Roe Border Fallout: Barriers to accessing abortion in Canada make it an unlikely haven for Americans

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TORONTO — Winnipeg’s Women’s Health Clinic is overwhelmed. The facility is one of only a few abortion clinics in Manitoba, a Canadian province of 1.3 million people. It processes about 100 requests each week and says it performs up to 30 percent more abortions than it receives government funding.

Even before the US Supreme Court struck Roe v. calfthe Following a nearly 50-year-old precedent protecting abortion rights in the United States, some of these abortion requests came from Americans. Now the clinic — 70 miles from the North Dakota border, where a withdrawal ban goes into effect this month — is waiting for more.

“It’s too early to say” if and by how much inquiries from Americans will increase, said Blandine Tona, the clinic’s program director. But even a small number could weigh on the clinic, “so one of the things we’ve done is organize, prepare.” including considering whether to offer abortions on more days per week.

Prime Minister Justin Trudeau and other Canadian leaders have condemned the US Supreme Court ruling; His administration has said it won’t turn away Americans who can’t get abortions at home. But with long distances between many clinics, few providers and barriers to cross-border travel, that shouldn’t be a big solution.

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Canada decriminalized abortion in 1988, and abortion rights enjoy broad political support there. But while access has improved over the decades, it remains limited outside of the major metropolitan areas and depends on the ability to travel.

“We have supported people where the nearest abortion provider is several days away by car,” said Jessa Millar, who runs Action Canada’s Sexual Health and Rights Hotline.

Some patients at the Women’s Health Clinic travel to Winnipeg from Kenora, Ontario, about 130 miles away. TK Pritchard, executive director of the Shore Centre, which provides medical abortions in Kitchener, a town in southwestern Ontario, said it has clients from northern Ontario. Booking dates are three to four weeks in advance.

The center has received calls from a small number of people in Michigan since the coup roe who are curious about abortion access in Canada, Pritchard said, but the point is “not hearing from people who are actually looking for dates.”

“One of our challenges is that … it’s really difficult to keep up with the demand that’s already there,” Pritchard said.

When abortion pills became commercially available here in 2017, there was optimism that they would help improve access, particularly in remote and rural areas. But proponents say it’s still patchy.

“Most general practitioners don’t prescribe it and just refer it to an abortion clinic,” said Mohini Datta-Ray, executive director of Planned Parenthood Toronto.

Jill Doctoroff, executive director of the National Abortion Federation Canada, said that since its inception in April 2021, about 600 people have signed up for its abortion pill prescribing training course. Last weekend, following the US Supreme Court decision, 70 people signed up.

“It shows that one of the implications of the decision is that people realize there are access issues in their own country and they wanted to be able to do something,” she said.

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Several states bordering Canada have or will soon have abortion bans in place. In other border states like Michigan and Montana, the status of abortion rights is uncertain.

Even if access were improved in Canada, advocacy groups said there are other barriers – including the need for a passport and the cost of the procedure, which could be as much as $600 – that would likely deter Americans from crossing the border and make them more likely to travel to other US states.

That cost “would make it unaffordable for many Americans,” said Joyce Arthur, executive director of the Abortion Rights Coalition of Canada. “It’s still early and we don’t know how it will end.”

According to the Canadian Institute for Health Information, there were more than 74,000 abortions in Canada in 2020. Most abortions in the country are performed during the first trimester of pregnancy.

Each province and territory has different pregnancy limits for medical and surgical abortions, as well as rules that determine if and when parental consent is required.

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On Prince Edward Island, where government policy kept the island abortion-free for more than three decades until 2017, surgical abortions are no longer performed after about 12 weeks. Islanders are often referred to other Atlantean provinces, including neighboring ones New Brunswick, where the procedure is only covered if performed at one of three hospitals.

Abortion at 24 weeks is limited in Canada and sends a small number of people to the United States each year – cross-border travel feared could be jeopardized by the court ruling.

Analysts and Advocates are watching other potential cross-border waves, especially as some federal and state lawmakers announce intentions to bar women in other states from having abortions, penalize out-of-town doctors, or stem the flow of abortion pills by sending by-mail illegally.

What if these bans extend to other countries, or if people persecuted in the United States for having or having an abortion seek refuge in Canada?

A key test in Canada’s extradition law is the “double criminality” – whether the conduct for which someone is wanted is also illegal in Canada. Since neither performing an abortion nor prescribing the abortion pill is illegal in Canada, such requests are unlikely to pass the test, said Robert Currie, a law professor at Dalhousie University in Nova Scotia.

But in some cases, he said, double-crime analysis could involve “implementing” US legal background.

In a case where prosecutors tried to extradite a Canadian who prescribed the abortion pill to an American, “we can imagine the court saying that the ‘essence of the crime’ was selling prescription drugs in a market, on illegal to sell,” Currie said, “and the fact that it was an abortion drug is just ‘background’.

“That could be a big problem.”

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Canada’s Supreme Court decriminalized abortion in 1988 case R. v. morning coins.

“Forcing a woman, by threat of criminal sanction, to carry a fetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound encroachment on a woman’s body and thus a violation of the safety of the person,” the court said in a 5-2 decision.

The ruling did not create an abortion right in Canada, and there is no federal law enshrining one.

Prior to the decision, abortion was restricted to those who had received approval from a “therapeutic abortion committee” of doctors at an accredited hospital. A majority on the panel had to agree that continuing a pregnancy “would be dangerous or likely [the woman’s] life or health.”

Some hospitals didn’t have enough doctors for a committee. Others only saw patients who lived in a specific geographic area or set quotas for the procedure. All other providers of abortions, or women who got them, faced criminal penalties.

Some Canadian woman crossed the abortion line. According to a Statistics Canada report at the time, more than 3,480 Canadian residents had legal abortions in the United States in 1984. At the rehearsal in R. v. morning coinsthe director of a women’s health center in Minnesota, testified that many Canadian customers faced delays at home.

Arthur of the Abortion Rights Coalition of Canada noted this story.

“The clinics have been very hospitable and I know that up here it was a reflection of the tables being turned,” she said. “We want to help the Americans get up here. We want to return the favor, but we also recognize that it will be a challenge for us and at the end of the day we won’t be able to help that many Americans.”


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