Abortion Is An Essential Service, But The Pandemic Is Making It Harder To Access

Travelling for abortion care is even harder when the coronavirus has shut everything down.
For many Canadians, abortion services are harder to access during the coronavirus pandemic.
For many Canadians, abortion services are harder to access during the coronavirus pandemic.

Canada’s provincial and territorial governments have deemed abortion an essential medical service, and one that continues to be available during the COVID-19 pandemic. But reproductive health advocates say existing barriers to abortion access have become even more significant now.

Calls to a 24-hour info line provided by Action Canada for Sexual Health and Rights increased by 30 per cent in the last two weeks of March, according to communications director Laura Neidhart.

“Our team who runs the access line has heard from an increasing number of people who have a lot of questions or are facing new barriers and old barriers to abortion access,” Neidhart told HuffPost Canada. STI testing and contraception are harder to access, too.

What’s happening in New Brunswick is ‘absolutely infuriating’: advocate

One of the country’s most significant barriers is in New Brunswick. The province’s only freestanding abortion clinic, Clinic 554 in Fredericton, is on the brink of closure and has been up for sale since October. Because the province’s health service funds abortions only if they take place in hospitals, and not private clinics, patients who need abortion services have to pay out-of-pocket for clinic procedures, which can cost up to $850.

Clinic 554 in Fredericton is New Brunswick's only freestanding abortion clinic, and it's been facing closure for months.
Clinic 554 in Fredericton is New Brunswick's only freestanding abortion clinic, and it's been facing closure for months.

For people who cannot travel to Fredericton or who can’t afford the fee, the only option is to seek out abortion care by going into crowded hospitals. Under normal circumstances, this isn’t ideal — but during a pandemic, it’s downright dangerous and “absolutely infuriating,” said Jessi Taylor, a spokesperson for Reproductive Justice New Brunswick.

“People are risking their health and safety during the pandemic because going to hospitals, they’re much more likely to contract the virus,” she told HuffPost Canada.

“We’ve seen a lot of hospitals that have policies trying to limit the amount of visitors or people in the hospitals who don’t need to be there. But we haven’t seen that with abortion care. And abortion care is definitely something that we’re already set up to do [outside of hospitals].”

HuffPost Canada contacted the province’s health minister Ted Flemming several times for comment, but his office declined to respond.

Travelling for abortion care takes even more resources now

The existing difficulties people face seeking abortions at hospitals are still present, and in some cases are made worse by pandemic conditions, Taylor said.

For many people throughout the province, getting to the province’s only hospitals that provide the service, in either Bathurst or Moncton, involves significant travel, often overnight. That’s already a time and money barrier for many people. But with schools and daycares closed down, women with children face another issue.

We don’t have access to this data in Canada, but in the U.S., 59 per cent of women seeking abortions already have children.

With schools and child care shut down in most of the country, many people have an even harder time seeking abortion care.
With schools and child care shut down in most of the country, many people have an even harder time seeking abortion care.

“Anyone who’s trying to access the procedure, even if they do have the funds to travel, they can’t access child care,” Taylor said. “That becomes even more expensive and more difficult to navigate.”

That’s largely been the case elsewhere in the country, said Neidhart: Existing barriers become even more significant. “Everything’s being exacerbated, because suddenly your ability to get places and see service providers has been drastically reduced,” she said.

Closed border makes access more difficult

Another big issue is related to gestational limits. Late-term abortions are very rare: 2016 data found that less than three per cent of abortions performed in Canadian hospitals that year took place after 20 weeks. While there isn’t a very large demand for late-term abortions, they can be life-saving, as they generally occur only when there’s a very serious birth defect or if the mother’s life is at risk.

There are very few places in Canada that will perform abortions after 23 weeks, Neidhart explained, which is why Canadian women will sometimes cross the U.S. border to access abortion care.

“With a closed border, that becomes increasingly difficult,” she said. Since late March, the Canada-U.S. border has been closed to all non-essential travel. Women seeking abortions can bring a letter from their doctor stating that they’re travelling for essential medical reasons, but theoretically, it’s possible that they would be turned away, Neidhart said, as what’s considered essential by Canadian authorities may not be treated the same way in the States.

No abortion pill shortages at this stage

Neidhart said Mifegymiso, the two-pill combination that induces abortion, still seems to be readily available in most areas. Since the novel coronavirus was declared a pandemic in March, Action Canada has heard of many more problems people had accessing the surgical procedure than accessing the pills, she said.

So far, there doesn't seem to be a problem with access to medical abortion.
So far, there doesn't seem to be a problem with access to medical abortion.

But availability isn’t the whole story, because several provinces don’t cover Mifegymiso under their health plans. It costs between $300 and $450.

We need to guard reproductive rights during a crisis: expert

Diana Sarosi, director of policy and campaigns for Oxfam Canada, warns that a pandemic, like a war or a natural disaster, can sometimes lead to an increased political will to strip women of their rights.

“What we’re really afraid of is, in these kinds of crisis contexts, it can threaten women’s rights and lead to a rollback in women’s rights,” Sarosi told HuffPost Canada.

She pointed to the ongoing discussion around abortion in the U.S. as an example. The governor of Texas recently declared abortion “non-essential,” and thus barred doctors from providing them during COVID-19 emergency measures. (Church services, on the other hand, he views as essential). Ohio, Oklahoma, Indiana, Iowa and Mississippi have followed suit, while Kentucky, Louisiana and West Virginia are mulling the question.

Neidhart points out the significant reason abortion is in fact an essential service: “Obviously abortion is unlike other things in that it can’t wait for this pandemic to be over.”

But the shutdowns in many American states could strain the clinics that remain open, which may permanently make the procedure harder to access, Time Magazine has reported.

“That is something that we really need to watch out for here in Canada as well,” Sarosi said.

If you need an abortion, here are some resources:

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