CANADA – Seeking support for abortion care from the two national hotlines

Image caption: Action Canada for Sexual Health & Rights

by Demont C, Doctoroff J, Foster AM

Contraception Journal May 2023;121:


Introduction: Both the National Abortion Federation Canada and Action Canada for Sexual Health and Rights operate national toll-free hotlines that provide information, financial support, and travel assistance to those seeking abortion care. We aimed to characterise callers to both hotlines before and after the onset of the Covid-19 pandemic.

Method: Hotline personnel routinely document information about callers and type(s) of assistance needed and received. We received call logs from both organisations for a two-year period (April 1, 2019 through March 31, 2021). We exported these data to Microsoft Excel® and analysed them using descriptive statistics. We analysed case notes for content and themes.

Results: Over the study period the two hotlines worked with 270 callers seeking support to obtain abortion care. Nearly two-thirds of callers (n=174) were seeking support after 14 weeks gestation, including 69 callers (26%) who were at or beyond 24 weeks gestation. Most callers were seeking support to obtain abortion care outside of their province of residence because services at their gestational age were not available. Caller needs were similar before and after the onset of the pandemic, but fewer travelled to the United States for later abortion care in the Covid-19 era. Patient assistance hotlines play an important role in helping some Canadians navigate the health system to obtain needed abortion care. The needs of those seeking care at later gestational ages points to gaps in current service availability. Identifying ways to expand later abortion care, and particularly after 24 weeks, in Canada appears warranted.

Conclusions: Although abortion is decriminalized in Canada, some abortion seekers need to travel considerable distances within the country or to the United States to obtain later gestational age care. National hotlines play an important role in helping abortion seekers navigate the system and provide critical financial support. Identifying ways to fully cover costs associated with abortion-related travel and accommodations, expand in-country later gestational age abortion care, and make permanent federal support for these hotlines and patient navigation services appears warranted.