When Roe V. Wade Is Overturned, America Can’t Rely on Canada For Abortion Care

by Sarah Sahagian

fiona paton/flickr

Canada isn’t the pro-choice utopia Americans think it is.

When Brett Kavanaugh’s Supreme Court nomination was confirmed in October of 2018, many of my acquaintances speculated Americans would soon be traveling to Canada for their abortion care.

Progressive pundits have pointed out that Roe. V. Wade, the Supreme Court decision that made abortion legal in America, is in danger of being overturned by the court’s conservative majority. Given Kavanaugh’s track record of blocking women from terminating their pregnancies, I understand where the prediction that American women could end up crossing the border for abortions comes from. Many Americans view Canada as a liberal haven, the refrain of “Well, time to move to Canada” likely passing through every Democrat’s mind every time more conservative legislation is enacted. But is the idea of Canada as a hypothetical abortion tourism destination a realistic one? If you’re a feminist activist living in Canada, you know the answer is probably not.

Soon after Kavanaugh’s confirmation, my friend Kaley wrote on Facebook, “Now everyone will know Canada’s secret shame.” That secret shame being abortion isn’t so easily accessible here.

In Canada, abortion is theoretically considered “an essential healthcare service.” It is available at a mix of publicly funded hospitals and private clinics. However, each province has its own limitations, and in many parts of the country, hospitals will not provide abortions of any kind past the 12-week mark in many parts of the country. And, much like in America, access to terminations is uneven, with major urban areas enjoying the best resources. Frederique Chabot, the Director of Health Promotion for Action Canada For Sexual Health and Rights, explains Canada’s abortion access problem like this: “In the US, there are more regulatory policies to delay access or close down clinics. But when it comes to vast geography and being able to access that service in a timely manner, Canada is in a similar situation.”

Women in the Northern regions of the country typically must drive long distances — or sometimes fly — to have their procedures. For example, a woman living in Moosonee, a city in the far North of the province of Ontario, could find herself taking a 7.5 hour bus ride to the nearest provider. She’ll also be on the hook for travel expenses and hotel accommodations, which makes abortion a privilege only some can afford. A similar situation plagues people living in the Northern parts of other Canadian provinces, such as Manitoba, Quebec, Alberta, and Saskatchewan.

In Ontario, the most populous province, there are a mere 11 abortion clinics for approximately 14 million residents. That’s not even one facility for every million people! To make matters worse, all but one of these clinics is located in the two largest cities, Toronto and Ottawa. For a breakdown of abortion access by province, please see this chart. It does not paint a progressive picture.

Much like in America, access to terminations is uneven, with major urban areas enjoying the best resources.

In 2015, medical abortion (the abortion pill) was finally approved by Health Canada after a long, drawn out process. At the time, it was touted as a way to help women in isolated communities take control of their reproductive destinies. However, the provinces of Manitoba and Saskatchewan still refuse to cover the cost of the drug. Add to this the issue that some doctors refuse to prescribe the it for religious reasons, and the fact it can only be used within the first ten weeks of pregnancy. Combined with the gestational limits, this is yet another hurdle for rural women who do not live in close proximity to the hospitals where the procedure is available. The abortion drug has not been a magic pill.

While I am lucky enough to live in Ontario, there are areas where abortions at private clinics are never reimbursed. In 2013, my friend Lily sought an abortion at a private clinic in Fredericton, New Brunswick. Already a mother of one, Lily and her husband conceived a second pregnancy by accident. They did not have the time or the money to devote to another child. While publicly funded abortions were in theory available to her at a local hospital, Lily discovered she would have to wait at least a month for the procedure. This was a scary prospect, because abortions in New Brunswick are only available for the first twelve weeks of pregnancy. Waiting for a free abortion would mean cutting the process down to the wire.

These long wait times at hospitals are common. In Nova Scotia, where the abortion pill is not provided by provincial healthcare, wait times for surgical abortions can easily be more than six weeks. This presents a significant obstacle, because the province does not provide abortions after the 15-week mark. Once an individual discovers they are pregnant, they have little time to weigh the options before scheduling a hospital abortion. And God help the person who doesn’t discover they’re pregnant until a couple months along!

Instead of waiting, Lily turned to a private clinic. However, the price of the procedure was around $700, a huge sum for Lily, who was paid per hour to work a part-time gig in publishing; her husband earned close to minimum wage as a day laborer. The nearest clinic only provided abortions one day a week, so Lily would be forced to take time off work. To make matters worse, it was Christmas time, and the couple did not want their young son to be deprived of presents. Remembering her experience, Lily told me, “It was a lot of money to pay, but I knew I couldn’t stay pregnant.” Fortunately, Lily’s father agreed to foot the bill her province would not pay.

The idea of Canada as a feminist utopia where getting an abortion is as easy as buying milk is a misconception built on good press and the belief that our country is cool. You know, because our Prime Minister donates money to Trevor Noah on Twitter.

As a Canadian feminist, it’s disconcerting — through admittedly flattering — when our neighbors to the South speculate my country has solved sexism, but we haven’t. Abortion access is not the only example of how Canada has failed women and non-binary people. For example, I could spill boundless ink discussing the crisis regarding missing and murdered indigenous women. Abortion access is one of many problems with which we’re still grappling.

It’s easy to see why people outside of Canada may be taken aback to hear we aren’t an abortion care paradise. In 2014, Justin Trudeau declared each candidate fielded by his political party was required to be pro-choice. Per his decree, Anti-choicers would be kicked out of his caucus and barred from running as Liberal candidates. At the time, Trudeau was a year away from becoming prime minister. Trudeau’s policy of zero tolerance for anti-choice politics was a splashy statement, one that set a feminist tone for his election campaign.

Trudeau’s declaration shocked many of our American cousins. On Fox and Friends, Jeanne Mancini, who organized the March for Life, contended Mr. Trudeau was “out of touch with mainstream America” (as if the Canadian PM should be primarily concerned with what Americans think). And despite pearl-clutching on the part of right-wing US pundits, you might be surprised to learn Trudeau talked the talk of promoting abortion rights without walking the walk.

Over three years after Trudeau became Canada’s self-identified “feminist prime minister,” women in much of Canada still do not have meaningful access to abortion. At present, we have no hope of becoming a reliable safe haven for Americans seeking abortion care. After all, we’re already failing people who live North of the 49th parallel.

When Prime Minister Trudeau was elected, I hoped no Canadian women would ever have the stressful abortion experience my friend Lily had again. It’s now been five years — and one federal election — since she had her abortion, and regrettably little has changed. There’s still only one abortion clinic in Fredericton, clinic 554. They are only allowed to provide terminations until the 15-week mark. And patients are still not reimbursed for the cost of their procedures.

Over three years after Trudeau became Canada’s self-identified ‘feminist prime minister,’ women in much of Canada still do not have meaningful access to abortion.

So why, in a supposedly feminist country like Canada, do women and non-binary folks have wildly different access to reproductive healthcare depending on where they live? In 1988, the Supreme Court of Canada threw out the country’s laws criminalizing abortions in a landmark decision called R. v. Morgentaler. In accordance with this decision, the Federal government has no power to prevent a woman from obtaining an abortion at any point during her pregnancy. However, since healthcare is provided to Canadians by our provincial governments, those seeking terminations are at the mercy of the sort of care their provincial healthcare system offers. Most provinces do not provide this access past the 15-week mark.

Because tourists do not typically have access to pregnancy terminations in Canadian hospitals, hypothetical abortion tourists would be forced to use our private facilities. On average, over 650,000 abortions occur in the United States each year. It’s unlikely Canada, with a total of 55 clinics, could make a significant dent in that number, but it would increase wait times for people living in Canada. Next, there’s the matter of cost. In the province of Ontario, documented residents who have provincial health insurance will have the cost of their procedures covered by the government. Those who lack such documentation will pay anywhere from 450 to 900 Canadian dollars. However, out-of-country patients would likely have to pay around $2,000 for the procedure. That’s on top of the plane or bus ticket American patients would already be purchasing to get here, and we must not forget that those with criminal records and precarious immigration statuses would sadly not permitted to enter our country.

In 2019, Prime Minister Justin Trudeau will be up for reelection. There are certainly things he could do to improve abortion access across the country. He could provide additional funding to the provinces, funding that is earmarked specifically for reproductive healthcare. To bridge the access gap, he could also establish federal funding for women who do not live near abortion providers to travel for such treatment. It is time for our feminist prime minister to walk the feminist walk he talks so well.