Leaked Roe v. Wade draft puts B.C. abortion access in the spotlight
Just under 12,000 abortions were provided in the province in 2020
The leaked draft opinion revealing the intentions of the U.S. Supreme Court to strike down Roe v. Wade is bringing a renewed focus to the state of abortion access everywhere, including in British Columbia.
The landmark decision has protected the right to abortion nationwide in the United States since 1973. But should it be struck, it's believed a number of individual states in the U.S. would react by severely rolling back access to abortion, or banning it outright.
"What's happened south of the border is horrific ... And honestly, I think it's less about abortion and more about oppression and controlling women's bodies," said Michelle Fortin, Options for Sexual Health executive director.
"But the way that we access abortion as part of health care in Canada is very different. So I am not worried about our right to abortion."
There is no law against abortion in Canada and the vast majority of Canadians — 78 per cent, according to Fortin — support a woman's right to choose.
But that doesn't necessarily translate to easy access, especially for racialized and Indigenous women, and those living far from a big city.
"If you live in an urban centre you are not going to have an issue accessing abortion — so in Vancouver, Victoria, Kelowna, even up in Prince George. But in more rural and remote communities, not so much," said Fortin.
According to 2019 data, B.C. has 23 abortion service providers in urban centres and only one in a rural district.
Quick uptake of abortion pill in Canada
Just under of 12,000 abortions were provided in B.C. in 2020, about 2,300 fewer than in 2011. Fortin attributes the drop to better access to IUD contraception and improved sex education.
Anyone seeking to end a pregnancy in the first 10 weeks has easiest access to a medical abortion via prescription for Mifegymiso, also known as the abortion pill.
Described as a game changer in addressing historical gaps in abortion access, Mifegymiso was approved for use in Canada in 2015 and made free to anyone in B.C. in 2018. Another barrier to use was removed in 2019 when health officials dropped the requirement for an ultrasound before prescribing.
At least one Vancouver clinic is now offering medical abortions via virtual or telehealth appointments to anyone anywhere in the province.
"We've actually seen [Mifegymiso abortion] uptick very quickly in Canada. It's been in the States for about a decade longer, and I think it's still only at 23 per cent [of abortions] there, but in Canada it's already approaching 40 per cent," said Fortin.
Surgical abortions more challenging to access
Under B.C.'s medical services plan, surgical abortions are available from "the fifth week after the last menstrual period up to the twentieth week of pregnancy."
According to University of British Columbia obstetrician and gynecologist Dr. Ruth Habte, obtaining a surgical later-term abortion is particularly difficult for those living in remote locations.
"Take the example of someone in a northern community who has children to look after but needs to travel or come down on a plane," she said.
"If it's a surgical procedure ... it's like a multi-day process to get the body ready to have this done. So certainly there are barriers. And I think that that's something we do need to think about and address in our policies."
As campaign organizer for AccessBC, Hapte said the province still has a long way to go in supporting the spectrum of reproductive care, including making prescription contraception free, something all three major provincial parties have promised.
"It makes very little sense to have the downstream outcomes of pregnancy covered," she said.
"If you have high blood pressure in pregnancy, if you need prenatal care, if you want an abortion, all of those things are covered. But all the upstream preventative effects are not."