How One Canadian Province Is Leading North America in Fucking Up Abortion Access

It's not just the US—in New Brunswick, women have to navigate a confusing and costly labyrinth to get a safe and legal abortion, and there's only one clinic that operates in the province.

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Apr 12 2016, 3:45pm

Image courtesy of Reproductive Justice New Brunswick

On the world stage, Canada is America's polite big sister. While Americans are struggling with universal health care and gun control, Canadians are dousing poutine with maple syrup and merrily making doctors appointments. But here's what flies under the radar: New Brunswick, Canada's second-smallest province, has abortion restrictions in place that rival those currently in place in Texas.

Anyone who wants to get an abortion in New Brunswick has two options: navigating the province's judgmental and confusing hospital system or paying $700 to go to the only community clinic in the province.

Previously the Morgentaler Clinic, Clinic 554 is a squat, unassuming building in downtown Fredericton. The anti-choice Right to Life headquarters sits next door. Dr. Adrian Edgar is the medical director, and he runs a family practice from the clinic. For security reasons, he's not allowed to disclose who on his staff performs abortions or to have his picture taken for this article. In the past, staff and their families have been threatened just for working there.

And there are protesters. They carry crucifixes and miniature fetus dolls. They wave signs, chant, and chase down cars driving into the parking lot. They've thrown holy water at the building and the patients.

"I know that patients booking to come for an abortion are nervous that they're going to be exposed to that kind of lateral violence. They don't want to run into someone they know from church or run into someone who is a friend of their parents or grandparents," says Edgar. "There are also patients who bring their kids because they can't find adequate child care on that day. They don't want to brings their children across a picket line."

Hannah Gray has volunteered at the Morgentaler Clinic; she's a member of the activist group Reproductive Justice New Brunswick. "One day a year [the pro-life protesters] used to come and lay roses up the ramp [leading into the clinic]," she says. "People used to come and crap on the ramp. Like, we would have to go clean up human poop off the ramp."

Luckily, Gray says, being a clinic, they have access to biohazard bags and gloves. But, even with gloves, shit on the steps is still shit on the steps.

Clinic 554. Photo by Emily Baron Cadloff.

In 1989, then-New Brunswick Premier Frank McKenna introduced an amendment to the Medical Service Payment Act. According to Gray, Regulation 84-20 started as McKenna's "fuck you" to Dr. Henry Morgentaler.

At the time, 84-20 stated that women seeking an abortion would need two doctors to certify the procedure was medically necessary. The abortion must also be performed by an OB-GYN (Morgentaler was a family doctor), and only in one of two hospitals (Morgentaler didn't have hospital access), in either Bathurst or Moncton.

"This law was only created when the Morgentaler Clinic started, and it was only meant for Frank McKenna to stop Morgentaler from practicing. That's the only reason why those laws exist. There's no medical basis for them—they're just pure restrictions," says Gray.

In a surprise to no one, this created a lot of issues for both doctors and patients. Doctors, like many trained professionals, are hard to come by in New Brunswick. The current waiting list to get a family doctor has over 10,000 people. So finding not one, but two pro-choice doctors who can certify that an abortion is necessary is no easy feat.

With a population of roughly 750,000 people, the province of New Brunswick could fit comfortably inside Austin, TX, or Edmonton, AB. And, like the other Maritime provinces, it's primarily rural. About 48 per cent of people who call New Brunswick home live outside of an urban center.

People used to come and crap on the ramp. Like, we would have to go clean up human poop off the ramp.

That means travel is more than a small problem. Most people are driving two to four hours each way to get to Clinic 554—if they have access to a car. And, if you can get a hospital abortion, you have to make that trip twice. The hospital visits have a 24-hour waiting period after the mandatory ultrasound and counseling.

One of the tenants of the Canada Health Act is universality, which mandates that procedures should be made available to all Canadians universally.

Sarah Rodimon is a PhD candidate at the Carleton University, studying abortion access in New Brunswick. She argues that the provincial government is not following federal laws. "Abortion isn't provided on uniform terms. It's available in a hospital but not in a clinic. It's accessible for folks who can travel, but it's not accessible for folks who can't," says Rodimon. "Access really means different things to different people, and it's defined differently depending on who you're talking to."

The government is willfully ignorant about the associated costs beyond travel expenses, according to Rodimon. "When we talk about geography, we talk about travel, but like the lesser known expenditures of travel," says Rodimon. "Besides the transportation, there's childcare, elder care, the cost of taking time off of work, the cost of accommodation—the list goes on."

In 2014, there appeared to be some good news. The provincial Liberal party was elected, with the young, pro-choice Brian Gallant as the new premier. The Liberals won in a landslide; during the campaign Gallant came out promising to remove "all barriers to abortion services in the province."

What Gallant did, according to Gray, is to "remove the part of the law that said you needed two doctor referrals and that an OB-GYN had to do it." This means things are theoretically better now. But on a practical level? Not so much. The government granted a third hospital license to perform abortions, but it's also located in Moncton.

"They say, 'Look at how much we've done. We've added a hospital!' But then they tell you the hospital is only five minutes away from the other hospital that has access," says Gray.

How can they get away with this? Well, while Canada is mostly a socialist paradise, with its hot Prime Minister and inclusive policies... abortion isn't actually legal in the country. In 1988, the Supreme Court of Canada struck abortion from the Criminal Code, decriminalizing the procedure. But no formal law legalizing it was introduced in its place, leaving the individual provinces to regulate it.

That's when New Brunswick's previous government pounced, introducing 84-20 and ensuring the health care system was a labyrinth designed to trip people up when they needed help the most.

"The current legislation is not based in medical science or medical knowledge. There's no reason for the legislation to be set up the way it is right now that's related to health care," says Edgar. "It makes no sense. And any way that I look at it, I can't make sense of it. From a health care perspective, from a patient perspective, from a provider perspective, it doesn't make sense to me."

Counter-protesters at the annual Right to Life memorial. Photo courtesy of Reproductive Justice New Brunswick.

As it stands now, neither the federal nor provincial governments plan to do anything about the level of access in New Brunswick. The federal health minister, Jane Philpott, has said she has no current plans to withhold much-needed funding, in the form of Health Transfer Credits, to persuade the province to make changes.

When asked if there are current plans to expand access to other facilities across the province, provincial health minister Victor Boudreau issued this statement: "We are monitoring the current program to see if more access is required. We are gathering data in order to make an evidence-based decision on this matter."

But for the people on the ground, that's just not good enough. It's unlawful. "I've let the Minister of Health himself know [that the current situation is not legal]," says Edgar. "So they're certainly aware that what they're doing is illegal. The government is aware of that. And yet they're not doing anything to stop."

So why? Why does the government continue to legislate human bodies like this? "I think it's a bunch of old white guys who are of extreme privilege who have weird moral preoccupations and exercise undue influence," says Hughes.

Any way that I look at it, I can't make sense of it. From a health care perspective, from a patient perspective, from a provider perspective.

What can activists do from here? Well, they could sue the government.

In late March, activists on Prince Edward Island achieved a major win. In late December 2015, the group Abortion Access Now PEI filed papers to take the government to court, citing the lack of access on the island as a violation of rights under the Canadian Charter of Rights and Freedoms.

Instead of fighting the suit, the PEI provincial government backed down, citing the charter and the Canada Health Act as reasons they would likely lose. Now, the PEI government is building a central clinic and will be providing surgical abortions on the island for the first time in nearly 35 years.

New Brunswick activists could do that. In fact, they've tried before, but not successfully. "Historically in New Brunswick," Hughes explains, "[the government] did the same analysis, came to the same conclusion that they don't have a case, and have responded by litigating people to death basically. Just dragging it out until people had spent all the resources."

Instead of listening to the voters like the government of Prince Edward Island did, New Brunswick has often dug in its heels when it comes to court cases. But with the tide turning on PEI, New Brunswick is left on the wrong side of history—the lone holdout in the fight against the freedom of choice.

"At this point, New Brunswick becomes the only province in the country who is acting illegally, when it comes to providing abortion services in Canada. So it's only a matter of time," says Edgar. "Do they really have to be sued in order to do what is both lawful and in the best interest of patients? Why do they need to be sued in order to do that?"