I wrote an essay re abortion access in Canada y’all should EDUC8 urselves!!!!!!!!!
note: im bad at papers not: i hate writing papers note:i handed this in 10 days late and a few pages short
Although abortion is legal for the duration of a pregnancy in Canada, women’s access to this health care procedure may be limited in many parts of the country. The discrimination that many women face when attempting to obtain an induced abortion is harmful to women’s health. The Canada Health Act states that “continued access to quality health care without financial or other barriers will be critical to maintaining and improving the health and well-being of Canadians.” (1984) However, many women do face barriers when seeking induced abortions, especially women in rural, northern, and Atlantic Canada.
Though abortion was decriminalized in Canada in 1988, adequate abortion care has not become entirely accessible to all Canadian women. There are plenty of factors that impede a woman’s right to make her own reproductive choices.
The Canadian Mental Health Association states that “services to women must be based on the fundamental principle that a woman’s mind and body belong to her” (2012) however, there are Canadians involved in government and healthcare that do not agree with or adhere to this position. According to Shaw (page 39, 2006), some barriers that women who require abortion care face include the cost of travel involved in obtaining an abortion, the lack of qualified abortion providers, hospital staff that are unknowledgeable about abortion proceedings at their respective locations, judgmental gatekeepers, conscience clauses, bad referrals, and anti-choice doctors and organizations. Though the Canada Health Act states that ‘in order to satisfy the criterion respecting universality, the health care insurance plan of a province must entitle one hundred per cent of the insured persons of the province to the insured health services provided for by the plan on uniform terms and conditions,’ (1984) women in all provinces may encounter physicians who are anti-choice. These practitioners may refuse to inform a woman seeking an abortion which clinics or hospitals perform abortions, delay information or referrals, or they may refer the woman to an anti-choice organization, such as a ‘Crisis Pregnancy Centre’(CPC), rather than a doctor or centre which could support the woman in making an informed decision.
There are only two territories, Northwest Territories and Yukon, and zero provinces in Canada in which provincial healthcare covers the cost of travel when necessary to access abortion care, even though the majority of abortion providers are within 150 kilometres of the Canada/United States border (Canadians for Choice, page 1, 2006). This is problematic because most provinces have very scarce abortion access in rural areas. Manitoba has no abortion provider anywhere north of Winnipeg; northern Ontario, northern Quebec, and northern Saskatchewan, are all severely lacking abortion access. In Newfoundland and Labrador, the only two providers are in Newfoundland. Prince Edward Island (PEI) has zero abortion providers, but will cover procedure costs, not including travel, at an out-of-province hospital, provided a woman attains two referrals. Requiring someone to travel in order to see a physician is understandable when a specialist is needed for a rare condition. Requiring someone to travel in order to see a physician for a procedure that takes place hundreds of times a day and does not require deeply specialized training is completely unnecessary. “Smaller communities,” according to the Abortion Rights Commission of Canada (ARCC), “often have no doctors able or willing to perform abortions, because of the stigma still attached to abortion, fear of being known and targeted in a small community by local anti-choice activists, and the lack of abortion training offered at Canadian medical schools”. Even doctors who do not instigate the conscience clause may be opposed to performing abortions for fear of backlash from the community.
Access to the abortion procedure in much of rural Canada is severely limited. 95 percent of Canada’s land is considered to be rural. 31% of the country’s population is rural, and 2/3 of the people living in rural Canada are women. Yet, only 17% of physicians live and practice in rural Canada (Sutherns, p. B3). The population to healthcare provider ratio is even greater in the territories, where 59 percent of the population is considered to be living in rural areas. Two out of three hospitals in the North West Territories provide abortion services, but only one hospital in each Yukon and Nunavut provide these services (Shaw, p. 27, 29, 38, 2006). One reason for the lack of abortion providers in rural areas is that ‘among rural participants, a common concern identified was professional and personal isolation as an abortion provider’ (Dressler, Maughn, Soon, Norman). Physicians in rural areas are meager, but physicians in rural areas who provide abortions are extremely scarce. These physicians may face stigma and become outsiders in their communities due to the obligations of their jobs. However, since abortion is one of the few areas in which a physician can invoke a ‘conscience clause’, many rural physicians may opt out of performing this already difficult-to-access procedure (Shaw, p. 44, 2006). Because, according to Sutherns, rural women are less likely to travel to access medical services (p. B6), and the fact that local physicians might opt out of an important surgical procedure that affects only women, women are lacking access to fair and equal medical treatment, as demanded by the Canada Health Act (1984). This lack of adequate medical resources leaves rural women with limited choices in regards to their reproductive health, and thus overall health.
It is critical that women in rural communities have equal access to health care since these women face higher rates of fertility, greater chances of economic instability, are more likely to commit suicide, and face a greater risk of violence (Sutherns, B5). Theorists suggest that these factors may be related. Gentile states that psychosocial factors “may also contribute to increase the rate of maternal suicide attempts during pregnancy [including] teen age, unplanned pregnancy, unmarried status or recent divorce, unemployment, and difficult access to safe abortion service” (2011). The author, however, goes on to state that induced abortion is a contributor to suicide as well, without considering the pre-existing factors that may be prominent in some women post-abortion, or the factors that contribute to women’s decisions to have an abortion, especially in regards to rural women. Since factors such as poverty and unemployment are greater among rural women, when these factors meet with rural life and limited access to health care, the resulting correlation is something Gentile does not consider.
As previously mentioned, abortion access in Atlantic Canada is quite limited. PEI’s Catholic Register boasts that the province has been ‘abortion free since 1986’. PEI is the only province in Canada with absolutely no abortion providers. As a result, a woman must obtain her abortion in another province, usually in New Brunswick. However, to access an abortion at the one hospital in New Brunswick where the procedure is performed, a woman must obtain two referrals from two doctors. In this case, PEI health care will cover the cost of the procedure, though a woman is still responsible to cover the travel and any other expenses included in the trip. These requirements seem manageable, assuming that in all circumstances a woman will encounter a pro-choice doctor. This is not always the case. The aforementioned conscious clause is technically acceptable even in a situation that calls for abortion referral, or requests for information (National Abortion Federation, p. 1). If a woman chooses to opt out of the double-referral regime, she may obtain an abortion at a clinic in New Brunswick, but she must pay for the procedure herself, along with all the costs associated with traveling to another province. The system in place in PEI does not only reduce a woman’s choice of reproductive options in the province, it also affects her access to treatment opportunities.
Yet another concern when examining women’s reproductive healthcare options in Canada is the observation that late-term abortion access is extremely hard to come by, all across the country. According to the Abortion Rights Coalition of Canada (ARCC) there are only two hospitals in Canada which treat abortion clients up to 23 weeks (2006, p. 1). This abhorrent lack of access means that women who require this essential procedure are forced to travel to the United States. Since many provinces disallow reciprocal billing for abortion care attained out of province, one would personally have to cover all expenses. Access to physicians trained in late term abortion care is crucial, as many of these surgeries are emergencies, and the procedure is complicated. The ARCC gives some examples of how dire late-term abortion situations can be, including “desperate social circumstances, an abusive relationship, or an unexpected fetal diagnosis, such as a serious birth defect, which may jeopardize the health of the mother or the child”. Oftentimes these procedures are lifesaving, but they may also be accompanied by trauma and grief for the family. In any case, women should not have to endure massive amounts of travel, foreign hospitals, and healthcare bills, nor face the stigma regarding late-term abortion from those who are uninformed of the circumstances surrounding the issue, in order to access the procedure .
The ARCC puts it well when they state, “unfortunately for millions of women, access to abortion does not meet the standards of the Canada Health Act”. This lack of adequate healthcare is discriminatory towards anybody able to become pregnant. When a medical procedure is seen as universally pertinent, the population ensures that it is readily available. When a procedure is applicable to only the female half the population, it is somehow greatly unavailable. Women in rural areas, PEI, and the territories deserve equal rights to all surgical procedures that people living in urban areas have. In general, women deserve equal rights to medical care that pertains to their own bodies as men have. Women deserve physicians who are well trained in every common procedure, and women deserve physicians who will fully inform them or direct them to accurate, non-biased information. Abortion rights are equal to all other rights, and covered by the Canadian Charter of Rights and Freedoms in section 7 which state the ‘right to life, liberty, and the security of person’ and the ‘right not to be deprived thereof’. Therefore the inaccessibility of abortion rights violates even the Canadian Charter of Rights. This inaccessibility attaches greater stigma to an essential medical procedure that deeply impacts women all over the country.
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