On May 19, 2021, Texas lawmakers signed the Heartbeat Act into law. This legislation prohibited anyone in Texas from receiving an abortion once a fetal heartbeat is detected, which for most pregnancies is around six weeks. Mass outrage followed the bill’s passage and protests sprang up.
While this was happening, many people in Canada watched in shock and disgust. Perhaps lost in the indignation on this side of the border was the fact that, somewhere in Canada at that very moment, there was more than likely someone panicking in a rural town thinking about exactly how they would access a safe abortion themselves. In Alberta there are only three places where you can receive a surgical abortion and all of these are within the major cities of either Calgary or Edmonton.
THE RURAL ISSUES
Lauren Lagoutte created the Red Deer and Area Pro-Choice Facebook group and is a qualified “abortion doula”, meaning she helps people find safe access to abortion, gives emotional support and helps raise funds for travel and other possible costs. Lagoutte has been a loud pro-choice activist since her teen years but chose to take on the role of abortion doula after moving from Vancouver to Red Deer.
Upon arriving in Red Deer, Lagoutte was in search of volunteer opportunities and fell victim to a crisis pregnancy centre which is something many pregnant people encounter as well. These centres are heavily funded by anti-abortion groups and their websites can give the impression that they’re
abortion clinics. However, when people get in touch with them, they use methods of shame to convince people to carry to term. Lagoutte found an Edmonton based crisis pregnancy centre online and originally planned on volunteering with them, it was not until she did more research that she realized the centre’s true motives.
This was Lagoutte’s first brush with abortion hurdles in Alberta. The second was when she herself needed an abortion. “I very much know what it’s like to go to a doctor and be like, ‘Hey, so I’m in this situation. What do I do?’ And the doctor was like, “Uh, you have a baby?””
In Alberta there are only three places to access abortion, and all of these are within the city limits of either Calgary or Edmonton. This means that any person needing a surgical abortion would have to travel to one of these two cities. Some procedures can be two days long requiring patients to find overnight accommodations, not to mention the cost of gas, assuming that person even has access to a vehicle. According to a study done by the Canadian Institute of Health Information, upwards of 12,000 Albertans received abortions in 2020.
Lagoutte had had abortions prior but in Vancouver, her rural experience was much different. “I was lucky that my partner and I made the choice together and he was able to drive me because we had to go to Calgary. It was before Mifegymiso (the abortion pill) was a big thing or really an option in Canada so it was surgical, so I did need someone to come with me… Just even obtaining the information on how to access abortion in Alberta, I had to do the leg work myself and because I come from a media based family, I’m really good at finding the information I need but not everyone is as adept as me.”
The access issue is just as acute outside major urban areas in other parts of Canada. Makeda Zook is the access line manager for Action Canada for Sexual Health and Rights. She says they receive around 300 calls a month from woman around Canada seeking abortion services.
“We hear a lot from people in more rural areas. And we do find that often times we are supporting folks from rural areas a bit more because access to all kinds of sexual health services, especially abortion care, is really challenging.”
There is an option that can help people within rural communities. Mifegymiso, otherwise known as the “abortion pill,” could allow people access like never before. According to Action Canada for Sexual health and Rights, the abortion pill works by blocking progesterone which is needed for a pregnancy. This causes the pregnancy to end, the uterus to contract and the cervix to relax which allows the contents of the uterus to be pushed out of the body. The abortion pill is relatively new and only became available to the Canadian public in 2017 although it has been used in countries such as France and China for over 30 years. It can be prescribed by any doctor in Alberta.
Although there are many issues in trying to obtain it and with abortion being a time sensitive issue many people do not have the ability to be prescribed it in time as it can only be taken in the first ten weeks of pregnancy according to Action Canada for Sexual health and Rights website.
The issue with the pill is — as a result of how new it is — many Alberta doctors do not know enough to prescribe it. The other issue is many doctors refuse to prescribe the pill for “moral issues.”In Alberta doctors are legally allowed to refuse to prescribe the pill because of personal morals, however doctors legally must refer patients to someone who will if they refuse. But those referrals are not happening, according to Chantal Parkinson, the president of the Pro-Choice Society of Lethbridge and Southern Alberta.
Last year the group started an initiative in which they sent out letters to every doctor in Alberta informing them of the abortion pill, the laws around it and what they can do. This year they are planning a medical training seminar for doctors. Parkinson says oftentimes doctors are just uninformed when it comes to the subject. “In training to become a physician, unless you are actively seeking out that information about abortion and abortion care and prescribing Mifegymiso or even IUDs you won’t come across it. It’s one of those kinds of like extracurricular courses,” says Parkinson.
“We think the supreme court’s going to cave and we are not going to have a national right to abortion anymore in the States.”Autumn Reinhardt-Simpson
Autumn Reinhardt-Simpson is the founder of the Alberta Abortion Access network and has helped people with everything from driving to appointments, to finding travel funds and being a shoulder to cry on. She says that once patients find the appropriate services, the travel, funds and time off work are also major hurdles.
One of Reinhardt-Simpsons’ clients received the run around from their doctor until she was too far along to receive care. “There are strictly no limits in Canada in terms of when you can or cannot perform an Abortion but clinics often set their own terms and so usually post 24 weeks they just are not going to do it,” Reinhardt-Simpson explained.
“And so this person, it was really awful too, because she was a severe alcoholic, she already had some kids and she very aware of her situation and she said ‘I’m not going to stop what I’m doing, I know how it is and I don’t even know what this fetus is going to be like because of the drinking’ and I tried following up with her a few times to see what we could do and never heard back so I’m pretty sure that, that happened (she had the baby).”
Conscientious Objection allows doctors in Alberta to refuse care if they are morally against what is being provided, however there are laws these doctors must follow if this is the case.
In an email statement The College of Physicians and Surgeons of Alberta (CPSA) explained “If a physician is unwilling to provide care for ethical reasons, as sometimes occurs with MAID [medical assistance in dying] or abortions, this does not remove a physician’s responsibility to ensure the patient has access to the care they require. The physician must, in a timely fashion, refer their patient to another physician who can provide care. This is outlined in CPSA’s standard of practice on Conscientious Objection.”
However, Reinhardt-Simpson, Lagoutte and Parkinson have all said that they have had many clients who’s doctors either did not refer them in a timely manner or at all. Parkinson has even said that she’s encountered people who have been “fired” by their doctors with the excuse that their needs have become “too complex.”
In an email statement CPSA replied to these concerns saying “CPSA’s role is to guide physicians and support them in giving patients the best care possible. If a patient has a concern with the care they’re receiving, we encourage them to reach out to CPSA to better understand their concerns and how we can best support them.”
In the reporting process with CPSA the patient involved must be named and through the complaint CPSA will give the name to the doctor. This leaves people with no options to report without causing risk of more trauma to themselves. Lagoutte says she does not even tell her clients to report as a result of the risk of trauma to them.
WHERE DO WE GO FROM HERE?
Reinhardt-Simpson, Lagoutte and Parkinson all encourage people to ask their doctors if they prescribe the pill. They also suggest reaching out to their local lawmakers and MLAs.
Despite attempts by the US federal government to block the heartbeat act they have ultimately been unsuccessful. And while Canadians may feel safe from something similar to the heartbeat act now Reinhardt-Simpson who grew up in the US warns of what could be.
“We grew up in a situation where we thought we would always have a right to abortion and now just this year we think they are going to claw it back. We think the supreme court’s going to cave and we are not going to have a national right to abortion anymore in the States.”