People living in Labrador and rural Newfoundland currently have to travel — and deal with the associated costs — in order to access surgical abortions, and the owner of the province's only freestanding abortion clinic says expanding that access may be more difficult than it seems.
Rolanda Ryan, owner of Athena Health Centre in St. John's, says abortion would be broadly offered in an ideal world, but limited equipment, training requirements and a shortage of physicians create challenges.
"That's … a bit of a pipe dream at this point because, you know, you need people who are trained and who are willing and you need the resources there," she said in an interview with CBC News.
Ryan said Athena Health Centre does telehealth appointments with patients in Labrador and rural Newfoundland.
Ryan said the clinic can prescribe Mifegymiso — commonly known as the abortion pill — for patients who are nine weeks or earlier in their pregnancy. The clinic can either send the prescription through the patient's local pharmacy or send the medication via mail or the DRL bus.
Once a month, Athena Health Centre travels to Corner Brook and to central Newfoundland to perform surgical abortions. There is no regular service in Labrador.
As well, even those locations can still be out of reach for people living in remote parts of the province. While the procedure itself is covered under the province's Medical Care Plan, travel, accommodations, food and other expenses are not.
'No or limited access': Labrador MHA
Earlier this week, Planned Parenthood N.L. executive director Nikki Baldwin told CBC News she'd like to see hospitals offer surgical abortions.
During question period on Thursday, Torngat Mountains MHA Lela Evans asked the government to look into that request.
"Rights, but no or limited access," said Evans regarding abortion services in Labrador.
Health Minister John Haggie said he's willing to work with the Athena Health Centre to address gaps in services.
"We recognize that Labrador is a challenge. We need to recruit interested primary care providers to provide that service much … closer to home, and that is part of an effort the department will continue to pursue," Haggie said.
In response to a question from CBC News, Haggie said the problem with trying to expand abortion services is that health-care providers also need the resources to offer counselling before the procedure and support following the procedure.
"Athena is an integrated kind of one-stop shop for all of that," he said.
"We know that we have real geographical challenges and Labrador is where we see them most of the time. …It's not our intent to provide any kind of barrier to anybody in a rural or remote area."
Haggie said just 10 per cent of abortions occur in hospital settings.
Anti-abortion views persist
Ryan said accessing a OB/GYN is difficult in some parts of the province, and some health care providers have concerns about being the only abortion provider in a certain area.
In 2016, Athena Health Centre went to the Supreme Court of Newfoundland and Labrador to ban anti-abortion protests within a 40-metre radius of its building. Anti-abortion views persist in Newfoundland and Labrador, including in some religious communities.
"If you have an anti-choice cohort in that community, that could make that physician's life pretty miserable," Ryan said. "I think there's some degree of, you know, concern when people decide whether or not they want to be a known abortion provider."
Health-care providers who are willing to perform abortions still need the resources, equipment and training to provide care.
"People need to really be invested in it to take on the training and then to be the, you know, provider," Ryan said.
The long-simmering conflict over abortion in the United States came to a head this week when a draft U.S. Supreme Court opinion was leaked, revealing the court is set to overturn the 1973 Roe v. Wade ruling which legalized abortion in that country.
The leak triggered strong reactions from pro-choice and anti-abortion advocates alike, with protests erupting across the United States.
Ryan is one of two Canadian representatives on the board of the National Abortion Federation, the professional association of abortion providers in the United States.
"I really feel like we're at a tipping point in the States, but I feel like we have a chance now to do something before, you know, before it actually happens," she said.