephen Harper has been popularly quoted as saying, “As long as I’m Prime Minister, we are not reopening the abortion debate,” Conservative backbenchers continue discussing the issue in the media, and in the past have brought forward private member’s bills in attempts to give personhood rights to fetuses, or ban coercion to have an abortion.
In April 2011, the federal government denied funding to the International Planned Parenthood Federation (IPPF), which had applied for an $18 million grant. Later in the year, the Canadian International Development Agency did grant IPPF with a $6 million grant over three years. The renewed funding has been criticized by anti-choice advocates such as Conservative MP Brad Trost, who said that IPPF should not receive federal funding due to its support for abortion.
IPPF is an organization that promotes and advocates sexual and reproductive health and freedom internationally, as well as provides information and education, promotes access to services, and campaigns in order to improve legislation and remove barriers to services. Their website says they do provide "safe abortion services," including providing qualified practitioners in clean conditions, where national law allows it.
The CIDA funding for IPPF is to go towards services in Afghanistan, Bangladesh, Mali, Sudan, and Tanzania. Each of these countries has strict restrictions on abortion, none provide services for women upon request.
In 2001, the United States, under then-president George Bush, reinstated a policy which prohibited funding to non-governmental organizations performing or promoting abortion. Once the policy took effect, the rates of induced abortion rose in sub-Saharan Africa, leading researchers to speculate over the connection. A study done at Stanford University in 2011 concluded that “reduced financial support for family planning may have led women to substitute abortion for contraception.”
A 2007 World Health Organization study indicated that 67,000 women die each year due to complications from unsafe abortions, primarily in countries where abortion is not permitted under the law.
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,” says Hof, “should not receive a penny of federal funding.”
One of the goals that Hof and the CLC are working toward includes “defunding of abortion from the medical services plan.” However, this has been attempted previously, with little success.
In 1995, under pressure from the Committee to End Taxpayer-Funded Abortions, the Alberta government attempted to define “medically required” abortions as versus those that are not medically necessary in an effort to fund only those deemed required. 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,” says Arthur. “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. You can’t have decisions being made around women’s health that are not related to what the woman needs herself.”
Arthur also notes that not funding abortion would be discriminatory, as women who are well-off could easily get an abortion, “but it’s the poor women and the disadvantaged women who are stuck, and that’s unjust,” she says.
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, on an equal basis.” This echoes the sentiment expressed by the Morgentaler Clinic, “Every mother a willing mother.”
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 believes that “in a civilized society it [abortion] should not be tolerated.”
In a 2010 online Angus Reid poll, 39 per cent of respondents responded positively to 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 explains that 90 per cent of abortions happen by 12 weeks, the other eight per cent happen by 16 weeks, and one to two per cent are done by 20 weeks. Only roughly 0.3 per cent of abortions happen after 20 weeks, and in those cases there are major complications, such as serious fetal abnormalities, or extremely young women who were unaware of their condition.
“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,” says Arthur. “The idea of criminalizing abortion would just be from the myth of women having a lot of abortions, but that doesn’t happen,” she says.
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, and would 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, were already illegal under the Criminal Code, and the bill did not turn into law; but it did spark conversation in regards to various influences over women’s fertility.
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 in regards to pregnancy and abortion is evident from both pro-choice as well as anti-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 are misleading, and exist in order to coerce women 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,” says Arthur. “The problem with these hotlines and these crisis pregnancy centres is that they are very deceptive. You see, all the advertising [says], and they say, they will help you with all your options … but in fact, that’s not what they get … They engage in all the standard misinformation tactics, and scare them [women] and confuse them with really unprofessional counseling techniques.”
A 2010 report by the Sex Information and Education Council of Canada showed that there has been a 36.9 per cent decline in Canada’s teen birth and abortion rate between 1996 and 2006, owing to an increase in contraception and birth control use.
In Canada, however, the Medical Services Plan does not universally fund birth control or contraceptives, though there are advocates that say they should.
In the United States, the Obama administration announced that all health insurance plans must cover birth control as preventative care for women, as it is also more cost-effective than dealing with unwanted pregnancies and births. Many Conservative and Republican leaders have spoken out against the requirements, although they do not officially come into effect until 2013.
Globally, countries with the best access to contraceptives and sex education have the lowest abortion rates. The Netherlands, for example, have one of the lowest abortion rates in the world, and they have fully funded birth control, as do many other European countries with similarly low abortion and teen pregnancy rates.
In regards to the Canadian government funding birth control, Hof does not believe we should add more costs to the health care system. “Birth control and contraception are life style choices. In no other situation do we facilitate choices by financially supporting them with tax dollars,” says Hof. “We don’t buy people cigarettes if they choose to smoke. We don’t use tax dollars to enable people who choose to do drugs to do so. The suggestion that people’s choice to use birth control should be paid for with tax dollars is wrong on so many levels,” he says.
However, Arthur counters that we give people free health care, regardless of why they need it, including smokers with lung cancer and people with addiction: “Ninety-eight per cent of women have used contraception at some point,” she says. “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.”
Editor's note: some small clarifications were made to sections about IPPF on March 4, noting that safe abortion services are provided where national law allows it and that some countries where CIDA provides funding for IPPF have strict restrictions on abortion and may not provide services for women upon request.