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USask med school ends placement at pregnancy centre after students raise concerns

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Geographic barrier to abortion exists in Saskatchewan: experts
WATCH: Depending on where you live in the province, options for abortion differ. Anna McMillan explains what access looks like and how advocates say it could be improved – May 21, 2021

The University of Saskatchewan college of medicine will no longer offer a placement at the Saskatoon Pregnancy Options Centre (SPOC) after a group of students raised concerns almost a year ago.

Pro-choice advocates refer to SPOC as a crisis pregnancy centre — a type of clinic that advocates say are not transparent about their beliefs around abortion and that spread false medical information.

On their About Us page, SPOC says they do not use labels such as pro-life, anti-abortion or pro-choice.

“We are pro-woman, pro-family and pro-information,” the page states.

“We hope that with our support and resources — personal counselling, prenatal education, parenting classes, community service referrals and more — our clients will choose the gift of life.”

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In a statement to Global News, SPOC interim executive director Anne-Marie Hughes said SPOC does not “make choices for women.”

SPOC states on their website that while they do not help arrange abortions or offer referrals, they “do not obstruct our clients’ decision to have one.”

Joyce Arthur with Abortion Rights Coalition of Canada said the problem with crisis pregnancy centres is they appear to be unbiased in the support they offer clients.

“But in reality, a vast majority of these centres are religious in nature (and) call themselves Christian ministries but often not in an obvious way. The one thing that they have in common, and our group has studied this, these groups, is that they misinform people on abortion in particular but also contraception and sexual health issues.”

Arthur explained it’s hard to tell what CPCs beliefs are just by looking at their websites.

“I think what happens as well is many funders and other secular agencies or governments even, they don’t recognize these places being advertised. So they might get funding or a grant or get recognized in some way, and people aren’t aware that they’re anti-choice.”

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Frédérique Chabot, a spokesperson with Action Canada for Sexual Health and Rights, said some CPCs are more “outright” and “forceful” in terms of tactics they use.

“Some of them are sneaky and couch the information they share in language that resembles human rights language, feminist language, women’s health language,” Chabot said.

“There’s a variety of tactics, but at the end of the day the purpose is that people make a specific decision when it comes to unplanned pregnancies that they’re carrying.”

Chabot said the number of crisis pregnancy centres in Canada “vastly outnumber legitimate” sexual health and reproductive health centres.

ARCC conducted a study on crisis pregnancy centres in 2016 and is in the process of updating that study now.

That 2016 study found that almost half of CPCs in Canada provide false medical information about a debunked theory known as post-abortion stress.

SPOC lists symptoms of this on their website, from general sadness to experiencing disturbing thoughts about babies and abortion, alcohol and drug abuse and having thoughts of suicide.

A 2008 task force on mental health and abortion completed by the American Psychological Association found that the majority of studies on the topic had methodological problems — often severe ones.

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The report said research found terminating a pregnancy does not increase a woman’s risk for depression, anxiety or post-traumatic stress disorder.

Arthur added that when going over a woman’s options, CPC websites push adoption over abortion and make it seem easy and pain-free. CPCs also list risks for both abortion and contraception, and though some may be accurate, Arthur explained they are exaggerated.

“They just create this state of atmosphere that makes abortion seem scary and dangerous while still claiming to be here for you or, ‘I’m going to help you with all your options,’” Arthur said.

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Chabot said some CPCs will share information in a more subtle way “that is maybe more manipulative.”

“We don’t know who’s doing what because there’s no regulation of those centres and there’s no accountability around how this information is shared,” Chabot said.

“The goal is the same, which is to discourage people from having an abortion.”

Chabot added some CPCs offer services such as ultrasounds to appear more legitimate.

“Or in the case of what’s happening in Saskatchewan, there would be medical students on site that adds a certain weight (and) adds a certain legitimacy to the kind of counsel that is being offered in those centres.”

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Students bring up their concerns to medical school

The Gender Engagement in Medicine (GEM) student group at USask brought their concerns forward about medical students being offered a placement at SPOC in a second-year course.

Afsoun Amiraslany, the co-president of GEM, said the group specifically focuses on addressing inequities in health care and works to provide a more intersectional perspective of health care, in particular how it relates to gender and sexuality.

Amiraslany, who just finished her second year at the medical school, explained that second-year students have a module to complete as part of their medicine and society course.

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In the course, students volunteer with community organizations to see how they may improve the social determinants of health care.

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Executive members of GEM noticed that SPOC was one of the options for placements and reviewed the centre to gain more information about the potential placement option.

Amiraslany brought up a number of concerns they had about the centre, including the mention of “post-abortion stress,” on SPOCs website.

“Finding this out, we were very concerned as a student group that focuses on reproductive rights (and) women rights,” Amiraslany told Global News.

In September, GEM wrote a letter to the course director and module director expressing their concerns.

“We showed them our research and we said we find it very concerning that this is an organization that our college is affiliated with and partners with for a student’s formal medical education,” Amiraslany said.

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The GEM executive was then invited to a meeting on Oct. 28 with faculty and an ethicist chosen by the school.

GEM received a response on June 28 from the school stating their decision to keep SPOC as a placement option, a decision that disappointed the group.

“Pushing aside the whole controversial topic of abortion and the values and morals and everything that comes behind that, we should be concerned as a college, as a student body, when an organization that we are putting students into for formal education is spreading medically inaccurate information,” Amiraslany said.

Amiraslany believes if the organization in question was dealing with any other medical condition or procedure, such as diabetes or cancer, and did not offer patients a treatment option or included medically inaccurate information, the college would not partner with them.

After GEM received the news that SPOC would continue to be a placement option, another executive member expressed his concerns on Twitter.

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After that tweet went out, Amiraslany said GEM has heard from students who had placements at SPOC. The students said they witnessed “strategies used to outright manipulate women into not going through with medically terminating their pregnancies.”

Arthur said she was shocked to hear about the USask incident and started worrying that other programs such as midwifery, nursing and social work may have students doing placements as CPCs as well.

“It goes back again to that problem about even reputable universities and other agencies may not recognize that these places are anti-choice. They appear to be secular, legitimate agencies,” Arthur said.

Global News reached out to other medical schools in the country. All responded that they did not have placement options at a crisis pregnancy centre.

Chabot said it was concerning that future doctors and health-care providers “are not being taught how to provide full spectrum reproductive health care.”

“They’re being taught anti-choice rhetoric and counselling of patients that reinforce stigma around abortion,” Chabot said.

Chabot added these placements have an impact on students during their formative years as health-care providers.

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“Being in those spaces, steeped in that kind of language, in that kind of rhetoric, has to be taken seriously,” Chabot said.

USask removes option after review

After GEM raised concerns about the medical school’s decision on social media, the school has decided the placement will no longer be an option for students.

In a previous letter to the GEM executive, academic director Greg Malin and Associate Dean Meredith McKague outlined a number of plans moving forward to gather more information.

This included a meeting with the Saskatoon Sexual Health clinic leadership who have expressed concerns, discussions with faculty who have contacted the school with concerns, and collecting more information from students.

On July 20, faculty members including Malin and McKague informed the GEM executive that SPOC would no longer be included as a placement site option.

“This was a decision that required a variety of perspectives. We are grateful to your group and to students, faculty, and organizations that provided input to this decision,” the letter stated.

An emailed statement from Preston Smith, dean of the college of medicine, stated that the college reviews its partnerships for the Year 2 Community and Workplace-Centred Learning Experiences on a regular basis “to ensure our students are able to achieve their learning objectives.”

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“When concerns are raised, like in the case of the Saskatoon Pregnancy Options Centre, a more in-depth review is completed,” the statement added.

Amiraslany said their group welcomes the news.

“It’s been a very long process, about a year or so, to see that what we wanted to set out to achieve actually worked out in the end,” Amiraslany told Global News.

Hughes said they were disappointed that medical students would no longer have the option to complete a placement with SPOC.

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“The practicum was a great opportunity for students to observe how we work with clients from diverse backgrounds as we work with many Indigenous and new immigrant women in need. We view it as a loss for all involved and the wider community,” the statement added.

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SPOC added since they are not a medical office they do not arrange for medical procedures such as ultrasounds, lab work or abortions and said clients are informed of this early on.

“A woman’s autonomy and self direction are the most important parts of any meeting.  Some women come to our centre stressed after an abortion because they find no one around them is comfortable hearing about their grief.  We offer a safe, non-judgemental place to talk about their experience,” the statement added.

Hughes said she was unavailable for an interview.

— with files from Amanda Connolly 

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