Public Policy, Rights, and Abortion Access in Canada

Abstract

The Supreme Court of Canada's 1988 decision to invalidate federal criminal law restrictions on abortion is often portrayed as paving the way for unregulated “abortion on demand” in Canada. This depiction belies the patchwork of regulatory barriers to access in place at the provincial level and obscures a host of litigation for improved funding and access across the country. This article explores the policy and legal landscape surrounding abortion access since 1988. Our findings suggest that provincial policies and lower court judgments have shown considerably different interpretations of what the Court's landmark ruling requires. In part, this is a result of a problematic distinction that the Court's reasoning makes between “negative rights,” which are protections against state interference, and “positive rights,” which would require the state to take action or provide funding to ensure access. We examine the implications of this distinction from both a rights and policy perspective, ultimately arguing that courts are not the only, or best, body through which to realize positive rights. Instead, we argue that legislatures need to take seriously their obligations under the Canadian Charter of Rights and Freedoms.

Medical Abortion in Midwifery Scope of Practice: A Qualitative Exploration of the Attitudes of Registered Midwives in British Columbia

“…Induced abortions are a common procedure for Canadians: nearly 1 in 3 women will experience an abortion during their reproductive lifetime . Despite this commonality, abortion access is uneven throughout Canada and British Columbia . Over the past few decades, the number of abortion providers in Canada has decreased, and fewer education programs are offering training in the area .…”

“…Urban abortion clinics offer specialized care in ambulatory settings with counseling support from allied health professionals and various procedural options . By contrast, rural abortion care, when offered, is almost exclusively in hospital operating rooms, with fewer procedural options and considerably higher rates of general anesthetic with no access to specialized counseling support …”

“…1 Despite this commonality, abortion access is uneven throughout Canada and British Columbia. [2][3][4][5][6][7][8][9][10] Over the past few decades, the number of abortion providers in Canada has decreased, and fewer education programs are offering training in the area. 6 This phenomenon, described as the greying effect, is a major contributing factor to the decline in access to abortion across Canada.…”

“…5 By contrast, rural abortion care, when offered, is almost exclusively in hospital operating rooms, with fewer procedural options and considerably higher rates of general anesthetic with no access to specialized counseling support. [7][8][9]12 ✦ There is a growing body of evidence highlighting a lack of access to maternity care and abortion care in rural communities, with related adverse health and social outcomes. At the same time, midwifery is emerging as a solution to both these challenges.…”

“We Have the Law, We Need the Access!:” Activism, Access and the Social Organization of Abortion in New Brunswick

“…Many scholars have written about the uneven distribution of abortion services in Canada, as well as the implications this has for people's ability to access care (Ackerman 2016;Dressler et al 2013;Eggertson 2001;Haussman 2001Haussman , 2015Johnstone 2014;Johnstone and Macfarlane 2015;Norman et al 2009;Doull 2012, 2013;Shaw 2006;Vogel 2015 One of the most significant findings among researchers in this area is identifying the sharp divide that exists between rural and urban access to abortion in Canada, where the bulk of services tend to be located in large urban centers (Ackerman 2016;Doull 2012, 2013;Shaw 2006). As Sethna & Doull (2013) and Shaw (2006) have demonstrated, the clustering of abortion care in urban centers leaves rural and remote areas of the country largely underserviced, creating disproportionate access barriers for women living in rural, Northern or coastal communities.…”