Today, as the new government sat in the Legislature for the first time in Fredericton, reproductive rights advocates once again rallied for the right to free and accessible abortion.
Fifty days since being elected, the Liberal government of New Brunswick has struck down a regulation in the Medical Services Payment Act that stated an abortion had to be deemed “medically necessary” by two doctors.
Premier Brian Gallant has said that medical professionals who are trained in the procedure will now be allowed to perform abortions in hospital. Formerly only two approved doctors in the province performed in-hospital abortions.
In some ways, New Brunswick has now caught up with the 1980s. In other ways it hasn’t. Abortions performed outside of a hospital will still not be funded, even though the point of allowing non-specialists to perform abortions is to increase timely access.
“Every Mother a Willing Mother, Every Child a Wanted Child” were the words that guided the Morgentaler Clinic, which was able to offer experience and expertise in a pro-choice environment. Now, with zero government funding, the facility lies fallow.
When we talk about choice in Canada, we are often referring to a person’s right to choose whether to carry a fetus to term. But we need to move beyond congratulating ourselves for giving a nod to bodily self-determination. The right to choose is nothing without its companion: the right to access.
Less actively obstructing the right to choose and not funding needed options is not pro-choice.
Choice is nothing but an ideology if it is not backed up with real-life choices. Believing in the right to choices is about believing in dignity, informed consent, and access.
But like so many things in Canada, access has a lot to do with money, politics, and geography.
Where I live in Quebec, I am a short distance from a handful of clinics and hospitals. I feel fairly certain that if I were to require an abortion, I would receive timely care and perhaps even be able to make these choices: Who, from what organization, will I speak to about my options? Will I go to a nearby clinic or the nearby hospital? If I have complications or questions, which of the resources nearby will I turn to?
If I feel uncomfortable in a particular setting, I can find another. I probably will not have to pay for the abortion, and I can feel confident that this potentially worrying and time-sensitive matter will be over within a couple of weeks. I will not need to rent a car or find childcare or drive for hours or stay overnight somewhere strange. And I have the option of receiving free and confidential counselling following the procedure. While of course the system is not perfect, I do have choices. In the next province over, this situation is but a dream.
Abortion is safe to perform outside of a hospital setting, and safe when done by trained non-specialists including nurses. Limiting the procedure to hospitals limits accessibility, especially in rural areas where the nearest major hospital, which may or may not have a pro-choice policy, is hours away. There is no reason to not open up abortion services so that a trusted family doctor, or a nurse who firmly believes in this work, can do it in a nearby clinic. A bustling, overcrowded hospital may not be everyone’s place of choice, with good reason.
The empowering element about specialized abortion clinics is that one self-refers; that is, one requests an abortion rather than gains a physician’s approval, as is done in a hospital setting. Worryingly, hospitals can make their own regulations regarding abortion. In a pro-life atmosphere, these regulations may or may not be in the best interests of people seeking abortions.
Meanwhile, Health Canada’s stalled approval of the safer, simpler medical abortion drug, RU 486, is another example of choice versus choices. While not patently blocking someone’s right to choose abortion, it impedes the prescription of what the World Health Organization describes as an essential medication.
Not treating abortion the same as any other important medical procedure simply because it is morally charged for some folks can never support access to choices; it only limits them. Increasing accessibility to the utmost of the government’s ability, addressing poverty, and circulating good information is what will make a significant difference.
Paying lip service to a vague notion of choice is not good enough, though it can certainly sound good coming from a politician. Premier Gallant speaks well, but his actions have demonstrated an incomplete commitment to reducing barriers to abortion access.