Study finds northern prisons lack abortion and contraception policies

Northern governments say all inmates have the opportunity to access reproductive health services, but some researchers and advocates say clearer policies are needed to reduce barriers. 

Researchers with the University of New Brunswick conducted a systematic review of abortion and contraception policies across the country. The study, which was published in The Prison Journal last November, found many Canadian correctional facilities don't have a formal mandate to ensure access to these services. 

The study found northern institutions have few policies in place that address reproductive health care. 

Assistant professor and lead author Martha Paynter said as women and gender-diverse people are the fastest-growing demographic in Canadian prisons, institutions should be prepared to meet their unique needs. 

"It's important to have a policy in place before someone acutely needs it," she said.

Paynter described the health complications that can occur if care is delayed, as pregnant inmates wait on the progress of bureaucratic approvals. 

"In terms of abortion or any pregnancy-related concern, it does not wait. It's going and it's on a clock." 

The study also found the Yukon and the Northwest Territories don't collect data around the frequency of pregnancy and outcomes in corrections — but Nunavut does. It said between 2013 and 2023, eight per cent of women admitted to custody in Nunavut were pregnant. 

Paynter said this kind of data is critical to understand the scope of the issue and how to address it. 

"The fact that we don't have good statistics on this is quite alarming," she said.

How do the territories compare?

Christina Emberley, a spokesperson for the Nunavut Department of Justice, said in a statement that corrections regulations — which came into force in 2024 — require wardens to ensure access to medical treatment in cases of medical emergency. 

"This would include procedures such as a planned or unplanned termination of the pregnancy," she wrote.

Emberley also said there is a directive that inmates be referred to counselling and prenatal care if pregnant.

The Northwest Territories Department of Justice said in a statement to CBC that pregnant inmates are referred to correctional health services to learn about their options, which include abortion and carrying the pregnancy to term. 

A statement from the Yukon government is included in the study, which says if inmates choose to have an abortion, medication or referral to surgical intervention are offered. 

The spokesperson added: "There is no record of any women inmates having given birth while sentenced or remanded to Whitehorse Correctional Centre. As such, there is no set policy or protocol that deals with such an event in Yukon."

In response to a follow-up from CBC News, the Yukon Department of Justice said it had nothing to add. 

'We had the first inmate to come in pregnant' 

Kat Owens is the director of the Reproductive Justice Project with the Women's Legal Education and Action Fund (LEAF), a national charity that works to ensure Canadian laws, policies and practices promote equality. 

"In Canada, the vast majority of [incarcerated people] are in pre-trial detention and those facilities are typically overcrowded and have terrible conditions," Owens said. "When we're not meeting basic hygiene needs, how are we meant to ensure that people are able to have their reproductive health needs met?"

She said the North's current approach expects inmates to know their rights and advocate for them. 

"At a bare minimum, having a policy that outlines exactly what's available would be a huge benefit to people who are incarcerated so they know what they can ask for," she said. "Having to ask on sort of an ad hoc basis is really putting a huge burden on people who are already in a very stressful situation and facing a lot of different barriers."

Owens said clearer policies would also help service providers understand the standard they'll be held to.

Paynter suggested a good start would be a mandate to offer inmates a pregnancy test and the option to have contraception prescribed while incarcerated. They should also be assured that abortion is available, free and legal, she said. 

"Because these services are highly stigmatized, it's very important to have overt, clear, permissive policies in place," said Paynter. 

CBC spoke to a physician working at Whitehorse Correctional Centre (WCC). Their identity is not being released due to safety concerns.

"We've been getting — for at least three years now — quite a significant amount more female inmates than we used to," they said. "We started a whole bunch of new policies and programs just in the last couple of years because [we had] the first inmate to come in pregnant."

The physician described internal concern and confusion from Yukon Department of Justice staff about how to deal with the situation. 

"After advising Department of Justice staff that us physicians are trained to provide excellent prenatal care, tensions eased," the doctor said, adding that they are "very proud" of the quality of service the small team has been able to offer since. 

Afterward, the medical team worked to create a medical directive to "solidify the approach to care" during pregnancy and created a comprehensive plan around reproductive healthcare. 

"We call them directives rather than policies so we can change them without having to go through seven layers of bureaucracy," they told CBC. "So we can change them easily as guidelines change." 

These directives must be approved by the director at WCC, institutional physicians and the health services manager, the physician said. While they said the correctional facility has had disorganized healthcare in the past, a lot of hard work has been done to improve healthcare in the facility. 

"Reproductive health care is well established at WCC now," the physician said. "Unfortunately, initially it was quite reactive, but now it is very proactive and a standard part of the care we can provide at WCC."

Kerry Nolan has served time in the Whitehorse correctional centre. She now works as an advocate at the Victoria Faulkner Women's Centre, and told CBC women speak to her about their experiences at WCC. 

"Their needs were not met, whether it's physical, mental, spiritual, emotional," said Nolan. "It's especially bad in women's corrections."

When asked about this perspective, the physician said inmates have better access to care than the average Yukoner. 

"It's a common thing we hear. It's very frustrating. I think this is unfortunately a population that is maybe not… It's not necessarily the truth. There is a nurse onsite from 8 a.m. to 11 p.m."

The physician explained that nurses trained in trauma-informed care triage patients and decide who sees a physician, who visits the facility on a weekly basis. 

But Nolan said the difficulty wasn't always getting in front of a nurse — but feeling heard once there. 

"They don't listen, there's no respect, we're criminals at this point," said Nolan. "We all have a story and not everybody's story is squeaky clean or rosy. We can't judge them on that. People do what they do to survive. 

"We need trauma-informed care because we have an amazing amount of trauma within our community." 

The case for making a plan

Should pregnant prisoners be shackled and handcuffed? Should women undergoing an abortion procedure or a medicine-induced miscarriage be under surveillance? Should women who give birth in prison be separated from their children, or should children be raised in prison? 

These are some of the complex ethical questions other provinces have navigated and addressed through prison policies, which are detailed in the study.

"There are a lot of things to figure out," said Paynter. "How are we going to do this in a way that has dignity and is humane? And you can't sort that stuff out when the clock is already ticking." 

In the Northwest Territories, recent statistics show 97 per cent of female prisoners are Indigenous. The Yukon and Nunavut don't publicly release those figures, and did not respond to a request by deadline. 

"We know that incarcerated people are disproportionately Indigenous, Black, two-spirit, LGBTQ and have disabilities," said Owens. "So going in, there's already complex health histories, high needs, people who have faced systemic discrimination." 

Pauktuutit, a national non-profit representing Inuit women, told CBC Inuit women experience a disproportionately high rate of high-risk pregnancies, complicated and preterm deliveries, maternal mortality, teenage pregnancies and sexual violence.

"It is important to note that culturally safe and trauma-informed reproductive healthcare services are essential in a population with a high incidence of child sexual abuse, sexual assault, intimate partner violence and colonial experiences," spokesperson Sneha Nampally wrote in a statement. 

Ultimately, Pauktuutit, Paynter and Owens told CBC they question whether reproductive justice is possible in correctional settings. 

"Inuit women, girls, and gender-diverse individuals do not belong in prisons," said Nampally. 

"They belong with their communities and in healing centres where the connections between colonialism, resource and service deprivation, and the criminalization of Inuit are understood and addressed."