Abortion in Canada - it’s legal, but is it accessible?

Prince Edward Island is the only jurisdiction in Canada where abortion services are not available.

The province announced with some fanfare Tuesday that arrangements have been made for the Moncton hospital, in neighbouring New Brunswick, to provide abortion services to island women beginning in July, but the fact remains that abortions are not available within PEI’s boundaries.

The province’s medical health plan covers only procedures performed at the hospital, not at a private clinic.

The private Morgentaler Clinic in PEI closed last July because of the lack of funding from the province. The government then rejected an offer to have physicians from outside the province travel to PEI on a regular basis to offer the service. Before it closed its doors, the clinic said between 70 and 80 women paid for their own abortions annually at the facility.

Women in PEI will no longer need a doctor’s referral to terminate a pregnancy.

The province had been sending women to the hospital in Halifax for the procedure but there have been reports of wait lists up to five weeks at the Nova Scotia facility. And the provincial health care plan does not cover travel costs of going out of province for the procedure.

Premier Wade MacLauchlan says the arrangement meets the provincial government’s charter obligations and the 1988 Morgentaler court decision that made abortion legal in this country.

There were no abortions reported in PEI in 2013, according to statistics from the Canadian Institutes for Health Research.

There were 82,869 abortions performed in Canada that year. About 35,000 were done in hospitals and the rest in private clinics but access to abortion services varies broadly across Canada.

Access is particularly challenging for women in northern and rural communities.

New Brunswick

As of the beginning of this year, New Brunswick no longer need referrals from two physicians that an abortion is medically necessary. The province does not pay for abortions performed at private clinics; only abortions performed by gynecologists or obstetricians in hospital. There are two hospitals and one private clinic in the province that offer the procedure.

There were 1,036 abortions reported in New Brunswick in 2013.

Alberta

The provincial health plan pays for abortions, whether in the province’s two private clinics or the two hospitals where the service is available.

There were 13,376 abortions reported in Alberta in 2013.

British Columbia

The province has seven private clinics and 18 hospitals where abortion services are provided. The procedure is paid for by the provincial health plan. No doctor’s referral is necessary.

Private clinics are located in Metro Vancouver, Victoria, Kelowna and the Kootenays.

There were 9,574 abortions reported in B.C. in 2013.

Manitoba

Abortion services are fully funded, whether performed in the two hospitals or the two clinics where they are available. All are located in Winnipeg – a lengthy journey for women from the northern half of the province.

There were 3,873 abortions reported in Manitoba in 2013.

Newfoundland

Abortion services are fully funded by the provincial health plan. There is one hospitals and one private clinic that offer abortion services and both are located in St. John’s. Only travel expenses for women whose pregnancy terminations are medically necessary are covered by the health plan. There are no abortion providers in Labrador.

There were 223 abortions reported in Newfoundland and Labrador in 2013, according to the CIHI, though the private clinic did not report.

Nova Scotia

There is one hospital in the province that provides abortion services and no private clinics. There have been reports of wait lists up to five weeks at the Queen Elizabeth II Health Sciences Centre. The provincial health plan pays the full cost of hospital procedures.

There were 2,077 abortions reported in Nova Scotia in 2013.

Ontario

There are eight private clinics and 28 hospital in the province that provide abortion services, which are both fully funded by the provincial health plan.

There were 25,108 abortions reported in Ontario in 2013.

Quebec

There are 17 hospitals and 36 clinics that provide abortion services in the province – the most widespread access of any province. The provincial medical plan pays the full cost of both.

There were 25,253 abortions reported in Quebec in 2013.

Saskatchewan

There are no private clinics and two hospitals that provide abortion services, located in Saskatoon and Regina. The cost of the procedure is covered by the provincial health plan. The wait list is three to four weeks in Regina and two to three weeks in Saskatoon.

The plan also covers the procedure for Saskatchewan residents in clinics in Edmonton or Calgary, according to Planned Parenthood Regina, but does not pay travel expenses.

There were 1,921 abortions reported in Saskatchewan in 2013.

Northwest Territories

The territorial health services plan pays for all abortions, whether therapeutic or medically necessary. Two of the three hospitals in the territory offer the procedure. There are no private clinics but the provincial health plan covers the cost of travel to another province for the procedure.

There were 211 abortions reported in the Northwest Territories in 2013.

Nunavut

Abortion services are available only at the Baffin Regional Hospital in Iqaluit. There are no private clinics. Travel costs are covered with a doctor’s referral. The cost of the procedure is fully covered by the provincial health plan.

There were 96 abortions reported in Nunavut in 2013.

Yukon

Surgical abortion services are available only at Whitehorse General Hospital. There are no private clinics in the territory. A referral is needed from a doctor of a nurse practitioner, for residents of remote communities, and the cost of the procedure is fully covered by the territorial health plan.

There were 121 abortions reported in Yukon in 2013.

The termination of pregnancies in Canada remains overwhelmingly a surgical procedure in Canada, performed at clinics and hospitals.

Health Canada has yet to approve the medical abortion drug Mifepristone, or RU 486, though it has been on the market for nearly two decades and has been approved in more than 60 countries. There is a combination of two drugs approved in this country for medical (pharmaceutical) terminations –methotrexate and misoprostol. The drugs can be administered at a clinic or doctor’s office.

Information compiled from Canadian Institutes of Health Research, Abortion Rights Coalition of Canada, Planned Parenthood. Very few provincial health information websites provide a comprehensive list of where abortion services are available or clear contact information.