sippor:

Melissa co-developed this infographic for the Third Wave Foundation.

In Canada there is no abortion law. It is legally treated as any other medical procedure. There is no time at which abortion becomes criminal to obtain or perform. In the absence of legal regulation its allocation is overseen by provincial healthcare plans, the Canada Health Act, knowledge, status, poverty, fear, geography and threats.

The abortion itself is free or cheap in most circumstances if you qualify for your provincial healthcare plan, University Health Insurance Plans, Canadian Military Insurance and Interm Federal Health, which covers refugees and protected persons. While not everyone in Canada qualifies for their plan due to things like immigration status, residency issues or a lack of proper ID, the majority of women in Canada do not have to worry about how they’re going to pay for their abortion. There are exceptions. On Prince Edward Island there are no abortion providers and the province only pays for women to have abortions elsewhere if they are deemed medically necessary. Only ten women in Prince Edward Island had their abortions covered by the province in 2007. In B.C. women having a medical abortion must pay for the medication, which costs around $80 and is often covered by private prescription coverage. In New Brunswick only hospital abortions are covered. If you are covered by a provincial plan you must have the abortion in that province or a location approved by your provincial plan for immediate coverage. If you have an out of province abortion you may have to pay for it out of pocket and seek reimbursement from your own provincial plan later depending on which plan you have. You may not get reimbursed. In Ontario, if you do not have OHIP you may be able to get financial assistance through things like Ontario Works and ODSP (welfare/disability), but I don’t think many people realize that.

If you are not covered by a healthcare plan you can often access healthcare at clinics or centres that receive funding specifically for this purpose. I used to use this before I became a resident. But I know of no such funding for women seeking abortions - it is possible that it exists but I don’t know about it. Clinics may have other patient-assistance funding available. A first trimester abortion at a clinic costs around $350-450. 

The primary barrier for women seeking abortion is the scarcity of abortion providers in some locations. Canada is an enormous country and there are many women living in remote communities, even communities so isolated they are accessible only by airplane. These women can face profound hardship in accessing abortion services. In Manitoba there is only one clinic and only two of the 52 hospitals provide abortions. In Saskatchewan four of their 68 hospitals provide abortions and there are no clinics. In Ontario 33 of 194 hospitals offer abortion - only one north of the TransCanada Highway - and there are eight clinics. In Alberta six of 100 hospitals provide abortions and there are only two clinics. Only one hospital in the Yukon provides abortions. In the Northwest Territories abortion is available at two of the three hospitals and in Nunavut they are available at a single hospital. If you are more than 12 weeks pregnant in Nunavut or the Yukon or more than 14 weeks pregnant in Saskatchewan women must travel to other provinces to obtain abortions. Travel expenses are covered by the government, but they do not account for lost wages or childcare. Travelling for abortion, funded or not, becomes much harder if you are a minor, if you are trying to hide your pregnancy or abortion from family members or a partner, if you have no one to take care of your children or animals, if you cannot take time off work or school. Especially if travelling the great distances sometimes required in Canada. Sometimes it becomes impossible.

The Canada Health Act should alleviate some of these burdens if followed, but several provinces act in violation of the Act without consequence.

A woman, a nurse, I know used to do crisis counselling in a fly-in community in northern Ontario. She came because so many young people had attempted or committed suicide. Sometimes it was not because they wanted to die, but because a suicide attempt would get them the fuck out of their town and it was the fastest way to do it. They would have to be flown to a hospital elsewhere and that was the whole point. Sometimes they would be too good at it and end up dead anyway.  One woman had lost all thirteen of her children to suicide. If this kind of desperation to leave exists in some remote communities, if there are such extreme barriers to leaving that suicide attempts become reasonable, expecting women, particularly young women, poor women and women in abusive relationships, to be able to travel whenever they want is entirely out of touch with reality. 

Canada does not have the fervent and widespread anti-choice community of the United States. The Conservative party has no official stance on abortion. I have seen abortion discussed in electoral politics only a few times and briefly, the most significant instance being the Unborn Victims of Crime Act in 2008 that was not passed. Most debates are about whether or not there should be debates. The only public anti-choice sentiment I have seen aside from a few stray protestors outside the Cabbagetown Women’s Clinic have been signs, mostly homemade, on Prince Edward Island and in Nova Scotia and one was in a church in a town of almost no one, where the graveyard has only a handful of surnames on its headstones. In 1992 the Morgentaler Clinic on Harbord, a five minute drive from my house, was bombed. In 1994 Dr. Garson Romalis was shot and injured in Vancouver, after which protests outside abortion clinics and doctors’ homes were banned in B.C. In 2000 he was stabbed and lived. In 1995 Dr. Hugh Short was shot in Ancaster and he lived too. In 1996 the Morgentaler Clinic in Edmonton was attacked with butyric acid. In 1997 Dr. Jack Fainman was shot and injured in Winnipeg. But these do not seem to be me to be a logical extension of a mainstream Canadian anti-choice activist community and the shootings have been linked to an American man. They were classified as acts of terrorism by the National Police Task Force.

Growing up in Hinsdale, a suburb of Chicago, there were devoted daily protestors chanting outside a gynecologist’s office, screaming at patients, after it was discovered she performed abortions. One afternoon in Laguna Beach a crowd took over the beach carrying enormous placards with photographs of mangled full term fetuses. In D.C. there is always a van plastered with similar photographs parked beside the monuments. These were everyday events, constant, widely supported, reflected in electoral politics constantly. Here there are anti-choice groups and activism. There is an annual march in Ottawa. But it is not like that. Maybe things are changing and there is an Americanization of anti-choice activism, but right now it is not like that and I don’t think it will be.

Pro-life groups have lost charitable status due to political activity. The Roman Catholic church withdrew funding from groups that harassed abortion providers. Some universities ban graphic anti-choice placards because they are offensive. 

In big cities we are relatively lucky. Both hospitals and clinics are viable options for many of us whereas clinics in small communities aren’t great for women who don’t want other people to know they’re having an abortion and are better served by hospitals. In Toronto we have a number of clinics, including feminist collectives, clinics that offer Saturday appointments, evening appointments, clinics whose websites contain detailed directions from the airport for women travelling from other towns, cities, provinces or countries, clinics that provide early abortion, others that only perform them after 7 weeks, that have waiting rooms not unlike the lobbies of mid-range hotels, that offer websites, services and translators in multiple languages. You get an appointment within a few days and some take walk-ins. We have public transportation and taxis so women don’t need someone who drives to accompany them if they choose sedation.  One has a tremendously inspiring executive director who used to be my professor. Some operate openly and can be identified from the street, others are hidden inside office buildings. I have yet to see a single protestor outside the one I pass every day. If you want general anesthesia you can go to a hospital. For a lot of women it is easy to obtain an abortion, it works the way it should. 

But the process of having an abortion in Toronto can feel secret, furtive and criminal. Not due to public anti-choice activists, but because of clinic policies designed to preserve the safety of them and their patients. We act in response to a ghost of violence and of shame. We act in avoidance of danger, as do the doctors who have abandoned the practice and new doctors who never start. Buying drugs feels more normal, less illicit. 

This is an ordinary process:

You call to make an appointment. You give your details and the woman on the telephone tells you she will call you back. She asks if you want a code name, if she can leave a message, tells you she will use an alias or a code word. She calls you back to confirm it’s really you. If you don’t call to confirm 24 hours before your appointment it will be cancelled. If you go to a provider inside an office building there may not be a listing for the clinic on the directory board and you have to follow the directions given to you on the telephone. You buzz the intercom and identify yourself. You may need to use a code word or phrase. You are buzzed into a holding room with security cameras and then buzzed through that door. You present your ID and the ID of anyone accompanying you through bulletproof glass. They make copies. After that you go into the waiting room. I have no idea what happens if you don’t have ID.

Women should not have to go to secret locations, use code words and aliases, and talk through bulletproof glass to avoid harassment, threats or harm to have a legal medical procedure.

And in the absence of a mass anti-choice movement to react to, there is no fervent, widespread, highly publicized movement to increase abortion access. Without a sustained public debate and immediate threat, the methods by which abortion access is challenged often remain unnoticed. After a number of Supreme Court cases that demonstrate a refusal to regulate abortion legally, smart anti-choice activism, the most threatening kind, is located not primarily in legal apparatus to create obstacles to abortion based arguments concerning morality, when life begins or fetal rights, but in challenges to interpretations of the Canada Health Act and provincial funding structures to create practical ones.  I see no real legal threat considering precedent and an overall refusal by even Harper to re-open the debate about the legal status of abortion - abortion restrictions were struck down based on the Charter, not popular opinion, and upheld in each challenge - even strengthened. 15.000 people marching in Ottawa does not change that. The site of our contest is not so much about an overall legal right to abortion, but about who pays, whether or not it is healthcare like any other, and about real access that accounts for the circumstances and experiences of Canadian women. 

….I had no idea.