Barriers to accessing abortion pills in Canada must be removed immediately because the future of the procedure in the United States is in jeopardy, advocates warn.
Pro-abortion groups have spent years pushing for universal coverage of medical abortions, which can be performed safely at home instead of requiring a trip to a hospital or clinic. But with the prospect of constitutional abortion rights being stripped for millions of Americans, these advocates say Canada could see a ripple effect.
“We have to wait and see, but I suspect we will see an increase in orders for (abortion pills) in the United States, which could translate into shortages of abortion pill drugs in Canada,” Dr. Dustin said. Costescu, an obstetrician-gynecologist at Hamilton Health Sciences and associate professor at McMaster University.
“I think people will start acquiring doses so they can use the drug if they need it in the future.”
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Fears over the future of abortion access in the United States were renewed on Monday when a draft document was leaked to Politico suggesting the Supreme Court is set to overturn Roe v. Wade, the landmark 1973 case that legalized abortion nationwide.
At least 13 states are poised to immediately bar the proceedings if the court’s final ruling – expected in June or July this year – reflects the draft ruling. More than a dozen other states could quickly follow suit.
In Canada, the right to abortion is legal but the procedure is not always easily accessible for those who cannot arrange to go to a clinic.
According to Action Canada for Sexual Health and Rights, the average wait time for surgical abortions is one to two weeks, but can climb up to five weeks for late-term abortion care, which is rarer. but may be medically necessary.
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Abortion pills — taken as a combination regimen of two drugs, mifepristone and misoprostol — can help overcome these barriers, but advocates say access can also be limited.
“There’s a common misconception that people can just go to their doctor or a walk-in clinic and get the pill right away, and that’s just not the case right now,” Makeda said. Zook, Access Line Manager for Action Canada.
“Most of the providers aren’t even listed on the stock exchange, so we have to refer women to them. Thus, the stigma that still surrounds abortion limits access and knowledge. »
Abortion pills were approved by Health Canada in 2015, but only became available in early 2017, with the two drugs packaged together under the Mifegymiso brand. Various restrictions, such as the requirement that only specially trained doctors, not pharmacists, prescribe the drug and watch the patient take the pill, were in place until November.
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All provinces and territories except Nunavut include Mifegymiso under provincial health insurance. Federal health plans also cover pills for Indigenous Canadians, refugees and prisoners.
Zook said coverage still allows some Canadians to slip through the cracks.
“It could be someone with precarious immigration status,” she said. “It could also be an international student whose private insurance does not cover abortion care. It could be a student with an Ontario health card, but who goes to school in British Columbia or Alberta.
Without adequate coverage, Zook says Mifegymiso costs between $300 and $400 per regimen.
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While rural and Indigenous Canadians have faced the same barriers to accessing abortion pills that exist for clinical procedures — namely the lack of rural providers compared to urban centers — advocates say the COVID-19 pandemic has contributed to close this gap.
“Ironically, the pandemic has helped give a boost to telemedicine abortion services, where people can call the doctor and get a prescription, then go to the local pharmacy to pick it up,” Joyce Arthur, executive director of the Abortion Rights Coalition of Canada, told The Canadian Press.
“There is still a lot of work to be done to improve this access as well. But it happens. And I think it’s a work in progress, but it’s definitely going to help a lot to relieve the stress on clinics and hospitals. : “
A University of British Columbia study published in January in the New England Journal of Medicine found that medical abortions accounted for 31.4% of all abortions in Ontario from November 7, 2017 – when restrictions were lifted – as of March 15, 2020. Before the pills were approved, only 2.2% of abortions were medical.
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The use of abortion pills has also increased in the United States, where mifepristone has been available since its approval by the Food and Drug Administration in 2000. More than half of abortions in the United States are now performed with pills rather than with surgery, according to Guttmacher. Institute, a research group that supports abortion rights.
Last year, the FDA lifted a longstanding requirement that women obtain abortion pills in person. Mail delivery is also now allowed nationwide.
But several conservative-leaning states, spurred on by the prospect of the overturning of Roe v. Wade, decided to restrict or ban access to abortion pills amid a simultaneous crackdown on surgical abortions and their providers. A total of 19 states require a medical clinician to be physically present when abortion pills are administered to a patient.
“Medical abortion will be where abortion access is decided,” said Mary Ziegler, a professor at Florida State University College of Law who specializes in reproductive rights. “It will be the battlefield that will decide the applicability of abortion bans.”
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Public Safety Minister Marco Mendicino said Wednesday he would speak with the Canada Border Services Agency to ensure its staff know that Americans seeking abortions can come to Canada to have their abortions done. cure.
Ahead of any influx, Zook says Canada must pursue universal coverage of abortion pills, expand telemedicine services across the country, and allow more health care providers like family doctors and walk-in clinics to offer prescriptions.
“We need to look very closely at the access issues that are already plaguing this country…and ask, ‘Okay, how can we actually improve access for people in Canada and then meet the possible demand of people coming the United States? ” she says.
— with files from The Canadian Press and The Associated Press
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