Access to abortion in Sudbury more complicated than just geography

·9 min read

If you only look at publicly available information, you’d think that it was impossible to access abortion services in the Greater Sudbury area.

In fact, a recently updated list of abortion clinics and services across the country from the Abortion Rights Coalition of Canada lists only one item located in Sudbury: Health Sciences North’s Options Clinic. But unlike other items on the list, which state what services are provided, all that’s listed for HSN is a phone number.

On its face, it seems like abortion is just one more medical procedure that poses significant geographic challenges, where local access is impossible, and only those with the time and money to spare can travel to receive it.

But the truth is actually more complicated, and geography is necessarily the main barrier.

ABORTION ACCESS IS CHANGING

When the United States Supreme Court overturned the landmark abortion case Roe v. Wade on June 24, the decision caused some in Canada to look more closely at what abortion access is like here.

Across much of Canada, accessing abortion services remains complicated and difficult, according to Joyce Arthur, executive director of the Abortion Rights Coalition of Canada.

“It's very much a patchwork quilt,” she said. “It can be very good in some of the major cities, in particular Vancouver, Toronto and Montreal. But outside of those cities, it can be much more difficult, possibly even impossible for some people.”

While it’s hard to pinpoint exactly, only about one in six Canadian hospitals currently provide elective abortion services. That includes medical abortions, which are procedures that used prescribed medication that can be taken at home for early stage pregnancy, typically up to 12 weeks; and surgical abortions, an in-clinic procedure that uses suction to empty the uterus, which is typically only performed up to 22 weeks, though many providers have much stricter limits.

According to Arthur, telemedicine has been one of those significant contributors to improving access across the country.

The abortion pill, Mifegymiso, can be prescribed by any physician, including family doctors and general practitioners. That means that if a patient seeking an abortion can find a doctor willing to give her the prescription, no travel is needed.

If none are willing to do so locally, services are available that can connect patients to physicians locally.

“There’s a lot of communities in Canada where a person can get on a phone call or video call with a doctor in Vancouver, and then get a prescription phoned into the local pharmacy and go pick up the pill. That's happening more and more.”

Still, it’s not a magic bullet.

“Anti-choice pharmacists can be a problem,” Arthur said. “There’s so many communities that still don't have pharmacies that would have it in stock.”

Across much of the country, access to surgical abortion also continues to pose a problem.

As an in-person procedure, lack of local access can meet extensive travel, taking time off work, and potentially costly accommodations. Remote, rural areas are the most affected by this.

That’s the problem that, on the surface, seems to exist in Sudbury.

“IMPOSSIBLE TO KNOW”

When The Star contacted Health Sciences North to see if we could glean more information about what abortion access looks like in Sudbury, we received a short and simple response from communications manager, Jason Turnball.

“HSN is legislated under the Freedom of Information Act and there are mandatory exclusions outlined under section 65 which specifically address abortion records,” Turnball wrote.

It’s this legislation that makes it so difficult to understand how accessible abortion is in any given area.

The most comprehensive list of abortion providers is managed by Action Canada, which offers a confidential hotline for those seeking information about sexual health, pregnancy options, and abortion.

According to Jessa Millar, who manages the access line, abortion is much more accessible, but much harder to track than it was before.

“Somebody could be asking their family doctor, ‘can you prescribe me Mifegymisto?’ And the doctor might say, ‘I’ve never done that before, but I don’t see why not.’ Then that person is an abortion provider, but they didn’t call to tell us that and they probably never will.”

As a result, she said, “It’s going to be kind of impossible to know how many doctors in Canada are able to prescribe and are prescribing abortion medication.”

That’s not necessarily a bad thing for those seeking an abortion. For one, it means that in more areas across the country, there are fewer hoops to jump through to access an abortion. For another, it means doctors are treating abortion pills like any other kind of medication.

The legislation also allows abortion providers to protect themselves from public backlash.

“Providers I’ve spoken to are interested in supporting people outside of their patient roster, they’re willing to have people self-refer to them to provide abortion care to the general public,” said Millar. “But they don’t want to be publicly listed as an abortion provider.”

In fact, only a small number of physicians and facilities who do provide abortions publicly identify that fact. According to the ARCC’s list of clinics, there are only 23 publicly declared providers in Ontario. But that number doesn’t accurately reflect that number of providers that actually exist in the province.

Action Canada’s database of providers — which is used to refer patients who call in to the nearest provider to them — includes a number of facilities and physicians who remain unlisted to the public. In other words, they will accept referrals from patients who gain their information through the access line, but they won’t publicly advertise that they provide abortion services.

“Stigma is still very prevalent, even though we live in a country that prides itself on believing that people have a right to bodily autonomy,” said Millar. “There is still abortion stigma. They still have some fear around being known for the services they’re providing. It’s too bad because that in and of itself creates a barrier.”

She added, “The more difficult it is to find out where to go, the longer it will take, and the more difficult it will be to access services at all.”

SERVICES AVAILABLE IN SUDBURY, BUT CHALLENGES REMAIN

In Greater Sudbury, there are no healthcare providers who publicly state that they provide abortion services, including HSN.

However, according to Public Health Sudbury and Districts, there are “multiple” providers of medical abortions, as well as one provider of surgical abortion.

While it isn’t easy to find this information on your own, there are several resources in place to direct patients to the proper care.

Public Health, for example, can be a first point of contact for many patients.

“There’s a lot of fear and anxiety during this time, so our role is to talk to them about the different options available to them,” said Carol Lougheed, a public health nurse in the health protection division. “We really encourage individuals to talk to someone they can trust, someone they can really count on for support, and just weigh the pros and cons.”

According to Lougheed, when a patient comes in with an unplanned or unwanted pregnancy, they can refer them to counselling and other services that help the patient decide how they want to proceed.

“We’re very supportive of the idea that this needs to be their own personal decision,” she said. “We’ll help them by giving them information, but we never encourage a client to make any specific decision.”

From there, they can refer them to support services or other health providers, whether they intend to continue their pregnancy, pursue adoption, or terminate the pregnancy.

While HSN won’t confirm whether its provides abortion services, it does have a phone number for their Options Clinic, which is publicly advertised as its point of contact for patients looking for information.

But just because these services exist, doesn’t mean access in Sudbury is without its issues.

According to Arthur, stigma and lack of knowledge are some of the most difficult issues to navigate, even in areas where services are offered.

The protection providers have under the Freedom of Information Act, for example, are “a catch-22. The issue is that the anti-choice have been known to try to ferret out information on who’s providing abortions, then they go and picket and harass doctors. That’s where that (protection) is coming from. But then people can’t find out where to go for services.”

Some of the groups hit hardest by this are marginalized and Indigenous communities, low-income people, immigrants, youth, and LGBTQ+ individuals.

Cass Kuntsi, who works with youth and is part of a group organizing a pro-choice rally in Sudbury in July, said she’s seen how stigma can prevent young people from reaching out.

“There’s a lack of education,” she said. “A lot of the time, they don’t want to ask because they either don’t have somebody that they trust to ask, or they’re embarrassed. If they don’t have somebody they can confide in, who can help them access resources, then they feel very alone and isolated.”

Connecting people with the resources they need, she said, is key.

“I think that education is super important, especially in our area,” she said. “It’s great to say don’t do it, but you also have to provide a solution for when a problem does arise. Ignorance is bliss until it’s not.”

Where does that start?

“Nurturance and validation,” she said. “It’s a really scary thing to do. You are absolutely are allowed to feel that way that you’re feeling.”

The Local Journalism Initiative is made possible through funding from the federal government.

mjensen@postmedia.com

Twitter: @mia_rjensen

Pro-choice rallies

Volunteers in Sudbury and North Bay are inviting area residents to join protests to condemn the recent United States Supreme Court decision to overturn landmark abortion case Roe v. Wade.

All participants are welcome. Volunteers say the events will go ahead regardless of wheather.

In Sudbury, the protest will be held July 17 at 1 p.m. in Bell Park.

A similar event will be held in North Bay on July 24 at 1 p.m. at the courthouse.

Any questions may be directed to NorthernOnProChoiceProtests@gmail.com.

Mia Jensen, Local Journalism Initiative Reporter, The Sudbury Star

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