Is Canada winning at abortion policy?
Two new studies show that Ontario is ahead of the game when it comes to abortion—rates are stable here, while the US and UK see big spikes
I miss my Feminist Friday posts, so I thought I’d provide a quick update on some new and exciting research.
In 2017, the abortion drug mifepristone became widely available in Canada through pharmacies. Before that policy shift, abortions were performed mainly as procedures in select hospitals and clinics across the country, leaving people in rural areas with few options.
Two new studies released this week focus on abortion access in Ontario (Canada’s most populous province) and show the impact of our distinct reproductive and health policy, and how we stack up against other Western countries.
The first study found that the proportion of regions in Ontario with a pharmacy that dispensed mifepristone increased from 20% in 2017 to 82% in 2022. By 2022, 91% of people who might use abortion services lived in a region with a dispensing pharmacy, up from only 37% in 2017.
Further, abortion trends examined in the second study show that although abortion rates in Ontario did increase following the 2017 policy, there was no significant spike like that seen in Scotland, England and the US (as expected, rates here did drop during the pandemic but went back to pre-pandemic levels by 2022.)
Why would greater availability of abortion mean that rates stabilized? The authors say that it may be because Canada is doing a stand-up job of meeting people’s need for reproductive health care. Unlike the US (and many other countries worldwide,) we have no laws that restrict access to abortion. Making the abortion pill publicly available like any other prescription medication was an unprecedented move.
We also have better access to contraception thanks to several policies, including a 2017 Ontario policy that provides free prescription medication to people under 25, BC’s 2023 policy to provide free contraception to all, and a 2024 national policy that’s currently being rolled out and will cover the full cost of contraception drugs for Canadians.
Data shows that abortion rates have risen sharply in countries such as Scotland, England, and Switzerland, where there is an overall decrease in the use of contraception (possibly influenced by misinformation/disinformation on social media about contraception’s side effects), higher cost of living, lack of primary care and sexual health services, and improved abortion access. In the US, where many states have introduced abortion bans, rates increased from 11.2 per 1000 females in 2020 to 15.9 in 2023.
It’s too early to say, but all of this could indicate that providing good-quality sexual and reproductive healthcare to all means fewer abortions over the long run (I mean, duh, but we still need data to back this up.)
Is it all good news?
As advocates know, there are still problems accessing abortion in some parts of Canada. Despite the big leaps we’ve made since 2017, many rural areas in Canada don’t have a pharmacy at all, while others have a pharmacy, but they don’t dispense the abortion medication. Further, uptake of the abortion pill has been slow in provinces such as Alberta and Quebec, and a study in the Lancet found that people are often traveling long distances to access abortion services.
Although access to the pill has increased across the board, local access to surgical abortions has decreased in Ontario – from 22% in 2017 to 18% in 2022. It’s unreasonable to assume that all abortions should be done with medication, as people can be living in situations that make it unsafe to have an abortion at home (for example, those who experience intimate partner violence.) As well, many people don’t discover they’re pregnant until around seven weeks, and the abortion pill is only available until nine weeks. Surgical abortion services (which can be provided past nine weeks) need to be protected, alongside improved access to the abortion pill.
What Canada is getting right is our centralized and strong policy that protects reproductive rights. It would be all too easy for us to lose this unique approach, especially in the current political climate. It’s vital that our Canadian policy is protected and strengthened by continuing to improve access to both medication and procedural abortion. Future research can help us to track whether rates here remain stable, and how social factors (for example, misinformation about the birth control pill) impact abortion rates in the future.
From my heart to yours,
Misty
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Living with a chronic, mysterious illness (Part 1)
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