A couple of abortion specialists in southwestern Ontario say Canadians shouldn’t take access to safe, legal abortions for granted because there are still barriers to care that are difficult to overcome, including absenteeism, lack of financial resources and distance from the city-centered clinics.
Christal Malone of London and Jennifer Surerus of St. Thomas are helping make access to safe abortions as seamless and easy as possible for people across the country.
Unlike doctors or nurses, their roles do not involve medical care. Instead, they provide physical and emotional support that runs the gamut from picking someone up from the airport to holding a thermometer to their mouth, even just giving someone a shoulder to cry on.
“We’re trying to support people to make the choices they need, and we’re not trying to convince people to do anything,” Surerus said. “Often people don’t have [support] from family and friends.”
Abortion is legal, but access is a problem
Unlike the United States, where the abortion legal landscape has undergone radical change since the landmark Supreme Court decision that struck down the constitutional right to abortion for the first time in 50 years, Canada has no laws restricting access to the procedure.
Malone, left, and Surerus attend an anti-abortion counter-demonstration outside the London Health Sciences Center in southwestern Ontario. They are shown with Surerus’ sister Tiffany, in the middle. (Contributed by Crystal Malone)
Abortion is legal in this country, regardless of the reason. The procedure is also paid for publicly through a combination of the federal and provincial health care systems, but just because it’s not illegal in Canada doesn’t mean Canadians should take it for granted, Surerus said.
“I think we’re too complacent here. Transportation, childcare, being able to take time off from work all play into the access equation.”
It’s a problem across the country, but it’s perhaps most acutely felt in Canada’s Atlantic region, where abortion restrictions are the highest and the federal government has cut off health care funding in provinces that haven’t provided adequate access.
In Ontario, 21,428 abortions were performed in 2020, according to the Canadian Abortion Rights Coalition. More than 15,000 of them were done in private clinics, and just over 5,000 were in hospitals in the province.
Urban and rural divide
Despite the number of procedures, disparities exist between urban and rural areas in Ontario, Alberta, Saskatchewan and Manitoba, where abortions are available only in urban settings, even though 35 to 40 percent of the population lives in rural or remote communities.
The charity says more than half of its callers need help with the cost of flights, accommodation and other travel costs, citing where they live as the biggest barrier to accessing safe care.
“It’s pretty awful,” Malone said. “It’s very difficult to access an abortion if you live in a rural area, and it’s very time-consuming and expensive to access certain types of abortion.”
Even in Malone’s hometown of London, a city of over 400,000, there is only one clinic. It serves a vast catchment area in southwestern Ontario, as well as people as far away as Newfoundland and Labrador, Prince Edward Island, Nova Scotia and New Brunswick—provinces where access to abortion is most limited.
When a patient arrives at the London clinic, the person must attend a minimum of three appointments before health workers agree to carry out the procedure.
“It can be really challenging to get time off work or get transportation and a lot of them start early in the morning. So if the person is not local, they have to come the day before to access the service,” Malone said.
Pro-choice charities like Action Canada are stepping in to help fill the funding gap and help connect people seeking abortions with doulas like Surerus and Malone.
There are almost twice as many crisis pregnancy centers in Ontario. at 77, compared to 38 hospitals and clinics that provide access to abortion, according to Action Canada.
“Anti-choice is strong here and there is a political component,” Surerus said.
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