Free access to abortion pill an important step forward in Ontario

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Artifact of Victories Past by R. Couse-Baker / CC BY 2.0

In its 2017 budget, released on April 27th, the government announced plans to provide the abortion pill free of cost to women in Ontario. This is a significant step forward, given the many barriers to accessing surgical abortion that exist in this province. That said, there will be challenges to equal access even to the abortion pill.

While it has not been illegal to have an abortion in this country since the Supreme Court of Canada decriminalized it in 1988, many women continue to face barriers to actually obtaining an abortion.

Women in Prince Edward Island have only been able to get an abortion in their own province since January of this year.

Until very recently, women in New Brunswick required the consent of two doctors before they could obtain an abortion.

Rural and remote (in)access

Access to abortion in rural communities is limited. Women living more than 100 kilometres north of the Canada/U.S. border will almost certainly have to travel out of their community if they need an abortion. In northern Canada, outside urban centres, a woman is likely to have to travel 250 – 750 kilometres to obtain an abortion and more than 1,000 kilometres if she is in the far north.

The travel that these distances require can make it difficult or impossible for young women, poor women or any woman who does not want anyone to know that she is having an abortion.

A 2015 Global News report found a patchwork of access to abortion across Canada. While there is one abortion provider every 28,394 square kilometres in Ontario, there is only 1 provider for every 219,326 women – the second lowest rate of providers in Canada (Saskatchewan is the lowest). Quebec has the highest rate of providers, with one for every 86,627 women.

Not surprisingly, the distances between providers in the north is long. In Nunavut, there is only one provider for every 1,877, 788 square kilometres, in the Northwest Territories, one per every 571,897 square kilometres and in Yukon, one per every 474,713 square kilometres.

Not everyone’s happy

Despite the fact that abortion is legal, many Canadians still oppose it. According to a 2016 Ipsos poll, 40% of Canadians oppose abortion in either some or all circumstances. This is a lower acceptance rate of abortion than in Sweden, France, Great Britain and Hungary. It puts us in a tie with Turkey and just a smidge ahead of the US., where 41% of the population opposes abortion in some or all circumstances.

Ongoing demonstrations, often aggressive and emotionally disturbing, by anti-choice activists outside abortion providers – both hospitals and clinic – create a real barrier to women accessing those facilities to have an abortion or even to discuss the possibility of an abortion.

In the future…

And, so, the arrival of the free abortion pill is positive news. Mifegymiso has been available in Canada since January. However, at a cost of $300 – $450, it has not been accessible to many of the women who need it. It provides a non-surgical option for women in the first 7 weeks of pregnancy.

While last week’s announcement was greatly heralded by abortion rights activists, as it should have been, a certain amount of caution is in order. All we know thus far is that the pill will be available “soon” and “in the near future,” so we have no firm implementation date.

The availability of the pill at no cost will increase access considerably, but access issues will remain for women in small, rural and remote communities.

To obtain the pill, the woman must have a prescription from a doctor, which she then takes to a pharmacy to be filled. In communities where both doctors and pharmacies are limited, women may encounter barriers if either the doctor or pharmacist is anti-choice. Women may be reluctant to ask for a prescription or to have it filled if they know the doctor or pharmacist. In remote parts of the province, women may still have to travel to see a doctor and to find a pharmacy.

Let us applaud Kathleen Wynne’s government for this important step, but let’s also insist that the voices of activists in rural and remote parts of Ontario are heard as implementation begins to roll out. For the 1988 decriminalization of abortion to have real meaning, abortion must be accessible to all who need it.

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