On Friday, June 24, the Supreme Court of the United States overturned the previous decision on Roe v Wade, enabling individual states to ban and criminalize abortions. Thirteen states with trigger laws tied to this decision have already enacted bans. Those involved in abortions, including people with uteruses seeking abortions and health-care providers offering them, will face criminal charges. While the landscape of abortion regulation in Canada is very different from the U.S., the overturning of Roe v Wade will impact Canadians (patients and physicians). Also, although abortion is decriminalized in Canada, access to it continues to be a challenge for people with uteruses and a topic of importance for the medical community.
Roe v Wade: Doctors Nova Scotia supports the tone and commitments in the statement made by the American Medical Association, condemning the U.S. Supreme Court decision and acknowledging the implications for the safety and autonomy of both patient and physicians. The criminalization of abortion will force this safe and essential medical procedure to be conducted through risky and potentially life-threatening means. Patients with the financial means to seek out safe care will do so, further widening health-care disparities for equity-deserving populations (namely Black, Indigenous, and People of Colour with uteruses). Physicians will be faced with a choice between providing life-saving patient care and facing criminal prosecution and not providing the life-saving care thus potentially harming the patient.
The Roe v Wade decision will also have implications for Canadian physicians and patients. Physicians practicing near the U.S. border may receive American patients seeking abortion care. Many Canadian patients rely on U.S. donor egg banks and/or fertility clinics for treatment, as they are not widely available in Canada. As of now, six states are defining life as beginning at fertilization, which could potentially impact In Vitro Fertilization procedures across the national borders.
Abortion in Canada: Abortion in Canada is decriminalized. It is regulated as a medical procedure, and no laws govern how or when it is offered in the country. Surgical abortion is offered in hospitals or primary care clinics, and drug-induced abortion (Mifegymiso) may be prescribed by family physicians and nurse practitioners (everywhere except Quebec) as of 2017. Abortion should not be codified in law, as this risks legal challenges—abortion is best protected as the health-care service that it is through legislation such as the Canada Health Act, not a new and discrete federal bill.
However, like many health-care services in Canada, there are gaps in access to abortion. Surgical abortion care services tend to be centralized in specific hospitals or sexual health clinics, mostly commonly located in urban centres. Many Canadians seeking abortions must face long travel times and high travel costs to access care. Reproductive justice and autonomy are especially critical issues for Indigenous people with uteruses in Canada. Indigenous communities have reported forced sterilization of people with uteruses as recently as 2018. Indigenous people seeking abortions face significant barriers.