Fallout at the deer border: Barriers to abortion access in Canada make it an unlikely haven for Americans

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TORONTO — The Women’s Health Clinic in Winnipeg is overworked. The facility is one of a handful of abortion clinics in Manitoba, a Canadian province of 1.3 million people. It responds to about 100 inquiries each week and says it provides up to 30% more abortions than it receives government funding.

Even before the U.S. Supreme Court struck down Roe vs. Wadethe With nearly 50 years of precedent protecting abortion rights across the United States, some of these abortion inquiries have come from Americans. Now the clinic — 70 miles from the border with North Dakota, where a tripping ban goes into effect this month — expects more.

“It is too early to say” if the demands of the Americans will increase and by how much, said Blandine Tona, director of programs at the clinic. But even a small number could tax the clinic, “so one of the things we’ve been doing is organizing, preparing,” including considering offering abortions more days each week.

Prime Minister Justin Trudeau and other Canadian leaders have condemned the US Supreme Court decision; his government said it would not turn away Americans who cannot have abortions at home. But with long distances between many clinics, providers have stretched and barriers to cross-border travel, this may not really be a solution.

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Canada decriminalized abortion in 1988, and abortion rights enjoy broad political support here. But even though access has improved over the decades, it remains limited outside major metropolitan centers and dependent on the ability to move around.

“We’ve supported people whose nearest abortion provider is days away,” said Jessa Millar, who runs Action Canada’s Sexual Health and Rights Helpline.

Some Women’s Health Clinic patients travel to Winnipeg from Kenora, Ont., about 130 miles away. TK Pritchard, executive director of the Shore Centre, which offers medical abortions in Kitchener, a city in southwestern Ontario, said he has clients from northern Ontario. He makes appointments in three to four weeks.

The center has received calls from a small number of people in Michigan since the reversal of deer who are interested in access to abortion in Canada, Pritchard said, but they are “not people who are actually looking to make appointments.”

“One of the challenges that we have is…it’s really difficult trying to meet the demand that’s already there,” Pritchard said.

When abortion pills became commercially available here in 2017, there were hopes that they would help improve access, especially in remote and rural areas. But defenders say it’s still uneven.

“Most family doctors don’t prescribe it and just refer her 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 about 600 people have signed up for her abortion pill prescribing training since it launched in April 2021. Last weekend, after the decision of the Supreme Court of the United States, 70 people registered.

“What this shows is that one of the impacts of the decision is that people recognize that there are access issues in their own country and that they wanted to be able to do something about it,” said she declared.

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Several states that border Canada have abortion bans in place or about to be imposed. In other border states, such as Michigan and Montana, the status of abortion rights is uncertain.

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

Those costs “would put it out of reach for a lot of Americans,” said Joyce Arthur, executive director of the Abortion Rights Coalition of Canada. “It’s still early days and we don’t know how it will pan out.”

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

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

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In Prince Edward Island, where government policy kept the island abortion-free for more than three decades until 2017, surgical abortions are not performed after approximately 12 weeks. Islanders are often referred to other Atlantic Provinces, including the New Brunswick, where the procedure is only covered if performed in one of the three hospitals.

Abortion after 24 weeks is restricted in Canada, sending a small number of people to the United States each year – cross-border travel that advocates say could be jeopardized by the court ruling.

Analysts and Advocates observe other potential cross-border repercussions, particularly when some federal and state legislators signal their intention to prevent women from having abortions in other states, penalize out-of-state medical practitioners, or halt the flow of abortion pills by sending them by illegal courier.

What will happen if these bans extend to other countries or if people persecuted for obtaining or performing abortions in the United States seek refuge in Canada?

A key test under Canadian extradition law is “double jeopardy” – whether the conduct for which a person is sought is also illegal in Canada. Since neither abortion nor prescribing the abortion pill is illegal in Canada, such claims are unlikely to pass the test, said Robert Currie, a law professor at Dalhousie University in Nova Scotia.

But in some cases, he said, the dual criminality analysis might involve “transposing” the US legal context.

In a case where prosecutors sought to extradite a Canadian who had prescribed the abortion pill to an American, “one can imagine the court saying that the essence of the offense was selling prescription drugs in a market where he was illegal to sell them,” Currie said, “and the fact that it was an abortifacient is just ‘background.’

“That could be a major problem.”

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The Supreme Court of Canada decriminalized abortion in the 1988 case R.v. Morgentaler.

“Forcing a woman, under 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 interference in a woman’s body. and therefore a breach of security of the person,” the court said in a 5-2 decision.

The decision did not establish a right to abortion in Canada, and no federal law enshrines one.

Prior to the ruling, abortion was restricted to those who had obtained approval from a “therapeutic abortion committee” made up of physicians from an approved hospital. A majority of the panel had to agree that the continuation of a pregnancy “would or would be likely to endanger [the woman’s] life or health.

Some hospitals did not have enough doctors to form a committee. Others only saw patients who lived in a certain geographic area or imposed quotas on the procedure. All other abortion providers, or the women who obtained them, faced criminal penalties.

A Canadian woman crossed the border to have an abortion. In 1984, more than 3,480 Canadian residents obtained legal abortions in the United States, according to a Statistics Canada report at the time. At trial in R.v. Morgentalerthe director of a women’s health center in Minnesota testified that many Canadian clients faced delays at home.

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

“The clinics were very welcoming, and I know there’s been an expression here that the tables are turned now,” she said. “We want to help Americans come here. We want to return the favor, but we also recognize that this is going to be a challenge for us and that we won’t be able to help as many Americans in the end.

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