The Clinical Ethics Working Group of the College of Physicians of Quebec has just published a report that denounces the current state of third trimester abortion services in Canada, which it describes as “disorganized”, “discriminatory” and “unacceptable”. The report finds that doctors who provide late abortions are “stigmatized, even intimidated”. Women are rejected by hospitals, and must travel to the USA where they have to pay $10-15,000 for an abortion. Others are “forced to continue the pregnancy”, for lack of access. Yet abortions in Canada are legal without time limits. The College has suggested setting up a specialised centre with the mandate to provide late abortions for the province.
In Quebec, only a few women request these abortions each year. Sometimes they did not know they were pregnant earlier. Others have “difficult, even tragic social situations”, explains the document. “More recently, there have been requests following Zika virus infection and requests for selective abortion. Cultural reasons may also be involved. The report also notes serious maternal health problems and serious fetal abnormalities.
As a sign of the climate prevailing on this subject in the health network, one professional medical association refused to comment so as not to “endanger the safety of women and carers” and “not to open a debate on this delicate issue”. Another said: “We will not comment on this matter as long as there are doctors who are the subject of death threats. We must protect them to guarantee the provision of care for women.” An anonymous community worker said that professionals who provide this type of abortion are called “baby killers” by colleagues. In addition, there are threats from anti-abortion activists. A health professional who also did not give her name said that security issues cause “a lot of concerns” for the teams.
“It’s still very taboo,” notes Patricia LaRue, director of the Outaouais Women’s Health Center. Even those who provide first trimester abortions are still discriminated against in their environment. They are told: “We know, you kill babies”. Doctors who agree to do third trimester abortions work in such secret that even Ms LaRue does not know their identity. The late termination of pregnancy exacerbates anti-abortion arguments and makes the decision to proceed more difficult for both the woman concerned and the caregivers,” she said. “Whether it is for the pregnant woman, the couple or the caregivers, the fact of ending the life of a fetus capable of surviving a termination of pregnancy is a source of suffering.”
In Canada, abortion is publicly funded as a medical procedure under the Canada Health Act. In Quebec, abortion is regulated like any other medical procedure by the Health and Social Services Act, health insurance and professional clinical standards. The report says there is no question of forcing health professionals to provide abortions. “The limits of doctors must be respected, like those of healthcare teams. But an institutional objection is not allowed.”
In the office of Minister of Health Danielle McCann, they are clear. “We want to protect the right of women to abortion. It is for them to decide what they do with their bodies, whether in the third, second or first trimester…. We understand that the third trimester abortion is very delicate. It is an issue that we look at with respect and caution.” The Department, she says, is still working to repatriate services that are available in the United States. Discussions in this direction are underway.
(Québec – Avortements tardifs: des services «désorganisés» et «discriminatoires», Des médecins
« stigmatisés, voire intimidés ». Des femmes refusées par des hôpitaux. D’autres qui sont
« contraintes de poursuivre la grossesse », faute d’accès)