Not a ‘uniform experience’: Women share their triumphs and concerns with accessing abortion in Canada

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TORONTO (CTV Network) — With the U.S. Supreme Court’s decision to overturn Roe v. Wade, Susan Brison is reminded of her decision to have an abortion in the late 1970s. She was in her early 20s when she became pregnant despite using the Dalkon Shield, an intrauterine contraceptive device.

“We were poor… We had nothing to offer a child at that point,” Brison told CTVNews.ca in a telephone interview on Wednesday.

Soon after realizing she was pregnant, Brison saw her general practitioner, who she said supported her decision to have an abortion. As of 1969, it had been legal to perform abortions in Canada under limited circumstances. In 1988, the procedure became completely decriminalized. Within less than a month, Brison had the procedure done at Mount Sinai Hospital in Toronto.

“Everything went very smoothly. There was no hassle, nobody was rude to me,” Brison said.

Brison is one of several women who reached out to CTVNews.ca to share their experiences with getting an abortion in Canada. But according to Meghan Doherty, the director of global policy and advocacy for Action Canada for Sexual Health and Rights, access to abortion is not as simple for all Canadians as it was for Brison, even today, despite the procedure being legal.

“I don’t think that’s a uniform experience across Canada,” Doherty told CTVNews.ca on Wednesday in a telephone interview.

GEOGRAPHICAL BARRIERS IN RURAL AREAS In 2016, a United Nations Human Rights Commissioners report highlighted a concerning lack of access to abortion and related services in Canada. Action Canada for Sexual Health and Rights has a toll-free and confidential phone and text line that receives an average of 250 to 400 calls each month from those looking for information on abortion and other reproductive health services. One of the main concerns among callers is a lack of abortion providers in their community, particularly among those who live in rural areas, Doherty said.

“We see that a lot of smaller hospitals in these areas are having difficulties with staffing and in terms of the kinds of services that they’re able to offer,” said Doherty. “That is also reflected on the availability of abortion care.”

For some people, this means travelling to other parts of the country for an abortion, said Jill Doctoroff, executive director of the National Abortion Federation of Canada. This can lead to complex travel arrangements that might involve securing child care services if the person already has children, or taking time off work, she said.

“In rural parts of the country [with] communities that don’t have bus or train services and your nearest option for abortion care is in the next town over, that might be an hour away,” she said. “For people who have limited resources … figuring out how to pay for that can be really hard.”

Ariane Lachance had an abortion earlier this year. Thankfully, she said, she was able to have the procedure done at a women’s health clinic within walking distance from where she lives in Montreal.

Without the financial means to care for a child or support from a partner, the 24-year-old said she broke down crying when she discovered she was pregnant.

“The only option was to get an abortion,” Lachance told CTVNews.ca in a telephone interview on Wednesday.

After searching for clinics online and speaking to others who previously had an abortion themselves, she scheduled an appointment. Within a week, Lachance had the procedure.

“I can’t even imagine the struggle that these people must go through, either traveling out of state or out of country to get access,” she said.

RACIAL BARRIERS TO ACCESS Since the introduction of medical abortion in 2017, which involves taking medication to induce an abortion, the procedure has become easier for those in remote communities to access, said Doctoroff. However, medical abortions can only be prescribed to those who have been pregnant for less than 10 weeks.

Beyond those early stages, surgical intervention is required, and the majority of those services are provided in urban centres, Doherty said.

Those who require an abortion later on in their pregnancy term face additional barriers to accessing services, Doctoroff said. In provinces such as Nova Scotia, surgical abortions are not performed after more than 16 weeks of pregnancy, for example. This may require people to travel to other parts of the country for the procedure. According to a study published by Action Canada for Sexual Health and Rights in 2019, no providers offer abortion services to Canadians more than 23 weeks and six days into their pregnancy. Those who are this far into their pregnancy and looking for an abortion often travel to the United States for the procedure instead.

Another group that often struggles to access abortion services is immigrants, said Doherty. Those without proper documentation may find it challenging to get an abortion, as they might not have health insurance to cover related costs.

Much of the systemic racism that exists in Canadian institutions also affects those looking to access abortion services in Canada, she said. This can lead to the discrimination of racialized communities, such as those who are Black, Indigenous or people of colour, in search of abortion services. The forced sterilization of Indigenous women that continues today is an example of the “racist treatment” racialized communities face in hospitals, said Doherty.

“Looking at health disparities across the country, we can see that people who are more likely to be subjected to discrimination on a range of grounds, but including race, are more likely to experience barriers in accessing all kinds of health services, including abortion,” Doherty said.

SCRUTINY AND SHAME AROUND ABORTION Despite its decriminalization in Canada in 1988, stigma around abortion remains, Doherty said.

“We live in a patriarchal society with particular gender norms and anything that is in relation to sexuality and gender that goes beyond that very narrow frame often comes under scrutiny, and with it comes stigma,” she said.

The more people talk about abortion, and work to ensure that it’s available to everyone in Canada, the easier it will be to normalize it as a common procedure and break the stigma, Doherty said.

For Jenn Howson, who lives in Calgary, the process of getting an abortion in 2018 was relatively hassle-free, she said. At 38 years old, Howson became pregnant unexpectedly. She and her husband already had a child together, and were not in the financial position to have another, she said.

“In that case, [abortion] was an option … that was available to me, and I had choices to make,” Howson told CTVNews.ca on Wednesday in a telephone interview. “If we relate it to stuff that’s happening south of the border, they don’t have that choice.”

After calling to book the appointment, Howson said she had a surgical abortion within a couple of weeks during her first trimester at a nearby hospital.

“I did a quick Google search, found the phone number to call [and] called them,” Howson said, describing the process to book an appointment. “It was quick and easy … that’s how it should be when it comes to anything for our health.”

Despite the relatively easy process, Howson said she faced mental barriers related to the stigma around having an abortion, fearing that others might think of her for having the procedure.

In addition to her abortion in 2018, Howson previously underwent a dilation and curettage procedure in 2011. Howson had the procedure, which is considered a method of early abortion, after suffering a miscarriage.

“Abortions are also done because they’re medically necessary,” she said. “We shouldn’t be shamed to have these types of procedures.”

In sharing her story, Howson hopes to contribute to a conversation where people realize it’s OK to talk about openly abortion. Part of the solution also lies in health-care providers being more vocal about the abortion services they provide, said Dr. Sarah Munro, an assistant professor of obstetrics and gynaecology at the University of British Columbia.

While most people may think they need to go to a clinic for an abortion, medical abortions in particular can be accessed through primary health-care providers, she said.

“It can be challenging, because of internalized stigma, for a client to ask their primary care provider about abortion options,” Munro told CTVNews.ca in a telephone interview on Wednesday. “In turn, it can be challenging for primary care providers to advertise to their clients that this is part of [their] practice.

“Stigma goes both ways.”

Along with increased awareness of abortion services, Action Canada for Sexual Health and Rights is also calling on the federal government to grant more funding so that clinics can keep up with demand, a struggle health centres in Ontario and Alberta continue to face, Doherty said.

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