Women’s reproductive control is still a highly contentious issue in many parts of the world, and as we have seen through recent Supreme Court decisions in the United States, the divisive issue is not solely one for developing nations.
As women are painted as second-class citizens, subject to prejudice and sexual harassment, unable to access consistent and affordable birth control and with their bodies seen as familial or spousal property, the consequences are often that unplanned pregnancies are high and unsafe abortions prevail. India is a prime example: although the country allows for abortion on broad grounds, it still accounts for exorbitantly high numbers of deaths and complications due to unsafe procedures, with accounts of one woman dying every two hours as a result.
That couldn't possibly happen in Canada. Unless you've been reading the news lately and discovered that when it comes to the Maritimes region, women are relegated to second-class when it comes to their reproductive rights and access to health services.
Although abortion in Canada has been legal since the Supreme Court decision in R v. Morgentaler in 1988, New Brunswick, with a population of just under 800 000 (2011), has refused to abide by provisions in the Canada Health Act of 1985, stating that medically necessary services provided by a physician must be provincially funded. The province has enacted Regulation 84-20, Schedule 2(a.1) into its Medical Service Payment Act, which reads as follows:
“unless the abortion is performed by a specialist in the field of obstetrics and gynaecology in a hospital facility approved by the jurisdiction in which the hospital facility is located and two medical practitioners certify in writing that the abortion was medically required”.
The Morgentaler clinic, run previously by the eponymous doctor until his death last year, provided abortions free of charge for women who could not afford them for the past 20 to 40 years, depending on the clinic's location. The office in Fredericton, New Brunswick has been offering women's health care for twenty years - this has included counselling, consulting on STI's and abortions - not only to women in the region but also to those from Prince Edward Island, where abortion services are also notoriously difficult to come by. Having provided services to over 100 000 women, it is the only private clinic in New Brunswick and the only one east of Montreal. Due to the restrictive nature of the Medical Services Act and the New Brunswick's Department of Health refusing to subsidize women's care, the clinic has been acting on the late Dr. Morgentaler's edict, that no woman needing an abortion should be turned away, and has been providing funding through its own means. In the past ten years, the clinic has contributed over $105 000 to subsidize abortions for women unable to pay the $700-$900 financial burden.
Those means have run out, and the clinic is shuttering its doors on Friday, July 18th.
New Brunswick's Regulation 84-20 inarguably violates women's constitutional rights as cemented in R v. Morgentaler in 1988, when the Supreme Court unanimously decided that to require a woman to seek approval from an abortion committee was a direct violation of the security of her person and created too deep of an interference to her bodily integrity. The same remains true for Regulation 84-20, which when requiring the approval of two doctors to confirm the 'medical necessity' of an abortion, places serious impediments on a woman's free right to choose, her reproductive rights and seriously hinders her bodily integrity. Moreover it creates an increased unnecessary burden to low-income women and women who live in geographically sparse areas, where access to both consistent and quality reproductive services is scarce.
In a province where more than 60 000 people are without a family physician, approval from two doctors is an impediment to access. In a province where only two hospitals perform abortions, if women travel out of province for abortive services, none of those expenses are refunded as the province does not provide reciprocal reimbursements for abortions. A different take on this would be to imagine an Ontario student at the University of New Brunswick who needed an abortion: she would have to pay $1800 at one of the two hospitals in the province - or go to the Morgentaler clinic. The last option is soon to be off the table.
This is further burden for poor women - women who can't afford to travel out of province, can't afford to take time away from their jobs or their families, don't have the means to travel to different hospitals to secure different signatures - while first finding a doctor who is pro-choice and willing to give his/her signature, only to be placed on a waiting list for the only two gynaecologists who currently perform abortions in the province. When women can't access the reproductive services they need, the number of women undergoing unsafe procedures or taking unsafe medications rises. Indeed, banning or restricting abortions has no affect on the number of women who will attempt it - and in areas across the world where abortion is illegal, unsafe abortions rates surge even higher.
Often what sets apart the rich from the poor is access. In India, like in Canada, federal laws have given broad grounds for a woman to have the complete control over her body and her reproductive rights. Just like in India, however, access remains hindered. Access, in the case of New Brunswick, is both political and geographical - and the latter is greatly influenced by economic status. The province is riddled with a gendered type of poverty: in 2011, 14.5% of women and 10.7% of men ages 18-64 were living in poverty - highest levels were among single mothers and their children: 28.9% of which are poor. Women without partners are the worst off, having an almost five times more likely to be poor factor than their male counterparts. While male poverty is linked to unemployment and labor, female poverty is more complex, involving a persistent wage gap (women earned 88.6% of what men did in 2013 in comparable jobs and hours), a large burden of unpaid work including childcare, eldercare, housework (meals, cleaning) then compounded by lack of affordable childcare and family-friendly workplace policies. Women can also be predominantly found within 'female job' clusters that are even further affected by pay inequity, and by consequence, 6.5% of women compared to 4.4% of men hold two jobs or more.
Creating laws that uphold women's rights to control their bodies and reproduction is only the first step. The second is ensuring access, not further measures of restriction, to those services that comply with the law. That New Brunswick has chosen to so blatantly disregard these legally protected rights and enact regulations that further bar access to basic services has severe consequences to a population that is already riddled with the feminization of poverty, and, it would seem, would only worsen the economic disparities that women currently face.
New Brunswick must repeal Regulation 84-20 and abide by the Canada Health Act. Abortion services and reproductive rights will be front and centre at the upcoming elections in September, and hopefully women's rights will be updated to the rest of the Canadian provinces in 2014.
There is a FundRazr campaign currently ongoing where I urge you to donate to keep the Morgentaler clinic open. With a goal of $100 000, this money will last only a short time, so any extra donations will help immensely.
You can also read more at Reproductive Justice NB, where the very brilliant Kathleen Pye is heading a campaign to save the Morgentaler clinic.
Its the very least we can do for women in Canada, where rights, access and health should be equal among us all.