UBC Wiki - User contributions [en]

GRSJ224/disparities in abortion access in Canada

2020-07-28T20:28:47Z

AlizaMarieSmith: /* External Links */

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
Proceeding 1969, all abortion methods were considered criminal in Canada.<ref name=":1" /> Due to various efforts, Canada has become one of the only countries that does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, '''Bill C-195''' and '''Bill C-150''', were modified over the 27th and 28th parliamentary periods. This bill legalized abortion under very strict conditions, permitting women to receive the procedure only if they received three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be conducted in hospitals, and women were required to report instances of abortion to a [https://en.wikipedia.org/wiki/Therapeutic_Abortion_Committee Therapeutic Abortion Committee].<ref name=":5" /> However, as providing abortion services was optional to hospitals and physicians, social stigmas and lack of funding continued to reduce the availability of abortion procedures.

===R. v. Morgentaler (1988-89)===
The strict restrictions of the Criminal Law Amendment Act stimulated the emergence of illegal abortion clinics that provided abortions to those not legally qualified to receive them. [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler], Dr. Leslie Smoling and Dr. Robert Scott founded one of such clinics in Toronto.<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>.

In 1988, Morgentaler directly challenged that the Criminal Code section pertaining to abortions in a Supreme Court trial, arguing that the regulations and restrictions imposed on people seeking abortions decreases accessibility.

On January 28, 1988, the '''R. v. Morgentaler''' trial concluded, ruling, in a majority judgement, in favour of Morgentaler. This constituted the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional".<ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada], [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson], stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> Federal jurisdiction on the issue provided limitations of provincial power on abortion service provisions and patient eligibility. Additionally, this bill allowed private and public clinics to open in Canada.<ref name=":3" />

==Modern Access Issues==
Despite its decriminalization and legalization within Canada, many issues continue to limit abortion access for individuals today.

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, varying access issues emerging among each jurisdiction, and cross-provincial travel to obtain abortion services.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref>
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of abortion services in most provinces within Canada.

In 2016, the United Nations’ [https://en.wikipedia.org/wiki/Convention_on_the_Elimination_of_All_Forms_of_Discrimination_Against_Women#Committee_on_the_Elimination_of_Discrimination_against_Women Committee on the Elimination of Discrimination against Women] stated that they remained concerned about persisting disparities in Canadian access to legal abortion services.<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow United Nations directives, by ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas,"<ref name=":2" /> many have continued to majorly fund urbanized areas. This has increased disparities in some provinces and territories, leaving many socio-economic issues to persist today, including higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among rural families.<ref name=":1" />

Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== Rural Access ===
In 2016, the UN Human Rights Office of the High Commissioner determined that Canadian rural populations face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" />

The presence of facilities that preform abortion services vary within provinces, but are more often found in urbanized city centres due to larger populations inhabiting those areas and increased provincially allocated funding. In 2012, only 15.9% of Canadian hospitals offered abortion services, with a majority of these located in urban areas.<ref name=":1" />

Quebec has shown continual and steady support for abortion services through dedicating funds to establish abortion clinics in underserved areas since the 1970s.<ref name=":4" /> This, in part, explains the high number of abortion facilities that can be found there. Quebec is also now the most equitable province in Canada, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is '''drug-induced abortion''' ('''[https://en.wikipedia.org/wiki/Medical_abortion medical abortion]''') due to its non-invasive nature and lessened recuperation time. Medicinal abortion increases access to abortion services as it can be obtained through most clinics and hospitals. However, drug-induced abortion is largely unavailable in many westernized nations, and Canada was exceedingly slow to approve commonly used medications to induce abortion,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of Canadian abortions being done surgically[[GRSJ224/disparities in abortion access in Canada#cite note-:4-6|<sup>[6]</sup>]] in fewer than 100 facilities across the country.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as they typically have to travel further to obtain abortions, increasing their personal costs in the form of transportation and time expenses.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===

==== "Gate-Keeper" Complexes ====
As these procedures often spark moral and ethical debates, some medical staff have come to identify as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patients about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures. In 2012, abortions were offered by less than 300 Canadian doctors.<ref name=":6" />

==== Anti-Abortion Movement ====
There have been various societal movements which aim to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding for abortions. This can create social norms and pressures that can negatively affect an individual's perceived reproductive choices, creating a hostile environment for women who may choose to obtain an abortion.

==Statistics and Relevancy==
* 31% of Canadian women receive an abortion during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
* In 2012, abortions were offered by less than 300 Canadian doctors.<ref name=":6" />
== References ==
<references />

== External Links ==
* [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson]
* [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement Canadian anti-abortion movement]
* [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Canadian Criminal Code]
* [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada]
* [https://en.wikipedia.org/wiki/Convention_on_the_Elimination_of_All_Forms_of_Discrimination_Against_Women#Committee_on_the_Elimination_of_Discrimination_against_Women Committee on the Elimination of Discrimination against Women]
* [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act]
* [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler]
* [https://en.wikipedia.org/wiki/Medical_abortion Medical abortion]
* [https://en.wikipedia.org/wiki/R_v_Morgentaler ''R. v Morgentaler'']
* [https://en.wikipedia.org/wiki/Therapeutic_Abortion_Committee Therapeutic Abortion Committee]

GRSJ224/disparities in abortion access in Canada

2020-07-28T20:28:03Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
Proceeding 1969, all abortion methods were considered criminal in Canada.<ref name=":1" /> Due to various efforts, Canada has become one of the only countries that does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, '''Bill C-195''' and '''Bill C-150''', were modified over the 27th and 28th parliamentary periods. This bill legalized abortion under very strict conditions, permitting women to receive the procedure only if they received three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be conducted in hospitals, and women were required to report instances of abortion to a [https://en.wikipedia.org/wiki/Therapeutic_Abortion_Committee Therapeutic Abortion Committee].<ref name=":5" /> However, as providing abortion services was optional to hospitals and physicians, social stigmas and lack of funding continued to reduce the availability of abortion procedures.

===R. v. Morgentaler (1988-89)===
The strict restrictions of the Criminal Law Amendment Act stimulated the emergence of illegal abortion clinics that provided abortions to those not legally qualified to receive them. [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler], Dr. Leslie Smoling and Dr. Robert Scott founded one of such clinics in Toronto.<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>.

In 1988, Morgentaler directly challenged that the Criminal Code section pertaining to abortions in a Supreme Court trial, arguing that the regulations and restrictions imposed on people seeking abortions decreases accessibility.

On January 28, 1988, the '''R. v. Morgentaler''' trial concluded, ruling, in a majority judgement, in favour of Morgentaler. This constituted the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional".<ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada], [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson], stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> Federal jurisdiction on the issue provided limitations of provincial power on abortion service provisions and patient eligibility. Additionally, this bill allowed private and public clinics to open in Canada.<ref name=":3" />

==Modern Access Issues==
Despite its decriminalization and legalization within Canada, many issues continue to limit abortion access for individuals today.

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, varying access issues emerging among each jurisdiction, and cross-provincial travel to obtain abortion services.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref>
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of abortion services in most provinces within Canada.

In 2016, the United Nations’ [https://en.wikipedia.org/wiki/Convention_on_the_Elimination_of_All_Forms_of_Discrimination_Against_Women#Committee_on_the_Elimination_of_Discrimination_against_Women Committee on the Elimination of Discrimination against Women] stated that they remained concerned about persisting disparities in Canadian access to legal abortion services.<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow United Nations directives, by ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas,"<ref name=":2" /> many have continued to majorly fund urbanized areas. This has increased disparities in some provinces and territories, leaving many socio-economic issues to persist today, including higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among rural families.<ref name=":1" />

Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== Rural Access ===
In 2016, the UN Human Rights Office of the High Commissioner determined that Canadian rural populations face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" />

The presence of facilities that preform abortion services vary within provinces, but are more often found in urbanized city centres due to larger populations inhabiting those areas and increased provincially allocated funding. In 2012, only 15.9% of Canadian hospitals offered abortion services, with a majority of these located in urban areas.<ref name=":1" />

Quebec has shown continual and steady support for abortion services through dedicating funds to establish abortion clinics in underserved areas since the 1970s.<ref name=":4" /> This, in part, explains the high number of abortion facilities that can be found there. Quebec is also now the most equitable province in Canada, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is '''drug-induced abortion''' ('''[https://en.wikipedia.org/wiki/Medical_abortion medical abortion]''') due to its non-invasive nature and lessened recuperation time. Medicinal abortion increases access to abortion services as it can be obtained through most clinics and hospitals. However, drug-induced abortion is largely unavailable in many westernized nations, and Canada was exceedingly slow to approve commonly used medications to induce abortion,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of Canadian abortions being done surgically[[GRSJ224/disparities in abortion access in Canada#cite note-:4-6|<sup>[6]</sup>]] in fewer than 100 facilities across the country.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as they typically have to travel further to obtain abortions, increasing their personal costs in the form of transportation and time expenses.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===

==== "Gate-Keeper" Complexes ====
As these procedures often spark moral and ethical debates, some medical staff have come to identify as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patients about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures. In 2012, abortions were offered by less than 300 Canadian doctors.<ref name=":6" />

==== Anti-Abortion Movement ====
There have been various societal movements which aim to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding for abortions. This can create social norms and pressures that can negatively affect an individual's perceived reproductive choices, creating a hostile environment for women who may choose to obtain an abortion.

==Statistics and Relevancy==
* 31% of Canadian women receive an abortion during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
* In 2012, abortions were offered by less than 300 Canadian doctors.<ref name=":6" />
== References ==
<references />

== External Links ==
* [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson]
* [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement Canadian anti-abortion movement]
* [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada]
* [https://en.wikipedia.org/wiki/Convention_on_the_Elimination_of_All_Forms_of_Discrimination_Against_Women#Committee_on_the_Elimination_of_Discrimination_against_Women Committee on the Elimination of Discrimination against Women]
* [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code (Canada)]
* [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act]
* [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler]
* [https://en.wikipedia.org/wiki/Medical_abortion Medical abortion]
* [https://en.wikipedia.org/wiki/R_v_Morgentaler ''R. v Morgentaler'']
* [https://en.wikipedia.org/wiki/Therapeutic_Abortion_Committee Therapeutic Abortion Committee]

GRSJ224/disparities in abortion access in Canada

2020-07-28T20:21:27Z

AlizaMarieSmith: /* Legalization and Decriminalization Processes */

Talk:The Problems with the Medicalization of Depression in Developed Countries

2020-07-26T20:04:27Z

AlizaMarieSmith: Talk page autocreated when first thread was posted

Thread:Talk:The Medicalization of Depression in Developed Countries/Article length

2020-07-26T20:04:27Z

AlizaMarieSmith: New thread: Article length

Hey! You have a great start to your wiki so far! I find this topic so interesting -- in fact, it is what I did my animation video assignment on! The only thing I worry about with your wiki at this point in time is the length of the article-- it seems like you have a lot of headings and sub-headings ready, which are all interesting and relevant! However, this assignment is only supposed to be 1250-ish words, so you might want to look into narrowing down your topic a bit so that you can comfortably go into depth in your discussions, as opposed to breadth of many topics! Examples could be choosing to discuss the medicalization of depression in a ''specific'' industrialized country, or choosing one of the broader sub-headings and seeing what you can discover about it! For example, you could do the history of the medicalization of depression in economically developed countries and discuss the major important historical developments in depth, or you could do issues in the medicalization of depression for minorities and discuss LGBTQ+ and ethnic minorities in more depth! These are just random ideas though-- I'm sure your wiki topic as is will turn out fantastic no matter what you decide!! I can't wait to read the finished wiki!:)

Thread:Talk:Discrimination and unequal treatment on female in workplaces in Canada/Sub-headings, statistics, and citations

2020-07-26T19:53:26Z

AlizaMarieSmith: New thread: Sub-headings, statistics, and citations

Hey! Awesome work on your wiki so far-- I really enjoyed reading it!! I just had a couple ideas that may improve your wiki. First, the titles of your sub-headings are quite long. In preparation for this assignment, I was reading up on how to create an effective wiki page and one of the suggestions was to make sure your headings are concise and informative for your reader. Perhaps shortening them to the topic before discussing it (I.e. changing "The salary and women's performance at work is unequal" to "Salary and Women's Performance", then going on to explain how/why it is unequal) might make your discussion more coherent to your audience. Just a thought, though! Secondly, I think including a "statistics" section might be helpful for your wiki, where you can put relevant information regarding, say, income disparities, discrimination statistics, etc.. I suggest this to everyone, really, but as a reader I find it so helpful when concepts are displayed in a statistical manner because it rally demonstrates the real-world relevance of these topics! Lastly, I noticed in citation 6 (the article by Nicole Fortin) there are two sets of quotation marks around the title of the article. Just a minor thing, but I thought I would share because I know how easy those things are to miss! Overall, great job!

Thread:User talk:AlizaMarieSmith/Reproductive Healthcare Disparaties

2020-07-26T19:34:51Z

AlizaMarieSmith: Blanked the page

Talk:The Reproductive Healthcare Disparities Among HIV Positive Women in Developing Countries

2020-07-26T19:34:26Z

AlizaMarieSmith: Talk page autocreated when first thread was posted

Thread:Talk:The Reproductive Healthcare Disparities Among HIV Positive Women in Developing Countries/Phrasing and Statistics

2020-07-26T19:34:26Z

AlizaMarieSmith: New thread: Phrasing and Statistics

Hey! Looks like you have a really good start on your wiki-- you chose a very interesting topic! I have just a couple of thoughts as I read through this article that I thought I would share: 1. I learned in one of my political science courses this year that the terms "developing countries", "poorer countries", etc. are not politically correct as they perpetuate the ideal of the westernized nation... Its just a minor comment but I think the term "less economically developed countries" (which can be shortened to "LEDCs" to save you word count!) may be more appropriate-- but it's totally up to you! 2. I can see that this article is a WIP, so I'm not sure what exactly you're planning on doing, but I think the use of a "statistics and relevancy" section might be helpful to clearly and concisely communicate the major issues (statistics of HIV diagnoses in LEDCs, contraceptive availability, etc.) that are related to your article! Once again, just a thought :) I can't wait to read the article in full once you're finished! Keep up the good work :)

User talk:AlizaMarieSmith

2020-07-26T19:30:43Z

AlizaMarieSmith: Talk page autocreated when first thread was posted

Thread:User talk:AlizaMarieSmith/Reproductive Healthcare Disparaties

2020-07-26T19:30:43Z

AlizaMarieSmith: New thread: Reproductive Healthcare Disparaties

Hey! Looks like you have a really good start on your wiki-- you chose a very interesting topic! I have just a couple of thoughts as I read through this article that I thought I would share:
1. I learned in one of my political science courses this year that the terms "developing countries", "poorer countries", etc. are not politically correct as they perpetuate the ideal of the westernized nation... Its just a minor comment but I think the term "less economically developed countries" (which can be shortened to "LEDCs" to save you word count!) may be more appropriate-- but it's totally up to you!
2. I can see that this article is a WIP, so I'm not sure what exactly you're planning on doing, but I think the use of a "statistics and relevancy" section might be helpful to clearly and concisely communicate the major issues (statistics of HIV diagnoses in LEDCs, contraceptive availability, etc.) that are related to your article! Once again, just a thought :)
I can't wait to read the article in full once you're finished! Keep up the good work :)

GRSJ224/disparities in abortion access in Canada

2020-07-26T19:15:50Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
Proceeding 1969, all abortion methods were considered criminal in Canada.<ref name=":1" /> Due to various efforts, Canada has become one of the only countries that does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, '''Bill C-195''' and '''Bill C-150''', were modified over the 27th and 28th parliamentary periods. This bill legalized abortion under very strict conditions, permitting women to receive the procedure only if they received three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be conducted in hospitals, and women were required to report instances of abortion to a [https://en.wikipedia.org/wiki/Therapeutic_Abortion_Committee Therapeutic Abortion Committee].<ref name=":5" /> However, as providing abortion services was optional to hospitals and physicians, social stigmas and lack of funding continued to reduce the availability of abortion procedures.

===R. v. Morgentaler (1988-89)===
The strict restrictions of the Criminal Law Amendment Act stimulated the emergence of illegal abortion clinics that provided abortions to those not legally qualified to receive them. [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler], Dr. Leslie Smoling and Dr. Robert Scott founded one such clinic in Toronto.<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>.

In 1988, Morgentaler directly challenged that the Criminal Code section pertaining to abortions in a Supreme Court trial, arguing that the regulations and restrictions imposed on people seeking abortions decreases accessibility.

On January 28, 1988, the '''R. v. Morgentaler''' trial concluded, ruling, in a majority judgement, in favour of Morgentaler. This constituted the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional".<ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada], [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson], stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> Federal jurisdiction on the issue provided limitations of provincial power on abortion service provisions and patient eligibility. Additionally, this bill allowed private and public clinics to open in Canada.<ref name=":3" />

==Modern Access Issues==
Despite its decriminalization and legalization within Canada, many issues continue to limit abortion access for individuals today.

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, varying access issues emerging among each jurisdiction, and cross-provincial travel to obtain abortion services.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref>
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of abortion services in most provinces within Canada.

In 2016, the United Nations’ [https://en.wikipedia.org/wiki/Convention_on_the_Elimination_of_All_Forms_of_Discrimination_Against_Women#Committee_on_the_Elimination_of_Discrimination_against_Women Committee on the Elimination of Discrimination against Women] stated that they remained concerned about persisting disparities in Canadian access to legal abortion services.<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow United Nations directives, by ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas,"<ref name=":2" /> many have continued to majorly fund urbanized areas. This has increased disparities in some provinces and territories, leaving many socio-economic issues to persist today, including higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among rural families.<ref name=":1" />

Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== Rural Access ===
In 2016, the UN Human Rights Office of the High Commissioner determined that Canadian rural populations face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" />

The presence of facilities that preform abortion services vary within provinces, but are more often found in urbanized city centres due to larger populations inhabiting those areas and increased provincially allocated funding. In 2012, only 15.9% of Canadian hospitals offered abortion services, with a majority of these located in urban areas.<ref name=":1" />

Quebec has shown continual and steady support for abortion services through dedicating funds to establish abortion clinics in underserved areas since the 1970s.<ref name=":4" /> This, in part, explains the high number of abortion facilities that can be found there. Quebec is also now the most equitable province in Canada, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is '''drug-induced abortion''' ('''[https://en.wikipedia.org/wiki/Medical_abortion medical abortion]''') due to its non-invasive nature and lessened recuperation time. Medicinal abortion increases access to abortion as it can be obtained through most clinics and hospitals. However, drug-induced abortion is largely unavailable in many westernized nations, and Canada was exceedingly slow to approve commonly used medications to induce abortion,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of Canadian abortions being done surgically[[GRSJ224/disparities in abortion access in Canada#cite note-:4-6|<sup>[6]</sup>]] in fewer than 100 facilities across the country.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as they typically have to travel further to obtain abortions, increasing their personal costs in the form of transportation and time expenses.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===

==== "Gate-Keeper" Complexes ====
As these procedures often spark moral and ethical debates, some medical staff have come to identify as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patients about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures. In 2012, abortion was offered by less than 300 Canadian doctors.<ref name=":6" />

==== Anti-Abortion Movement ====
There have been various societal movements which aim to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding for abortions. This can create social norms and pressures that can negatively affect an individual's perceived reproductive choices, creating a hostile environment for women who may choose to obtain an abortion.

==Statistics and Relevancy==
* 31% of Canadian women receive an abortion during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
== References ==
<references />

Thread:Talk:GRSJ224/disparities in abortion access in Canada/References/reply

2020-07-26T19:15:10Z

AlizaMarieSmith: Reply to References

Thanks!

GRSJ224/disparities in abortion access in Canada

2020-07-16T21:25:46Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
Proceeding 1969, all abortion methods were considered criminal in Canada.<ref name=":1" /> Due to various efforts, Canada has become one of the only countries that does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, '''Bill C-195''' and '''Bill C-150''', were modified over the 27th and 28th parliamentary periods. This bill legalized abortion under very strict conditions, permitting women to receive the procedure only if they received three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be conducted in hospitals, and women were required to report instances of abortion to a [https://en.wikipedia.org/wiki/Therapeutic_Abortion_Committee Therapeutic Abortion Committee].<ref name=":5" /> However, as providing abortion services was optional to hospitals and physicians, social stigmas and lack of funding continued to reduce the availability of abortion procedures.

===R. v. Morgentaler (1988-89)===
The strict restrictions of the Criminal Law Amendment Act stimulated the emergence of illegal abortion clinics that provided abortions to those not legally qualified to receive them. [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler], Dr. Leslie Smoling and Dr. Robert Scott founded one such clinic in Toronto.<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>.

In 1988, Morgentaler directly challenged that the Criminal Code section pertaining to abortions in a Supreme Court trial, arguing that the regulations and restrictions imposed on people seeking abortions decreases accessibility.

On January 28, 1988, the '''R. v. Morgentaler''' trial concluded, ruling, in a majority judgement, in favour of Morgentaler. This constituted the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional".<ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada], [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson], stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> Federal jurisdiction on the issue provided limitations of provincial power on abortion service provisions and patient eligibility. Additionally, this bill allowed private and public clinics to open in Canada.<ref name=":3" />

==Modern Access Issues==
Despite its decriminalization and legalization within Canada, many issues continue to limit abortion access for individuals today.

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, varying access issues emerging among each jurisdiction, and cross-provincial travel to obtain abortion services.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref>
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of abortion services in most provinces within Canada.

In 2016, the United Nations’ [https://en.wikipedia.org/wiki/Convention_on_the_Elimination_of_All_Forms_of_Discrimination_Against_Women#Committee_on_the_Elimination_of_Discrimination_against_Women Committee on the Elimination of Discrimination against Women] stated that they remained concerned about persisting disparities in Canadian access to legal abortion services.<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow United Nations directives, by ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas,"<ref name=":2" /> many have continued to majorly fund urbanized areas. This has increased disparities in some provinces and territories, leaving many socio-economic issues to persist today, including higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among rural families.<ref name=":1" />

Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== Rural Access ===
In 2016, the UN Human Rights Office of the High Commissioner determined that Canadian rural populations face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" />

The presence of facilities that preform abortion services vary within provinces, but are more often found in urbanized city centres due to larger populations inhabiting those areas and increased provincially allocated funding. In 2012, only 15.9% of Canadian hospitals offered abortion services, with a majority of these located in urban areas.<ref name=":1" />

Quebec has shown continual and steady support for abortion services through dedicating funds to establish abortion clinics in underserved areas since the 1970s.<ref name=":4" /> This, in part, explains the high number of abortion facilities that can be found there. Quebec is also now the most equitable province in Canada, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is '''drug-induced abortion''' ('''[https://en.wikipedia.org/wiki/Medical_abortion medical abortion]''') due to its non-invasive nature and lessened recuperation time. Medicinal abortion increases access to abortion as it can be obtained through most clinics and hospitals. However, drug-induced abortion is largely unavailable in many westernized nations, and Canada was exceedingly slow to approve commonly used medications to induce abortion,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of Canadian abortions being done surgically[[GRSJ224/disparities in abortion access in Canada#cite note-:4-6|<sup>[6]</sup>]] in fewer than 100 facilities across the country.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as they typically have to travel further to obtain abortions, increasing their personal costs in the form of transportation and time expenses.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===

==== "Gate-Keeper" Complexes ====
As these procedures often spark moral and ethical debates, some medical staff have come to identify as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patients about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures. In 2012, abortion was offered by less than 300 Canadian doctors.<ref name=":6" />

==== Anti-Abortion Movement ====
There have been various societal movements which aim to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding for abortions. This can create social norms and pressures that can negatively affect an individual's perceived reproductive choices, creating a hostile environment for women who may choose to obtain an abortion.

==Statistics and Relevancy==
* 31% of Canadian women receive an abortion during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-16T21:25:16Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
Proceeding 1969, all abortion methods were considered criminal in Canada.<ref name=":1" /> Due to various efforts, Canada has become one of the only countries that does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, '''Bill C-195''' and '''Bill C-150''', were modified over the 27th and 28th parliamentary periods. This bill legalized abortion under very strict conditions, permitting women to receive the procedure only if they received three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be conducted in hospitals, and women were required to report instances of abortion to a [https://en.wikipedia.org/wiki/Therapeutic_Abortion_Committee Therapeutic Abortion Committee].<ref name=":5" /> However, as providing abortion services was optional to hospitals and physicians, social stigmas and lack of funding continued to reduce the availability of abortion procedures.

===R. v. Morgentaler (1988-89)===
The strict restrictions of the Criminal Law Amendment Act stimulated the emergence of illegal abortion clinics that provided abortions to those not legally qualified to receive them. [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler], Dr. Leslie Smoling and Dr. Robert Scott founded one such clinic in Toronto.<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>.

In 1988, Morgentaler directly challenged that the Criminal Code section pertaining to abortions in a Supreme Court trial, arguing that the regulations and restrictions imposed on people seeking abortions decreases accessibility.

On January 28, 1988, the '''R. v. Morgentaler''' trial concluded, ruling, in a majority judgement, in favour of Morgentaler. This constituted the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional".<ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada], [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson], stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> Federal jurisdiction on the issue provided limitations of provincial power on abortion service provisions and patient eligibility. Additionally, this bill allowed private and public clinics to open in Canada.<ref name=":3" />

==Modern Access Issues==
Despite its decriminalization and legalization within Canada, many issues continue to limit abortion access for individuals today.

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, varying access issues emerging among each jurisdiction, and cross-provincial travel to obtain abortion services.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref>
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of abortion services in most provinces within Canada.

In 2016, the United Nations’ [https://en.wikipedia.org/wiki/Convention_on_the_Elimination_of_All_Forms_of_Discrimination_Against_Women#Committee_on_the_Elimination_of_Discrimination_against_Women Committee on the Elimination of Discrimination against Women] stated that they remained concerned about persisting disparities in Canadian access to legal abortion services.<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow United Nations directives, by ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas,"<ref name=":2" /> many have continued to majorly fund urbanized areas. This has increased disparities in some provinces and territories, leaving many socio-economic issues to persist today, including higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among rural families.<ref name=":1" />

Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== Rural Access ===
In 2016, the UN Human Rights Office of the High Commissioner determined that Canadian rural populations face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" />

The presence of facilities that preform abortion services vary within provinces, but are more often found in urbanized city centres due to larger populations inhabiting those areas and increased provincially allocated funding. In 2012, only 15.9% of Canadian hospitals offered abortion services, with a majority of these located in urban areas.<ref name=":1" />

Quebec has shown continual and steady support for abortion services through dedicating funds to establish abortion clinics in underserved areas since the 1970s.<ref name=":4" /> This, in part, explains the high number of abortion facilities that can be found there. Quebec is also now the most equitable province in Canada, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is '''drug-induced abortion''' ('''[https://en.wikipedia.org/wiki/Medical_abortion medical abortion]''') due to its non-invasive nature and lessened recuperation time. Medicinal abortion increases access to abortion as it can be obtained through most clinics and hospitals. However, drug-induced abortion is largely unavailable in many westernized nations, and Canada was exceedingly slow to approve commonly used medications to induce abortion,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of Canadian abortions being done surgically[[GRSJ224/disparities in abortion access in Canada#cite note-:4-6|<sup>[6]</sup>]] in fewer than 100 facilities across the country.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as they typically have to travel further to obtain abortions, increasing their personal costs in the form of transportation and time expenses.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===

==== "Gate-Keeper" Complexes ====
As these procedures often spark moral and ethical debates, some medical staff have come to identify as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patients about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures. In 2012, abortion was offered by less than 300 Canadian doctors.<ref name=":6" />

==== Anti-Abortion Movement ====
Additionally, despite the decriminalization of abortion in 1988, there have been various societal movements which aim to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding for abortions. This can create social norms and pressures that can negatively affect an individual's perceived reproductive choices, creating a hostile environment for women who may choose to obtain an abortion.

==Statistics and Relevancy==
* 31% of Canadian women receive an abortion during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-16T21:23:41Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
Proceeding 1969, all abortion methods were considered criminal in Canada.<ref name=":1" /> Due to various efforts, Canada has become one of the only countries that does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, '''Bill C-195''' and '''Bill C-150''', were modified over the 27th and 28th parliamentary periods. This bill legalized abortion under very strict conditions, permitting women to receive the procedure only if they received three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be conducted in hospitals, and women were required to report instances of abortion to a [https://en.wikipedia.org/wiki/Therapeutic_Abortion_Committee Therapeutic Abortion Committee].<ref name=":5" /> However, as providing abortion services was optional to hospitals and physicians, social stigmas and lack of funding continued to reduce the availability of abortion procedures.

===R. v. Morgentaler (1988-89)===
The strict restrictions of the Criminal Law Amendment Act stimulated the emergence of illegal abortion clinics that provided abortions to those not legally qualified to receive them. [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler], Dr. Leslie Smoling and Dr. Robert Scott founded one such clinic in Toronto.<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>.

In 1988, Morgentaler directly challenged that the Criminal Code section pertaining to abortions in a Supreme Court trial, arguing that the regulations and restrictions imposed on people seeking abortions decreases accessibility.

On January 28, 1988, the '''R. v. Morgentaler''' trial concluded, ruling, in a majority judgement, in favour of Morgentaler. This constituted the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional".<ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada], [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson], stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> Federal jurisdiction on the issue provided limitations of provincial power on abortion service provisions and patient eligibility. Additionally, this bill allowed private and public clinics to open in Canada.<ref name=":3" />

==Modern Access Issues==
Despite its decriminalization and legalization within Canada, many issues continue to limit abortion access for individuals today.

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, varying access issues emerging among each jurisdiction, and cross-provincial travel to obtain abortion services.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref>
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of abortion services in most provinces within Canada.

In 2016, the United Nations’ [https://en.wikipedia.org/wiki/Convention_on_the_Elimination_of_All_Forms_of_Discrimination_Against_Women#Committee_on_the_Elimination_of_Discrimination_against_Women Committee on the Elimination of Discrimination against Women] stated that they remained concerned about persisting disparities in Canadian access to legal abortion services.<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow United Nations directives, by ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas,"<ref name=":2" /> many have continued to majorly fund urbanized areas. This has increased disparities in some provinces and territories, leaving many socio-economic issues to persist today, including higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among rural families.<ref name=":1" />

Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== Rural Access ===
In 2016, the UN Human Rights Office of the High Commissioner determined that Canadian rural populations face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" />

The presence of facilities that preform abortion services vary within provinces, but are more often found in urbanized city centres due to larger populations inhabiting those areas and increased provincially allocated funding. In 2012, only 15.9% of Canadian hospitals offered abortion services, with a majority of these located in urban areas.<ref name=":1" />

Quebec has shown continual and steady support for abortion services through dedicating funds to establish abortion clinics in underserved areas since the 1970s.<ref name=":4" /> This, in part, explains the high number of abortion facilities that can be found there. Quebec is also now the most equitable province in Canada, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is '''drug-induced abortion''' ('''[https://en.wikipedia.org/wiki/Medical_abortion medical abortion]''') due to its non-invasive nature and lessened recuperation time. Medicinal abortion increases access to abortion as it can be obtained through most clinics and hospitals. However, drug-induced abortion is largely unavailable in many westernized nations, and Canada was exceedingly slow to approve commonly used medications to induce abortion,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of Canadian abortions being done surgically[[GRSJ224/disparities in abortion access in Canada#cite note-:4-6|<sup>[6]</sup>]] in fewer than 100 facilities across the country.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as they typically have to travel further to obtain abortions, increasing their personal costs in the form of transportation and time expenses.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
As these procedures often spark moral and ethical debates, some medical staff have come to identify as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patients about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures. In 2012, abortion was offered by less than 300 Canadian doctors.<ref name=":6" />

Additionally, despite the decriminalization of abortion in 1988, there have been various societal movements which aim to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding for abortions. This can create social norms and pressures that can negatively affect an individual's perceived reproductive choices, creating a hostile environment for women who may choose to obtain an abortion.

==Statistics and Relevancy==
* 31% of Canadian women receive an abortion during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-14T17:43:04Z

AlizaMarieSmith: /* R. v. Morgentaler (1988-89) */

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code], as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler], Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions were illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the Criminal Code).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler directly challenged that the Criminal Code section pertaining to abortions can completely prevent access to individuals.

On January 28, 1988, the '''R. v. Morgentaler''' trial concluded. The Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of [https://en.wikipedia.org/wiki/Negative_liberty negative liberties], or a person's individual right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility. Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.<ref name=":3" />

==Modern Access Issues==
Despite its decriminalization and legalization within Canada, many issues continue to limit abortion access for individuals today.

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== Rural Access ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures at all, with the procedure being offered by less than 300 doctors in Canada in 2012.<ref name=":6" />

Additionally, despite the decriminalization of abortion in 1988, there have been various social efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding for abortions. This can create societal norms and pressures that can negatively affect an individual's perceived reproductive choices, creating a hostile environment for women who may choose to obtain an abortion.

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-14T17:30:27Z

AlizaMarieSmith: /* R. v. Morgentaler (1988-89) */

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code], as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler], Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions were illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the Criminal Code).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler directly challenged that the Criminal Code section that pertained to abortions can completely prevent access to individuals.

On January 28, 1988, the '''R. v. Morgentaler''' concluded. The Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of [https://en.wikipedia.org/wiki/Negative_liberty negative liberties], or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility. Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.<ref name=":3" />

==Modern Access Issues==
Despite its decriminalization and legalization within Canada, many issues continue to limit abortion access for individuals today.

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== Rural Access ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures at all, with the procedure being offered by less than 300 doctors in Canada in 2012.<ref name=":6" />

Additionally, despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-07T18:36:51Z

AlizaMarieSmith: /* R. v. Morgentaler (1988-89) */

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code], as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, [https://en.wikipedia.org/wiki/Henry_Morgentaler Dr. Henry Morgentaler], Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the Criminal Code).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler directly challenged that the Criminal Code section that pertained to abortions can completely prevent access to individuals.

On January 28, 1988, the '''R. v. Morgentaler''' concluded. The Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of [https://en.wikipedia.org/wiki/Negative_liberty negative liberties], or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility. Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.<ref name=":3" />

==Modern Access Issues==
Despite its decriminalization and legalization within Canada, many issues continue to limit abortion access for individuals today.

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== Rural Access ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures at all, with the procedure being offered by less than 300 doctors in Canada in 2012.<ref name=":6" />

Additionally, despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-07T18:28:51Z

AlizaMarieSmith: /* Rural Access */

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the Criminal Code, as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access Issues==

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== Rural Access ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures at all, with the procedure being offered by less than 300 doctors in Canada in 2012.<ref name=":6" />

Additionally, despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-07T18:28:20Z

AlizaMarieSmith: /* Modern Access Issues */

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the Criminal Code, as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access Issues==

=== Provincial/Territorial Availability ===
Though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures at all, with the procedure being offered by less than 300 doctors in Canada in 2012.<ref name=":6" />

Additionally, despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-07T18:07:08Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, E. Steven Lichtenberg, Maureen Paul, Katharine O'Connell White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the Criminal Code, as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

Additionally, though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":5" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures at all, with the procedure being offered by less than 300 doctors in Canada in 2012.<ref name=":6" />

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-07T18:03:56Z

AlizaMarieSmith: /* Modern Access Issues */

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, Steven E. Lichtenberg, Maureen Paul, Katharine White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the Criminal Code, as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

Additionally, though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services in Canada by Region (2015)<ref name=":4" />
!QU
!BC
!ONT
!PRAIRIES (AB/SK/MB)
!ATLANTIC (NB/NL/NS/PE)
!TERRIRORIES (YT/NT/NU)
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures at all, with the procedure being offered by less than 300 doctors in Canada in 2012.<ref name=":6" />

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

Thread:Talk:GRSJ224/disparities in abortion access in Canada/Abortion Services by Province/Territory Table/reply

2020-07-07T17:56:04Z

AlizaMarieSmith: Reply to Abortion Services by Province/Territory Table

Thanks so much for the feedback! I'll fix that now :)

GRSJ224/disparities in abortion access in Canada

2020-07-07T17:53:52Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, Steven E. Lichtenberg, Maureen Paul, Katharine White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the Criminal Code, as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

Additionally, though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada.<ref name=":6">Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref>

The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" /> Additionally, many doctors refuse to provide these procedures at all, with the procedure being offered by less than 300 doctors in Canada in 2012.<ref name=":6" />

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-07T17:40:33Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, Steven E. Lichtenberg, Maureen Paul, Katharine White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the Criminal Code, as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

Additionally, though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada.<ref>Norman, Wendy V., Sarah Munro, Melissa Brooks, Courtney Devane, Edith Guilbert, Regina Renner, Tamil Kendall, Judith A. Soon, Ashley Waddington, Marie-Soleil Wagner, and Sheila Dunn. "Could Implementation of Mifepristone Address Canada's Urban-Rural Abortion Access Disparity: A Mixed-Methods Implementation Study Protocol." BMJ Open, vol. 9, no. 4, 2019, pp. 1-9, doi:10.1136/bmjopen-2018-028443.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" />

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-07-07T17:35:07Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does not consider obtaining an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law Amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 '''Criminal Law Amendment Act'''] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects, greatly influencing criminal procedures in Canada. It was passed in 1968 after previous editions of the bill, namely '''Bill C-195''' and '''Bill C-150''', were modified and edited over two parliamentary periods (the [https://en.wikipedia.org/wiki/27th_Canadian_Parliament 27th Canadian Parliament] and the [https://en.wikipedia.org/wiki/28th_Canadian_Parliament 28th Canadian Parliament]). In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5">Norman, Wendy V., Edith R. Gilbert, Christopher Okpaleke, Althea S. Hayden, Steven E. Lichtenberg, Maureen Paul, Katharine White, and Heidi E. Jones. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician, vol. 62, no. 4, 2016, pp. e209-e217.</ref> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" /> This was problematic because providing abortion services was optional to hospitals and physicians at this time, which meant that social stigmas and lack of funding continued to reduce the availability of abortion procedures and thus it was often not a viable solution for many women.

While the Criminal Law Amendment Act was an important step along the process, many women still found the restrictions to be too strict, and claimed that the Canadian government was still over-imposing their legislation upon a women's reproductive sovereignty. This stimulated an influx of illegal abortion clinics, where reproductive procedures were carried out despite the acting legislation on them.

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the Criminal Code, as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

Additionally, though the determination of criminality is under federal jurisdiction, healthcare provision is decided and enacted upon by each individual province and territory.<ref name=":3" /> This leads to divergent provincial funding strategies, and thus divergent access issues emerging among each jurisdiction. Additionally, this can stimulate cross-provincial travel to obtain abortion services, especially if access is limited in one province as compared to another.

For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow the United Nations directives, such as ensuring "that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and making "affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas"<ref name=":2" />, many have continued to solely or majorly fund urbanized areas. This has thus increased disparities in some provinces and territories, leaving many socio-economic issues to still persist today. These issues include higher rates of teenage pregnancies carried to full-term, lower rates of women pursuing secondary or post-secondary education, and higher rates of impoverishment among families.<ref name=":1" />
=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" />

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically,<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> in fewer than 100 facilities across Canada. The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

=== Social Aspects ===
Another prominent barrier to abortion is the social impacts of the procedure itself. As these procedures often spark moral and ethical debates, some physicians or doctors have come to identify themselves as "gate-keepers"<ref name=":3" /> who feel as though they are qualified to determine if and when an individual should have access to full reproductive care. There are many reports available of doctors who have deceived or coerced their patients into carrying out a full-term pregnancy by misinforming the patient about their eligibility to obtain the procedure, its effects, its availability, or the timing of it.<ref name=":3" />

==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance from abortion services increases, the likelihood that an individual is willing/able to get the procedure decreases.<ref name=":1" />
* As distance from abortion services increases, the more likely an individual is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224

2020-06-05T18:36:31Z

AlizaMarieSmith:

This '''Wikispace''' is a peer-produced shared resource that will evolve as students post content relating to GRSJ224. You are responsible for creating dynamic and informative wiki pages. As you add and update information throughout the semester, originality, resourcefulness, and creativity is encouraged. The wiki will be sustained for successive semesters so that the work you contribute will be available to future students.

=== ASSIGNMENT INFORMATION ===

To download and view full details of the assignment, click [https://canvas.ubc.ca/files/4963443/download?download_frd=1 here].

{| class="wikitable"
|-
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_preparation.gif ||
* Read: [https://library.educause.edu/~/media/files/library/2005/7/eli7004-pdf.pdf 7 Things you should know about Wikis]
* Choose a term from the table of contents
* Confirm your selection of topic with your instructor by the '''SECOND WEEK OF CLASSES'''
* Set up your wiki page.
* Instructions on how to use the Visual Editor on UBC Wikis: [https://wiki.ubc.ca/Help:Visual_Editor Help:Visual Editor]
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_finalizing.png ||
* Continue to work towards improving and finalizing your Wiki.
* Consider the wiki as a whole and the usefulness of adding images and links.
* Check your Talk page to see if your peers provided you with any useful feedback
* Ensure your Wiki is properly cited
* Proofread your Wiki

|-
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_research.gif ||
* Gather resources in relevance of your discoveries to class materials.
* Familiarize yourself with the wiki-authoring tools of [[GRSJ224/wikibasics|Wiki Basics]]
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_submit.gif ||
* Submit "Wikipedia Report" to your instructor in Connect

|-
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_drafting.gif ||
* Read: [http://en.wikipedia.org/wiki/Wikipedia:Writing_better_articles Wikipedia's guide to Writing Better Articles]
* Write content relevant to class material.
* Tailor your page to your audience.
* Check out your peers’ draft Wikis below and provide feedback using the [http://wiki.ubc.ca/Help:Talk_pages Talk pages]
* The intellectual rules of property DO apply: provide [http://en.wikipedia.org/wiki/Hyperlink links], not [http://en.wikipedia.org/wiki/Plagiarism plagiarisms].
|}

'''Helpful Links:'''
* [https://admin.video.ubc.ca/index.php/kwidget/wid/0_d2u58vo0/uiconf_id/11170637/entry_id/0_kmj3r79h Embed an Image]
* [https://wiki.ubc.ca/GRSJ224/racialdiscrimination Embed a Video]
* [https://admin.video.ubc.ca/index.php/kwidget/wid/0_d478y7sn/uiconf_id/11170637/entry_id/0_sg3scx28 Link to an external website]

=== TABLE OF CONTENTS ===
{| width="100%" class="wikitable" style="background:aliceblue; border-style:solid; border-width:1px; border-color: #AEDCF6;" border="1" cellspacing="5" cellpadding="2"
|-
| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Democracy</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Neoliberalism</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Post-coloniality</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Immigration</span></h2>====
*
*

|-
| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Discrimination</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Masculinity</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Medicalization</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">LGBT Families</span></h2>
*
*

|-
| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Reproduction</span></h2>[https://wiki.ubc.ca/GRSJ224/disparities_in_abortion_access_in_Canada Disparities in Abortion Access in Canada]
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Feminism</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Rituals</span></h2>====
*
*

|}

===ARCHIVE===
Here is an archive of the Wiki pages created by previous students: [[GRSJ224/archive|Archive of Wiki pages]]

GRSJ224

2020-06-05T18:33:46Z

AlizaMarieSmith:

This '''Wikispace''' is a peer-produced shared resource that will evolve as students post content relating to GRSJ224. You are responsible for creating dynamic and informative wiki pages. As you add and update information throughout the semester, originality, resourcefulness, and creativity is encouraged. The wiki will be sustained for successive semesters so that the work you contribute will be available to future students.

=== ASSIGNMENT INFORMATION ===

To download and view full details of the assignment, click [https://canvas.ubc.ca/files/4963443/download?download_frd=1 here].

{| class="wikitable"
|-
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_preparation.gif ||
* Read: [https://library.educause.edu/~/media/files/library/2005/7/eli7004-pdf.pdf 7 Things you should know about Wikis]
* Choose a term from the table of contents
* Confirm your selection of topic with your instructor by the '''SECOND WEEK OF CLASSES'''
* Set up your wiki page.
* Instructions on how to use the Visual Editor on UBC Wikis: [https://wiki.ubc.ca/Help:Visual_Editor Help:Visual Editor]
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_finalizing.png ||
* Continue to work towards improving and finalizing your Wiki.
* Consider the wiki as a whole and the usefulness of adding images and links.
* Check your Talk page to see if your peers provided you with any useful feedback
* Ensure your Wiki is properly cited
* Proofread your Wiki

|-
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_research.gif ||
* Gather resources in relevance of your discoveries to class materials.
* Familiarize yourself with the wiki-authoring tools of [[GRSJ224/wikibasics|Wiki Basics]]
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_submit.gif ||
* Submit "Wikipedia Report" to your instructor in Connect

|-
| https://connect.ubc.ca/bbcswebdav/courses/WS.UBC.FL.GRSJ.224.COURSECONTENT.2014S/Files%20for%20UBC%20Wiki/wiki_drafting.gif ||
* Read: [http://en.wikipedia.org/wiki/Wikipedia:Writing_better_articles Wikipedia's guide to Writing Better Articles]
* Write content relevant to class material.
* Tailor your page to your audience.
* Check out your peers’ draft Wikis below and provide feedback using the [http://wiki.ubc.ca/Help:Talk_pages Talk pages]
* The intellectual rules of property DO apply: provide [http://en.wikipedia.org/wiki/Hyperlink links], not [http://en.wikipedia.org/wiki/Plagiarism plagiarisms].
|}

'''Helpful Links:'''
* [https://admin.video.ubc.ca/index.php/kwidget/wid/0_d2u58vo0/uiconf_id/11170637/entry_id/0_kmj3r79h Embed an Image]
* [https://wiki.ubc.ca/GRSJ224/racialdiscrimination Embed a Video]
* [https://admin.video.ubc.ca/index.php/kwidget/wid/0_d478y7sn/uiconf_id/11170637/entry_id/0_sg3scx28 Link to an external website]

=== TABLE OF CONTENTS ===
{| width="100%" class="wikitable" style="background:aliceblue; border-style:solid; border-width:1px; border-color: #AEDCF6;" border="1" cellspacing="5" cellpadding="2"
|-
| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Democracy</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Neoliberalism</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Post-coloniality</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Immigration</span></h2>====
*
*

|-
| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Discrimination</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Masculinity</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Medicalization</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">LGBT Families</span></h2>
*
*

|-
| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Reproduction</span></h2>[[disparities in abortion access in Canada]]
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Feminism</span></h2>====
*
*

| valign="top" style="padding: 0; margin:0;width:25%" |
====<h2 style="margin:0; background:#2B3087; font-size:14px; font-weight:bold; border:1px solid #a3b0bf; text-align:left; color:#000; padding:0.2em 0.4em;"><span style="color:white">Rituals</span></h2>====
*
*

|}

===ARCHIVE===
Here is an archive of the Wiki pages created by previous students: [[GRSJ224/archive|Archive of Wiki pages]]

GRSJ224/disparities in abortion access in Canada

2020-06-05T18:29:16Z

AlizaMarieSmith: /* Modern Access Issues */

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5" /> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" />

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the Criminal Code, as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" /> Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies, and thus divergent access issues emerging.

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases, the less likely one is to get the procedure.<ref name=":1" />
* As distance to obtain an abortion increases, the more likely one is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T18:06:40Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5" /> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" />

===R. v. Morgentaler (1988-89)===
Despite its legalization, many people opposed the extreme legal and medical requirements that were included in the Criminal Code, as they greatly reduced the spaces available where was able to obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" /> Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies, and thus divergent access issues emerging.

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases, the less likely one is to get the procedure.<ref name=":1" />
* As distance to obtain an abortion increases, the more likely one is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T18:05:00Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion under very strict conditions. This act permitted women to receive an abortion, with the requirements that women receive three physicians' opinions that the pregnancy was a threat to her life or overall health.<ref name=":5" /> Abortions were also only permitted to be carried out in hospitals, and women were required to report their instances of abortion to the Therapeutic Abortion Survey.<ref name=":5" />

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

Additionally, this bill revoked the previous rule that abortions were restricted to being carried out in hospitals, allowing private and public clinics to open in Canada.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" /> Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies, and thus divergent access issues emerging.

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases, the less likely one is to get the procedure.<ref name=":1" />
* As distance to obtain an abortion increases, the more likely one is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T17:52:39Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion, ********.

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" /> Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies, and thus divergent access issues emerging.

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases, the less likely one is to get the procedure.<ref name=":1" />
* As distance to obtain an abortion increases, the more likely one is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T17:48:57Z

AlizaMarieSmith: /* Statistics and Relevancy */

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion, ********.

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" /> Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies, and thus divergent access issues emerging.

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases, the less likely one is to get the procedure.<ref name=":1" />
* As distance to obtain an abortion increases, the more likely one is to be younger and less privileged.<ref name=":1" />
* Only 15.9% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T17:47:56Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion, ********.

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" /> Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies, and thus divergent access issues emerging.

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases, the less likely one is to get the procedure.<ref name=":1" />
* As distance to obtain an abortion increases, the more likely one is to be younger and less privileged.<ref name=":1" />
* Only 17.8% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T17:46:48Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion, ********.

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" /> Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies, and thus divergent access issues emerging.

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

====Travel and Procedure Costs====
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases the less likely one is to get the procedure, and the more likely one is to be younger and less privileged.<ref name=":1" />
* Only 17.8% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T17:42:06Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion, ********.

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" /> Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies, and thus divergent access issues emerging.

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" /> For those residing in rural settings, obtaining timely abortions can be difficult because such travel needs to be scheduled and completed. Because of this, studies have indicated that women travelling from rural areas have higher rates of late-gestational ages, signifying that medicinal abortion is largely unavailable to them.<ref name=":5" />

===Travel and Procedure Costs===
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

===First Nations and Métis Women===
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases the less likely one is to get the procedure, and the more likely one is to be younger and less privileged.<ref name=":1" />
* Only 17.8% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T17:33:00Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref name=":3">Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion, ********.

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref name=":1" />

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of provincially allocated funds. For example, only 15.9% of Canadian hospitals offer abortion services, with a majority of these being located in urban areas.<ref name=":1" /> Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies, and thus divergent access issues emerging.

In Quebec there has been continual and steady support for abortion services and dedicated funds to establish abortion clinics in underserved areas since the 1970s. This, in part, explains the high number of abortion facilities that can be found there. The province is also now the most equitable in the country, with half of these abortion-providing facilities being located in rural areas.<ref name=":4" /> As abortion access varies so widely across provinces and territories (such as no facilities being located in Prince Edward Island) there is an abundance of provincial/territorial border crossings in order to access these services.<ref name=":1" />

===Travel and Procedure Costs===
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

===First Nations and Métis Women===
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases the less likely one is to get the procedure, and the more likely one is to be younger and less privileged.<ref name=":1" />
* Only 17.8% of general hospitals in Canada offer abortion services.<ref name=":3" />
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":1" />
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T17:03:34Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref>Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion, ********.

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.<ref>Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abrotion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi.org/10.1016/j.wsif.2013.02.001.</ref>

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of federally allocated funds. Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies,

(The province is also a leader in equitable access; half of its abortion facilities are in rural areas, and there’s at least one facility in every health region.) British Columbia has 16 facilities located in hospitals, community health centres and doctors’ offices; half of these are in rural areas. There are 16 facilities in Ontario, 8 among Alberta, Saskatchewan and Manitoba, 4 in Atlantic Canada and 4 in the territories. Of these facilities, only those in the territories and one in Atlantic Canada are located in rural areas. There is no facility in Prince Edward Island. One-quarter (17/67) of BC rural hospitals offer abortion service.

===Travel and Procedure Costs===
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

===First Nations and Métis Women===
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases the less likely one is to get the procedure, and the more likely one is to be younger and less privileged.<ref name=":3" />
* Only 17.8% of general hospitals in Canada offer abortion services.<ref>Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (March 2010): 17-34. doi:http://dx.doi.org.ezproxy.library.ubc.ca/10.1007/s10728-008-0101-0.</ref>
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":3">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Womens Stud International Forum, vol. 38 (May 2013): 52–62. doi: 10.1016/j.wsif.2013.02.001. </ref>
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T17:02:13Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref>Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion, ********.

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada. Further, there are legal and extra-legal obstacles that can limit access to abortion, such as differences in institutional policies, procedure costs, locations of abortion services, imposed gestational limits, and the presence of pro-life harassment.

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of federally allocated funds. Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies,

(The province is also a leader in equitable access; half of its abortion facilities are in rural areas, and there’s at least one facility in every health region.) British Columbia has 16 facilities located in hospitals, community health centres and doctors’ offices; half of these are in rural areas. There are 16 facilities in Ontario, 8 among Alberta, Saskatchewan and Manitoba, 4 in Atlantic Canada and 4 in the territories. Of these facilities, only those in the territories and one in Atlantic Canada are located in rural areas. There is no facility in Prince Edward Island. One-quarter (17/67) of BC rural hospitals offer abortion service.

===Travel and Procedure Costs===
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

===First Nations and Métis Women===
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases the less likely one is to get the procedure, and the more likely one is to be younger and less privileged.<ref name=":3" />
* Only 17.8% of general hospitals in Canada offer abortion services.<ref>Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (March 2010): 17-34. doi:http://dx.doi.org.ezproxy.library.ubc.ca/10.1007/s10728-008-0101-0.</ref>
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":3">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Womens Stud International Forum, vol. 38 (May 2013): 52–62. doi: 10.1016/j.wsif.2013.02.001. </ref>
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T16:56:50Z

AlizaMarieSmith:

==Overview==
Currently, '''pregnancy termination''' ('''induced abortion''') is legal in all provinces within Canada at all stages of pregnancy.<ref>Legislative Services Branch. “Consolidated Federal Laws of Canada, Criminal Code.” Justice Laws Website, Government of Canada, 14 May 2020, laws-lois.justice.gc.ca/eng/acts/C-46/section-287-20030101.html.</ref> Legalized in Canada since 1969 under the [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act], then further decriminalized in 1988 by the Canadian Supreme Court ([https://en.wikipedia.org/wiki/R_v_Morgentaler R. v Morgentaler]), safe, and open access to abortion clinics, contraceptive methods, and STI testing has continuously been made more available.<ref>Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (03, 2010): 17-34. doi: doi.org/10.1007/s10728-008-0101-0.</ref> However, there still stands manny legal and social barriers to abortion, thus creating observable inequalities in abortion access among Canadian provinces. As a result, many people often have to travel to access such abortion services, which thus increases socioeconomic, spatial, and cultural disparities with regards to abortion access.<ref name=":1">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Women’s Studies International Forum, vol. 38 (May 2013): 52-62. doi: doi.org/10.1016/j.wsif.2013.02.001.</ref>
==Legalization and Decriminalization Processes==
In the years proceeding 1969, all abortion methods were considered criminal.<ref name=":1" /> Due to various efforts in different mediums and fronts since this time, Canada has become one of the only countries who does consider having an abortion as criminal behaviour.<ref name=":1" />
===Criminal Law amendment Act (1968-69)===
The [https://en.wikipedia.org/wiki/Criminal_Law_Amendment_Act,_1968%E2%80%9369 Criminal Law Amendment Act] was a bill that altered the Canadian [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code] in many aspects and influenced criminal procedures in Canada. In regards to social justice, the bill decriminalized homosexuality and legalized abortion, ********.

===R. v. Morgentaler (1988-89)===
Despite its legalization, previous to 1988 there were many legal and medical requirements included in the Criminal Code that greatly reduced the spaces available where one could obtain such a procedure. Because of this, Dr. Henry Morgentaler, Dr. Leslie Smoling and Dr. Robert Scott founded a clinic in Toronto where abortions would be illegally preformed on women who did not have a certificate of approval from a therapeutic abortion committee or an approved hospital (as was required in the [https://en.wikipedia.org/wiki/Criminal_Code_(Canada) Criminal Code]).<ref name=":0">“R. v. Morgentaler.” Supreme Court Judgments, Supreme Court of Canada, 3 Dec. 2012, scc-csc.lexum.com/scc-csc/scc-csc/en/item/288/index.do.</ref>. These doctors believed that the regulations and restriction that were imposed on people who were seeking abortions made accessibility difficult for most, and impossible for many. Morgentaler challenged that the Criminal Code section that pertained to abortions can completely prevent access.

On January 28, 1988, the Supreme Court ruled, in a majority judgement, in favour of Morgentaler, thus constituting the previous section of the Criminal Code "arbitrary", "unfair" and "unconstitutional". <ref name=":0" /> The [https://en.wikipedia.org/wiki/Chief_Justice_of_Canada Chief Justice of Canada] [https://en.wikipedia.org/wiki/Brian_Dickson Brian Dickson] stated: "Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of security of the person."<ref name=":0" /> This argument highlights the notion of "negative freedoms", or a person's right to have freedom from state interference. Federal jurisdiction on the issue from the Supreme Court thus altered the Criminal Code further and provided limitations of provincial power on abortion service provisions and patient eligibility.

==Modern Access Issues==
Despite the decriminalization of abortion in 1988, there have been various efforts to limit abortion access in Canada. For example, the [https://en.wikipedia.org/wiki/Abortion_in_Canada#Anti-abortion_movement anti-abortion movement] in Canada protests open access to abortions and provincial health care funding of abortions.

In 2016, the United Nations Human Rights Office of the High Commissioner stated in a Canadian periodic report that "[the Committee on the Elimination of Discrimination against Women] remains concerned [...] at disparities in access to [legal abortion] services and to affordable contraceptives".<ref name=":2">United Nations Human Rights Office of the High Commissioner. Committee on the Elimination of Discrimination against Women. Concluding observations on the combined eighth and ninth periodic reports of Canada. CEDAW/C/CAN/CO/8-9. Heidelberg (Germany): ETO Consortium Secretariat; 2016:13 Available: www.westcoastleaf.org/wp-content/uploads/2016/11/2016-Canada-CEDAW-Concluding-Obs.pdf.</ref> Though some provinces have attempted to follow directives, such as "[e]nsur[ing] that invocation of conscientious objection by physicians does not impede women’s access to legal abortion services", and "[m]ak[ing] affordable contraceptives accessible and available to all women and girls, in particular those living in poverty and/or in remote areas", many have continued to majorly fund urbanized areas.<ref name=":2" /> This has thus increased disparities in some provinces and territories, leaving many issues to still persist today. For example, 46 of Canada's 94 facilities that provide abortions are located in Quebec, comparable to the second highest: British Columbia and Ontario's 16.<ref name=":4" />
{| class="wikitable"
|+Abortion Services by Province/Territory (2015)<ref name=":4" />
!QU
!BC
!ONT
!AB/SK/MN
!NB/NL/NS/PE
!YT/NT/NU
|-
|46
|16
|16
|8
|4
|4
|}
This suggests that there is a lack of needed abortion services in most provinces within Canada.

=== '''Rural Access''' ===
The presence of facilities that preform abortion services vary within provinces, and can often be attributed to urbanized city centres due to the higher populations that inhabit those areas and higher amounts of federally allocated funds. Additionally, within each of the 13 provinces and territories, the provinces have the right to choose the health services provided and policies enacted in each jurisdiction.<ref name=":5">Norman, Wendy V., et al. "Abortion Health Services in Canada: Results of a 2012 National Survey." Canadian Family Physician Medecin De Famille Canadien, vol. 62, no. 4, 2016, pp. e209-e217.</ref> This leads to divergent provincial funding strategies,

(The province is also a leader in equitable access; half of its abortion facilities are in rural areas, and there’s at least one facility in every health region.) British Columbia has 16 facilities located in hospitals, community health centres and doctors’ offices; half of these are in rural areas. There are 16 facilities in Ontario, 8 among Alberta, Saskatchewan and Manitoba, 4 in Atlantic Canada and 4 in the territories. Of these facilities, only those in the territories and one in Atlantic Canada are located in rural areas. There is no facility in Prince Edward Island. One-quarter (17/67) of BC rural hospitals offer abortion service.

===Travel and Procedure Costs===
The UN Human Rights Office of the High Commissioner determined that rural populations and disadvantaged members of society (such as racial minorities) both face a larger proportion of challenges when it comes to obtaining abortion procedures.<ref name=":2" /> For example, one has to acknowledge that the preferred method for pregnancy termination in early gestational periods (such as within the first trimester of pregnancy) is drug-induced abortion due to its non-invasive nature and lessened recuperation time. Additionally, since not all hospitals or clinics are prepared to perform surgical abortion procedures, medicinal abortion increases access to abortion as it as simple to obtain as any other prescription drug. However, drug-induced abortion is largely unavailable in many westernized nations (such as the United States), and Canada was exceedingly slow to approve commonly used medications to induce abortion, such as mifepristone,<ref>Berer, Marge. “Abortion Law and Policy Around the World: In Search of Decriminalization.” Health and Human Rights Journal, vol. 19, no. 1 (June 2017): 13-27. JSTOR, doi: https://www.jstor.org/stable/10.2307/90007912. </ref> leading to 96% of abortions in Canada being done surgically.<ref name=":4">Vogel, Lauren. “Abortion access grim in English Canada.” Canadian Medical Association Journal, vol. 187, no. 1 (2015): 17. doi:10.1503/cmaj.109-4947.</ref> The recuperation time of a surgical abortion is approximately two days, during which a woman can experience extreme cramps and vaginal bleeding. This loss of potential income spent recovering can have very uneven impacts for those who receive a lower economic income, further creating a barrier to those needing or wanting such a procedure. Furthermore, both surgical and medicinal abortions require multiple visits to the doctor, which similarly increase the personal costs of time and money that all women would have to sacrifice to obtain an abortion. However, this disproportionately impacts women from rural areas of Canada as typically have to travel further to obtain such procedures, signifying increased personal costs in the form of transportation expenses and time spent during the travel.<ref>Foster, Angel M., et al. “If I ever did have a daughter, I wouldn't raise her in New Brunswick:” Exploring Women's Experiences Obtaining Abortion Care Before and After Policy Reform.” Contraception, vol. 95 (2017): 477-484. doi:10.1016/j.contraception.2017.02.016. </ref>

===First Nations and Métis Women===
==Statistics and Relevancy==
* Abortion is experienced by 31% of Canadian women during their lifespan.<ref name=":5" />
* As distance to obtain an abortion increases the less likely one is to get the procedure, and the more likely one is to be younger and less privileged.<ref name=":3" />
* Only 17.8% of general hospitals in Canada offer abortion services.<ref>Kaposy, Chris. "Improving Abortion Access in Canada." Health Care Analysis, no. 1 (March 2010): 17-34. doi:http://dx.doi.org.ezproxy.library.ubc.ca/10.1007/s10728-008-0101-0.</ref>
* 18.1% of Canadian women travel more than 100 km to access abortion.<ref name=":3">Sethna, Christabelle, and Marion Doull. “Spatial Disparities and Travel to Freestanding Abortion Clinics in Canada.” Womens Stud International Forum, vol. 38 (May 2013): 52–62. doi: 10.1016/j.wsif.2013.02.001. </ref>
<references />

GRSJ224/disparities in abortion access in Canada

2020-06-05T16:53:02Z

AlizaMarieSmith:

GRSJ224/disparities in abortion access in Canada

2020-06-05T05:13:21Z

AlizaMarieSmith: /* Rural Access */

GRSJ224/disparities in abortion access in Canada

2020-06-05T05:10:05Z

AlizaMarieSmith:

GRSJ224/disparities in abortion access in Canada

2020-06-05T04:40:07Z

AlizaMarieSmith:

GRSJ224/disparities in abortion access in Canada

2020-06-05T04:39:13Z

AlizaMarieSmith: /* Rural Access */

GRSJ224/disparities in abortion access in Canada

2020-06-05T04:36:11Z

AlizaMarieSmith:

GRSJ224/disparities in abortion access in Canada

2020-06-05T04:34:11Z

AlizaMarieSmith: /* Statistics and Relevancy */

GRSJ224/disparities in abortion access in Canada

2020-06-05T04:32:32Z

AlizaMarieSmith:

GRSJ224/disparities in abortion access in Canada

2020-06-05T04:25:44Z

AlizaMarieSmith: /* Criminal Law amendment Act (1968-69) */