Lack of open dialogue about abortion perpetuates stigma and barriers, Ontario researcher says


A leaked draft of the U.S. Supreme Court’s opinion to overturn Roe v. Wade sparked conversations about barriers to abortion that still impact Canadians more than 30 years after it was decriminalized here.

Just because abortion has been legal in Canada since 1988 doesn’t mean the procedure is still readily available, says Jacqueline Potvin, a postdoctoral fellow at the University of Guelph in Ontario.

Potvin has conducted research on reproductive rights and justice globally, including how society talks about abortion.

“It’s often assumed that we’re fine, that everything is fine, that things that happen in other countries, things that happen in the United States won’t happen here,” Potvin said. “It has led to some complacency about the awareness of the barriers that still exist.”

Some of these barriers include different services between provinces and lack of accessibility in rural areas, which Potvin says particularly affects “people who are already marginalized” and who may not have the means to move.

If Roe v. Wade is overturned as a federal law, certain US state laws — known as “trigger laws” — would immediately go into effect, banning abortion. In Michigan, which borders Windsor, Ont., the state’s Republican-dominated legislature is unlikely to overturn that law and Democratic Governor Gretchen Whitmer cannot veto legislation already signed by another governor. almost a century ago.

Potvin said another challenge in efforts to access abortion may be the lack of open dialogue, and “that stigma and silence that allows stereotypes and taboos to persist.”

Windsor Regional Hospital in southwestern Ontario declined to discuss the abortion or provide any data relating to the procedure when contacted by CBC. (Mike Evans/CBC)

CBC News has reached out to Windsor Regional Hospital (WRH), Bluewater Health in Sarnia and the Chatham-Kent Health Alliance (CKHA) for data on how many abortions they perform, how many doctors assist them and whether there are waiting lists. All declined to discuss the topic of abortion or provide data.

“We have no publicly available information on this,” said CKHA spokesperson Fannie Vavoulis.

“We are not commenting on the matter at this time, primarily for the privacy and safety of patients and our clinical staff,” WRH spokesman Steve Erwin said in an email to CBC News. “For women who want this procedure, it is a private matter that we can arrange with them privately or with the help of a referred family doctor.”

Potvin said the response from the southwestern Ontario hospitals CBC contacted “makes me really sad. It’s really disappointing.”

Institutions likely have good data and have a good idea of ​​the [abortion] obstacles that might exist, and without this kind of information and data being shared, we also cannot understand how these obstacles are perpetuated.​​​​​– Jacqueline Potvin, researcher at the University of Guelph

On the one hand, Potvin can understand a health care provider’s reluctance to discuss abortion, as he may be targeted, sometimes violently, for being associated with the procedure. Ontario law prohibits abortion protesters from being within 150 meters of a facility that performs the procedure or the homes of staff and doctors who help women terminate a pregnancy.

However, the lack of openness from some health care providers can lead to fear of stigma or judgment, and could lead to a “shameful” experience, Potvin said. The lack of open and transparent discussions about abortion can also mean that anyone seeking an abortion “won’t even know where to start,” she said.

“A lot of women feel like they’re going completely blind,” Potvin said, adding that it could prevent a woman from getting timely care. “It makes it less accessible.”

It’s also helpful to publish local data on abortions, she said.

“Institutions presumably have good data and have a good idea of ​​what barriers might exist, and without that kind of information and data being shared, we also can’t understand how those barriers are perpetuated – how they continue. , how we can make abortion accessible [and] a more positive experience for people.”

Without sharing the data, there is a risk of perpetuating “the stigma and this silence that allows stereotypes and taboos to persist”.

Although the southwestern Ontario hospital organizations contacted did not release numbers, the The Canadian Institute for Health Information (CIHI) has annual data on abortions performed across the country. In 2020, there were more than 21,000 in Ontario, compared to almost 45,000 in 2012.

Ontario has 38 abortion providers, the second highest number in Canada behind Quebec, according to the latest data from the charity Action Canada for Sexual Health and Rights.

A Department of Health spokesperson told CBC News that more abortion services, both medical and surgical, are being provided in non-hospital settings.

Abortion bans ‘create inequality’: researcher

The Canadian government has said Americans may have access to abortions here if Roe v. Wade.

“Abortion bans don’t stop abortion, but they do create inequality in access to abortion,” Potvin said, referring to the means or resources a person would need to cross borders. national or international.

Avery White rallies for abortion rights at the Capitol in Austin, Texas on May 3 in response to news that the United States Supreme Court may be set to overturn the landmark Roe case vs. Wade who legalized abortion in the country. ((Jay Janner/American Statesman of Austin/Associated Press)

The hospitals are considered independent corporations, governed by a board of directors, and independently handle billing for uninsured people, according to the Ontario government.

“Some hospitals are working out payment plans so that bills can be paid over time and some hospitals will absorb some of the costs, allowing the patient to contribute what they can,” the Ministry of Health spokesperson said. Health, Bill Campbell.

Windsor Regional Hospital declined to comment on whether and how American women could access an abortion here and the associated cost if they are uninsured.

Local supports for those considering abortion

The Windsor Essex Community Health Center offers support for people with questions about abortion, but declined to speak to CBC News.

Felicia Lawal, chief nursing officer and director of public health programs for Windsor-Essex County Health Unit (WECHU), said: ‘Anything that helps de-stigmatize a problem is always beneficial. (WECHU)

However, the Windsor-Essex County Health Unit (WECHU) said it offered counseling services, provided by a public health nurse, for people wishing to terminate a pregnancy. After these discussions about how a pregnant person feels, the risks, and where to access abortion services, the health unit directs her to the Windsor Regional Hospital’s pregnancy hotline (519- 985-2662) for assistance.

“It’s not just personal health care [decision] – it’s difficult,” said Felicia Lawal, WECHU’s chief nursing officer and director of public health programs.

Lawal acknowledges that stigma on any issue, including abortion, can be harmful, and WECHU tries to help “support and advocate to break down barriers.”

“Anything that would help de-stigmatize an issue is always beneficial. So yes, if there is an opportunity for a more open dialogue, we will certainly champion and support it.”