Protecting reproductive rights and freedoms

As our neighbors to the south face the devastating effects of the US Supreme Court’s decision to overturn Roe v. Wade, we must consider how this landmark decision may affect abortion care in Canada as well. Shortly after this decision, Prime Minister Justin Trudeau called the overturn “horrific,” reiterating his support for women in Canada’s right to choose. It is reassuring to know that safe abortion care remains an essential medical service in Canada. However, up to 26 US states may ban or nearly ban abortion, and many of those states share a border with Canada. This may lead to an uptick of women traveling to Canada to get a safe abortion.

As a country, we have long had the obligation to provide this essential medical service to patients who live in Canada, and it would be prudent for us to maintain the infrastructure and capability to continue to do so. What does it mean for patients living in Canada who are looking for abortion care if we begin to see an influx of patients coming from the US looking for the same care? We need to ensure we maintain equal standards across provinces as well as safe access.

Women of lower socioeconomic status and women of marginalized races and ethnicities will be disproportionately affected by the decision to overturn Roe v. Wade. Unfortunately, in Canada, access to abortion care is similarly more difficult for certain populations. A 2013 Canadian study found that 18.1% of women living in Canada had to travel more than 100 km to access abortion services.[1] The uneven distribution of clinics across provinces also makes access to care variable, depending on which province one lives in. Currently, each province’s delivery of abortion care varies widely in terms of the number of clinics and providers available, as well as the legally allowed gestational limit.[2] Clinics that provide abortion services do not advertise their services for obvious reasons, and many patients may not be aware that the majority of clinics accept self-referrals. This could result in patients relying solely on their primary care providers for information and could lead to differences in how patients access abortion care.

Additionally, abortion care providers in Canada continue to face challenges regarding their anonymity and safety. It is crucial that the essential work they do continues to be supported by the government. There are still many areas of uncertainty as we navigate through the effects of the US Supreme Court’s decision to overturn Roe v. Wade.

Reflecting further on women’s health and rights, it has also been discouraging to hear about the recent severe formula shortage in the US, which left many mothers and babies scrambling to find a basic life necessity for the many babies who may not be able to breastfeed. The shortage impacted Canada’s formula supply as well, given our close proximity and many people crossing the border to look for formula. The lack of formula particularly impacts low-income mothers who may not have the ability to maintain a breastfeeding relationship due to inadequate maternity leave policies or lack of support from employers to allow pumping at work. Although breastfeeding is protected by the Canadian Charter of Rights and Freedoms, the reality is that many workplaces and institutions still do not provide adequate support for working mothers to breastfeed. As health care providers, we can normalize breastfeeding and support mothers who choose to breastfeed. There should also be increased awareness around breastfeeding in the medical school and residency curriculum.

Given what has happened to abortion care in the US, this is an important opportunity to reflect on what we currently have in Canada. We are fortunate enough to have this fundamental right protected here, but access is an ongoing issue. Access to abortion services must be made consistently available to those in need, and as a society, we must continue to raise awareness about the challenges women face with regard to their reproductive rights and freedoms.
—Yvonne Sin, MD

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References

1.    Sethna C, Doull M. Spatial disparities and travel to freestanding abortion clinics in Canada. Womens Stud Int Forum 2013;38:52-62.

2.    Action Canada for Sexual Health and Rights. Access at a glance: Abortion services in Canada. 19 September 2019. Accessed 23 August 2022. www.actioncanadashr.org/resources/factsheets-guidelines/2019-09-19-access-glance-abortion-services-canada.