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Access to abortion in Canada
In accordance with the 1988 Supreme Court of Canada decision R. v. Morgentaler, there are no criminal laws restricting access to abortion in Canada. In Canada, provincial and territorial governments are responsible for the administration, organization, and delivery of health care. The federal government has constitutional spending power through which it sets health standards across Canada. Funding for health systems under provincial jurisdiction are subject to provincial compliance with certain requirements set out in the 1984 Canada Health Act. It regulates the conditions to which provincial and territorial health insurance programs must adhere in order to receive the full amount of the Canada Health Transfer cash contribution. The Act states that provinces and territories must provide universal coverage for all insured persons for all medically necessary hospital and physician services, which abortion is considered to be.
Mifegymiso has the potential to close gaps in access to abortion in Canada
Despite the decriminalization of abortion, those who wish to terminate a pregnancy in Canada still face many barriers. Despite how medical abortion (or medication abortion) has shaped abortion access in other countries, it is not widely available in Canada. Medical abortion is an important way to expand choice for terminating a pregnancy. It is available earlier than surgical abortion, could reduce wait times for surgical abortion procedures and wait times overall, can be offered to people who prefer medical rather than surgical procedures, and could be administered by different health care providers, like registered nurses, which could increase access to abortion in more remote and rural areas.
Medical abortion is offered in few clinics and hospitals across the country. It is not widely available due to factors including lowered demand (as a result of lack of availability), the lack of formal billing codes for medical abortion, and the current off-label regimen used in Canada. If properly rolled-out, Mifegymiso has the potential to remedy many of these access barriers; unfortunately, restrictions on the drug’s roll-out will significantly hinder its potential. In response, the current restrictions are being publically criticized by a number of physicians, colleges of pharmacists, researchers, activists, stakeholders and sexual and reproductive rights organizations, including Action Canada for Sexual Health and Rights.