With the overturning of Roe v. Wade in the US, reproductive rights have been a major topic of discussion around the world, including Canada. While abortion is legal across Canada, there are still barriers people face in accessing this essential medical service. We recently spoke with Jessa Millar, Access Line Navigator from Action Canada for Sexual Health & Rights about abortion in Canada. Here’s what we learned.
The first thing to know is that in Canada, not everyone has equitable access to abortion. Jessa tells us there are several factors that come into play here, one being geographic location.
“The vast majority of abortion providers are located in larger towns and cities, meaning people sometimes need to travel out of town to access abortions,” she says. “This travel can add many barriers for people, as they may need to take time off work or school, explain their absence to people in their life, find childcare arrangements, and pay for travel and accommodation.”
Providing training on abortion service provision to more medical professionals, particularly those outside of urban centres, would help combat this barrier and improve access to abortion.
Financial barriers are also an issue. Abortion services are covered by provincial and territorial healthcare, but there are many people who do not have healthcare coverage. These people would have to pay between $350-$1500 for an abortion.
Those seeking access outside of their province or territory are covered, but not for prescription medications. The abortion pill (Mifegymiso) would cost them around $350.
But Jessa says the largest obstacle to accessing abortion in Canada is simply not knowing where to go.
“A family doctor or walk-in clinic should provide a referral to abortion services,” she says, “but the truth is, they are often unaware of how to connect people with local abortion providers.”
Myths & Misinformation
As Jessa tells us, many myths surrounding abortion seek to scare people, including misinformation around medical risks. Complications are rare—about 0.5% of abortions result in complications—and these are usually minor and treatable.
“There is no medically accepted evidence that shows any link between abortion and any type of illness or disease,” Jessa says.
In terms of pain, while people’s experiences are individual and can vary widely, the discomfort can typically be managed with medications and techniques. For surgical abortion, Jessa says local or general anaesthesia is used, and over-the-counter pain medications like Advil and Tylenol can be taken for mild cramping after a surgical abortion or during a medical abortion. Blood thinners like Aspirin should be avoided.
Action Canada has a list that breaks down the most common myths around abortion, which you can find on their website.
The two procedures used for those seeking an abortion are medical abortion and surgical abortion.
Medical abortion, or the abortion pill, involves the combination of Mifepristone and Misoprostol, which are sold together in Canada under the brand Mifegymiso. Medical abortion can be accessed up to 10 weeks into pregnancy, usually following bloodwork and an ultrasound. The pregnant person is provided with a prescription for Mifegymiso, which they fill at a pharmacy. The pills are taken to induce abortion at home or in the location of the pregnant person’s choosing. Bloodwork is usually done one to two weeks after, to ensure the abortion’s success.
Surgical abortion involves bloodwork, an ultrasound, anesthesia, and a procedure, which is done at a clinic or a hospital. The procedure for a first trimester abortion, which covers most abortions, is very low-risk, and completed in 5-10 minutes. It has a quick recovery time and typically no follow-up care.
As the pregnancy progresses, the doctor will rely on more medical techniques. The need for more medical training and resources means access to abortion care during the second or third trimester can be more difficult. People can call Action Canada’s Access Line at 1-888-642-2725 for help in finding an abortion provider.
Jessa walked us through the various stages of getting an abortion in Canada, starting with discovering you are pregnant, which typically happens when one misses a period. This, however, is not the only way people discover they are pregnant, as not everyone has a predictable menstrual cycle. They may learn of the pregnancy weeks later when experiencing symptoms or seeking unrelated medical care.
Pregnancy is confirmed with a urine or blood test, which can be arranged through a family doctor or walk-in clinic. The medical professional supporting the pregnant person will hopefully ask if they would like to be referred for prenatal care or abortion care. The medical professional may not know where to refer someone for abortion care. If this is the case, the pregnant person may try to find where to access abortion services online. They will need to call the abortion provider to make an appointment. They can usually self-refer, but if a doctor’s referral is needed, the pregnant person will need to connect with a healthcare professional.
The number of appointments depends on whether the person is seeking a medical or surgical abortion—it could be anywhere from one to four. Appointments may include providing information, bloodwork, ultrasound, the procedure, and aftercare. Some of these appointments can take place through telemedicine, especially if the medical professional is prescribing the abortion pill to someone remotely.
Aftercare may include some follow-up bloodwork. After an abortion, emotional support may be needed, and information should always be shared with anyone who has accessed abortion, letting them know which services to contact for questions and concerns.
Jessa tells us that people looking for logistical or emotional support at any point in the process can call Action Canada’s Access Line at 1-888-642-2725.
Abortion is unfortunately still stigmatized in Canada, despite it being an essential medical service. Talking about abortion openly and honestly in various social circles, if it feels safe, is one way to combat the stigma. It also helps for people to know you are a safe person to go to if someone needs to access abortion, or just wants to discuss it. Jessa says donating or volunteering your time with an organization that helps increase access is also a way to help. For example, Action Canada’s Norma Scarborough Emergency Fund helps people across Canada navigate barriers to abortion access, by paying their travel, medication, and other related expenses. You can donate to the fund through their website, or by emailing firstname.lastname@example.org.