Written by: Abbey Ferguson (she/her), certified Abortion Doula.
Edited by: Danielle LeBlanc (she/her), RN.
For those looking to their elders with questions regarding abortion access in the Maritimes, they may feel like they’re up against an uphill battle. Parents, friends, and family may describe driving outside of their province (or even country) for an abortion, dehumanizing referral processes, and general lack of support. While this is not necessarily the case anymore, the health authorities for PEI, New Brunswick, and Nova Scotia still have a long way to go to meet standards of excellent abortion access. Many people are still unaware of the changes to Maritime abortion access, and most major developments have occured within the last five years. Let’s look at some updates!
First, a quick clarification: federally, Canada has absolutely no legal restrictions on abortion. Abortions can be performed at any stage in pregnancy, both in-hospital and in private clinic settings. However, each province has the right to limit and organize abortion services as they see fit. Therefore, each province has wildly different “cut-off dates” and accessibility to abortion. “Cut-off dates” (or gestational limits) are pregnancy duration dates by which a pregnant person must have a termination, dictated by each individual province. These dates are determined by the availability, skill, and medical resources available to the abortion providers in the province and/or determined by the willingness of the provincial healthcare system to fund the procedure (which is then in turn determined by the morals of the current government).
Prince Edward Island
PEI has had abortion services on-island since January of 2017. Before then, PEI residents would travel to Moncton or Halifax, depending on their current stage in pregnancy and availability of the neighbouring province.
Current “cut-off dates” rest at 9 weeks for a medicine abortion (previously called a medical abortion) and 12 weeks and 6 days for a aspiration abortion (previously called a surgical abortion). They use a self-referral method, where a person looking to access an abortion would call PEI’s Women’s Wellness Program (-10 points for gendered language, as not only women need abortions!) at 1-844-365-8258. Aspiration abortion is only offered in Summerside, in a hospital setting. Medication abortions can be arranged through the Women’s Wellness Program, or it can be prescribed by a willing family doctor/nurse practitioner.
If a person is above 12 weeks and 6 days, but below 13 weeks and 6 days, they can self-refer to the Moncton Hospital at 1-844-806-9205. If a person is more than 13 weeks and 6 days, they can access an abortion in Halifax. They can self-refer by calling 1-833-352-0719.
To have a procedure in Halifax covered by their PEI health care, a request must be approved by the Out-of-Province Coordinator. It is unheard of for an approval to be denied. The PEI government website currently states that to access an abortion in Halifax, one must get a physician referral, but that is no longer accurate in practice. Out of province travel is to be paid privately, unless the pregnant person applies for funding.
Nova Scotia
Nova Scotia has the most liberal “cut-off dates” for an aspiration abortion in the Maritimes, at 15 weeks and 6 days. Thus, it does see its fair share of patients travelling in from other provinces. Medication abortions are offered up to 9 weeks.
The abortion system in NS was centralized in 2018, with the end of physician referrals and the establishment of the Women’s Choice Clinic (another -10 points for more gendered language). The Choice Clinic offers a provincial toll-free line (1-833-352-0719) where their team will arrange bloodwork, ultrasounds, and procedures in locations that make sense for the patient.
Currently, only hospital settings are available for aspiration abortions. Medication abortions can be arranged through the Women’s Choice Clinic through a network of providers located throughout the province, or it can be prescribed by a willing family doctor/nurse practitioner. Hospitals that provide aspiration abortions are located in Halifax, Bridgewater, Kentville, and Truro.
New Brunswick
New Brunswick “cut-off dates” sit at 13 weeks and 6 days for an aspiration abortion. Medication abortions are offerered up to 9 weeks. Previous to 2015, New Brunswick required two letters of referral from general practitioners. Currently, they use a self-referral system.
People can access an abortion by calling individual “family planning clinics” located in hospitals in Moncton and Bathurst. Abortion rights have made recent news in New Brunswick with the partial closure of Clinic 554 in 2020. Clinic 554 is still providing abortions, but is no longer offering gender-affirming care or family practice medicine. People can self-refer to Clinic 554 by calling 1-855-978-5434.
The New Brunswick government has refused to fund the out-of-hospital terminations provided by Clinic 554 (in direct opposition of the Canada Health Act), so those accessing an abortion through them must pay privately or apply for financial assistance. A lawsuit has been filed to fight the refusal to fund out-of-hospital abortions, as of January 2021.
While abortion access has grown greatly in the Maritime provinces in the past five years, Atlantic Canadians are still left wanting. Busy phone lines and long wait-times to hear back and book appointments are common occurrences, and can be uncomfortable and distressing for patients. Abortions are available up to 24 weeks in larger cities like Toronto and Vancouver. Ideally, people all across the country would have equitable access to terminations.
Instead, people who may have found out that they were pregnant later into their pregnancy, or changed their mind about their plan for their pregnancy, are forced to pay out-of-pocket for the travel to access out-of-province clinics. Gaps in abortion access are filled by non-profit organizations, rather than the healthcare system itself. People can apply for travel coverage (whether that be from PEI to NS, or NS to Ontario, etc) through Hope Air, the National Abortion Federation, and/or Action Canada, and hope that their application funds all or part of their travel costs. The Maritime provinces also benefit from the volunteers of Abortion Support Services Atlantic, which offers abortion doula services and drives to and from termination procedures. Let’s hope that the next five years bring even better abortion access to the Maritime provinces.
