I recently found the article, “Who Decides?” by Scott Lemieux via a post on Figleaf’s blog (I left a comment there and this post is a modified version of that comment).
Lemieux muses about abortion access in Canada:
In Canada, late-term abortions are not legally restricted, and Canada also doesn’t have the other kinds of restrictions found in many American states and doesn’t exclude abortion from guarantees of health care. As far as I can tell, there’s no evidence that Canadian women get late-term abortions at significantly higher rates (and historically overall abortion rates in Canada have actually been lower). Essentially, absent evidence to the contrary, I think the presumption in favor of a woman’s decision-making capacity is justified, and further restrictions are likely to do more harm than good.
I find Lemieux’s musings on what abortion and abortion access might be like in Canada to be highly misleading. Canada does not have the kind of easy access to abortion that Lemieux implies.
Lemieux is right when he says that there are no laws restricting abortion in Canada. But that does not mean there are no restrictions. Most abortions in Canada are done in hospitals (rather than clinics) and hospitals are left to make their own policy regarding abortion. Most hospitals do have policies that restrict late-term abortion access. Hospitals used to set a cut-off of 21 weeks (with exceptions made for mother’s health or foetal health), but recently with advances in prenatal testing (especially prenatal genetic testing) many hospitals have increased this limit to 24 weeks (again with health-based exceptions). In these cases hospital policy does not seem to reflect a commitment to women’s decision-making (after the early period of the pregnancy), instead the policies reflect changes in medical technologies and the dates at which reliable test results become available. Some clinics also place limits on when they will perform abortions.
Second, even though abortions are legal, no hospital or doctor is required to perform them. So Canada also has issues with access when women cannot find a doctor in their area willing to perform an abortion. In some cases this effectively means there is no access. One province (PEI) has no abortion providers at all; and a second (New Brunswick) has virtually no abortion providers. Canada is also a large country with a small population so even in the provinces that do have abortion providers, women in the northern or rural areas of those provinces might not be able to access abortions.
Third, while it is true that abortions are covered under most provincial insurance plans (so they are a part of our guaranteed health coverage, as Lemieux states), abortion is one of the few services that are excluded from reciprocal billing (PDF). Part of the guarantees made in the Canadian Health Act is that insurance coverage is portable from province to province. This means that if I live in Ontario, I am covered by the Ontario Health Insurance Plan (OHIP), but if I go on vacation to BC and have an accident I can still use my insurance in the BC hospitals. One of the few exceptions to this promise is abortion coverage. Most provincial insurance plans will cover abortion within that province, but will not cover abortions if you travel to another province. Obviously this can cause significant access problems for women in PEI and New Brunswick who cannot find access in their own province. It also limits access to abortion for college and university aged women who go to school outside of their home province. Most students remain covered under their home province, and if they find they need an abortion while in another province they will have to pay out of pocket.
Canada might not have any laws restricting abortion access, but this does not mean that access to abortion in Canada is unrestricted.
I include some links for further reading after the fold.
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