Abortion access in Canada: Could what’s happening in the U.S. happen here?

With the overturning of Roe v. Wade, there are a lot of people asking: what is the current state of abortion access in Canada? Could what’s happening in the U.S. happen here?

The answer is both yes and no. Our systems are different, abortion is treated as healthcare, but many barriers to access exist, and a well-resourced group of anti-rights activists continue to press on in Canada.

In Canada, abortion is considered healthcare and is regulated by the Canada Health Act, which means there is no law that specifically governs abortion (check out this link for a quick timeline of abortion in Canada as well as Why We Don’t Need a Law). But the thing is, in Canada like elsewhere in the world, just because someone deserves and is entitled to a treatment, it doesn’t necessarily mean they can get it.

Although abortion is healthcare in Canada and was decriminalized over 30 years ago, there are still barriers that exist for many people trying to access an abortion in this country. I hear about these barriers every day as an operator of Action Canada’s toll-free sexual health and options referral Access Line. It’s a common, safe and legal process, but here’s what’s in the way of access:

Misinformation and anti-choice activism

You might be familiar with the term crisis pregnancy centre (CPC). CPCs are all over the country, in big cities and small towns, posing as supportive “clinics” and steering people away from abortion as an option with false and misleading information about abortion. CPCs are one example of anti-choice activism; anti-choice actors are transnational and well-resourced groups that are working to slowly chip away at abortion rights in Canada. It took 20 years to reverse Roe v. Wade, and similar lobbying tactics are being used here.

Nowhere to go

Only one in six hospitals in Canada provides abortion services. The services that do exist are mostly located in large cities and in the most southern part of the country, near the U.S. border. This leaves people from many rural and northern regions without any type of abortion care. In addition, care is not equal across the country—in some places, abortion is only available up to 12 weeks of pregnancy, requiring patients at a later gestation to travel out-of-province. Even in major urban centres, barriers like long wait times, a limited number of providers and fee-for-service care models prevent patients from accessing timely care, leaving pregnancies to advance and increasing the potential for more intensive care to be required—care that isn’t necessarily accessible to everyone.

Lack of providers

Surgical abortion services are often low-profile, given the amount of violence and threats that have been directed at abortion providers, healthcare workers and pregnant people, so even when they exist in a community, they can be hard to find. There are also physicians and healthcare workers who continue to deny their patients abortion-related care as “conscientious objectors” and others who deliberately direct patients away from abortion services, leaving patients unsure of where to seek support.

People seeking an abortion prior to nine weeks of pregnancy should be able to ask any primary care provider for a prescription for a medical abortion (abortion pill) or for a prompt and non-judgmental referral for a surgical abortion. Unfortunately, a vast number of providers are not aware that the abortion pill (also known under the branding Mifegymiso) is within their scope, is approved for use in Canada and is considered the gold standard for medical abortion care. Primary care providers are encouraged to incorporate medical abortion into their scope of practice, and can even take additional courses if they wish to expand their knowledge.

Need access to an abortion but don’t know where to go? Call Action Canada’s Access Line for non-judgmental, information and referrals.

Stigma

Abortion is a straightforward medical—and therefore confidential—procedure, but it also shouldn’t have to be cloaked in secrecy. People living in families, relationships or communities that are anti-choice (or not explicitly pro-choice) may feel that they can’t share their experience or may face the reality of being unsupported or even prevented from accessing care. Comprehensive sex-ed is one way to support individuals, families, and communities to navigate stigma and work toward full, equitable and inclusive healthcare access and positive health outcomes.

Systemic barriers with serious harm

Of course, a multitude of factors impact a society’s ability to have excellent health outcomes. Access to abortion is impeded by systemic discrimination, racism, transphobia, poverty and other forms of oppression that impact individual and societal well-being. For those who already face the most barriers to the full range of sexual and reproductive health services, Black and Brown, poor, disabled, young and 2SLGBTQIA+ people, legal abortion has not translated into meaningful access.

We have witnessed this firsthand through our Norma Scarborough Emergency Fund, which has supported people facing financial barriers to abortion for over a decade. This includes people who do not have citizenship status or health insurance, who lack funds to travel outside of their community, and who do not have access to paid sick days to take time off to attend appointments. It also includes those who don’t feel safe accessing healthcare services, or who need low-barrier services. Without dismantling intersecting systems of economic, racial and patriarchal oppression, and addressing those within our healthcare systems, abortion remains out of reach for many, regardless of legality.

Healthcare under attack

The under- and defunding of healthcare services by governments across the country have an impact on abortion access. The more our healthcare systems struggle to get by, the fewer services will be available to people who need them. Political trends toward privatized healthcare and defunded education and community services push marginalized people into further, more dangerous margins and impede sexual and reproductive rights.

So, what’s the takeaway? Abortion is healthcare, but there’s a long way to go

While abortion is safe and legal in Canada, for too many people, it isn’t barrier-free or accessible at all. Remember the Canada Health Act? The current state of abortion care puts provinces and territories in direct violation of the act because it is not freely or universally accessible, causing many Canadians to struggle to access much-needed care.

Action Canada is working to ensure that abortion access in Canada is not only protected but expanded (learn more about what we’re doing and how you can get involved). Healthcare providers can include abortion care in their scope of practice and encourage colleagues to do the same, and can work to remove barriers at the level of service. Individuals can support grassroots community organizing efforts and get involved with local community efforts to respond to racial and economic injustice.

Together, we can ensure that abortion access is fully supported and is expanded to support the well-being of all our communities.

Further resources:

How to access abortion care in every province and territory – Chatelaine magazine

Status for all, abortion access for all! – Action Canada petition

Neglected Areas Toolkit – Action Canada resource

Aborsh – Rachel Cairns’s podcast

Coral Maloney is an Access Line navigator with Action Canada for Sexual Health and Rights. Action Canada is a voice for sexual and reproductive health and rights in Canada and globally and operates a Canadian sexual health and pregnancy options Access Line: 1-888-642-2725. If you would like to know more about Action Canada, subscribe to their e-newsletter.