Each new federal election cycle in Canada seems to bring with it the perennial question of what parties say they would do to protect or improve abortion access, and the current election is no different.
Liberal Leader Justin Trudeau on Wednesday laid out a series of promises in the party platform focused on improving abortion access, including regulating access under the Canada Health Act.
His promises come 18 months into the COVID-19 pandemic, which brought with it early panic at pharmacies about birth control pill shortages and pressure on provinces to treat abortion as an essential service amid rampant cutbacks on elective surgeries and procedures.
But since abortion is already allowed — though often inaccessible — at any point in a pregnancy in Canada, what exactly are the Liberals proposing in their vow to “establish regulations under the Canada Health Act governing accessibility for sexual and reproductive health services so there is no question, that no matter where someone lives, that they have access to publicly available sexual and reproductive health services”?
Here’s what you need to know.
Abortion is already allowed in Canada
As it stands right now, abortion access in Canada is a patchwork.
While the Supreme Court of Canada struck down the federal law criminalizing abortion in 1988 as unconstitutional, no government has put in place legislation to replace it.
That means there is no law about abortion in Canada: abortion is legal at all stages of a pregnancy but it is effectively left up to the provinces to decide where people can access abortion and what services are exempt from being publicly funded through provincial health-care plans.
Frederique Chabot, health promotion director with Action Canada for Sexual Health and Rights, noted that while abortion is legal, many Canadians do not have access to it.
“The Canada Health Act already ensures that health-care services, including abortion, should be accessible to all people in Canada,” she said. “This is already the law in Canada when it comes to health care and can be enforced to ensure that all people can access the services that they need.
“We welcome that all parties, or the majority of parties at this point — we’re still looking at how the conversation unfolds — are moving beyond being pro-choice or not and taking a deeper dive in terms of what access or what barriers to access have looked like across the country.”
Trudeau did not clearly answer when asked why the platform proposed adding regulations to the Canada Health Act, given that the government has already used the legislation to hold back provincial funding over limited abortion access.
“I think it’s clear to the vast majority of Canadians that we need to be a country that stands unequivocally for women’s rights, for a woman’s right to choose, and that’s not a theoretical right,” Trudeau said on Wednesday morning.
“That’s why we are continuing to stand strong in our defence of women’s rights and will continue to ensure that people have access to the reproductive health and services that they need right across the country.”
But campaign sources told Global News the goal is to create clear definitions and standards of what constitutes equitable access — though there’s no set goal yet for what those should be.
Crafting those standards would require input from experts, the campaign sources said, which could effectively create more teeth for the legislation in the event provinces fail to meet the requirements.
The proposal is not aimed at setting any new legislative parameters on abortion itself, or legalizing what is an already legal medical service.
Access to abortion remains a challenge: experts
Twice so far, the Liberal government in its two recent mandates held back money from New Brunswick over its refusal to fund the full range of abortion services in its jurisdiction in 2017 and 2021.
In both cases, the federal government held back roughly $140,000 in health funding after New Brunswick refused to fund abortions performed in Clinic 554, a sexual health clinic.
Instead, the province only funds abortions in two hospitals in urban centres, and has pushed back on warnings from the federal government that the limited access is insufficient under the act.
Sexual health advocates have long warned that multiple provinces fall short in meeting the requirement under the act to make sure that insured services like abortion are accessible.
Global News has also documented how dozens of Canadian women are forced to travel to other provinces or the U.S. for abortions each year out of a lack of access to the time-sensitive service at home.
Chabot noted barriers to abortion have been “persistent” in Canada for decades, particularly for those who live in rural areas or don’t have the money to travel to larger urban centres for abortion.
“We have seen problems that have been longstanding and that we need to see addressed in all of their complexities,” she said, noting lack of access to birth control remains a challenge for many.
The federal NDP platform also includes proposals to improve access to abortion.
The NDP have proposed funding prescription contraceptives through their national pharmacare plan and vowed to use the Canada Health Act’s existing powers to “make sure that the provinces make medical and surgical abortion available in all parts of the country, without barriers.”
The Conservative platform makes one mention to abortion when it states: “A Conservative Government will not support any legislation to regulate abortion.”
Tory Leader Erin O’Toole has said he is pro-choice, but had said he would support the conscience rights of doctors who refuse to refer patients for abortions. He reversed that position on Aug. 20, saying that doctors must refer patients for referrals for health care services like abortions or assisted dying.
There remain questions over what other measures could be taken to improve abortion access.
For example, would the Liberals be prepared to ask Health Canada to study whether birth control pills could be authorized for over-the-counter use, or whether they would be willing to offer up cash to the provinces specifically to be used for improving abortion access.
What the platform does add is a promise of $10 million for Health Canada to develop an online portal to provide “accurate, judgement-free, and evidence-based information on sexual and reproductive health and rights, which will include a section that counters misinformation about abortion.”
Trudeau also said re-elected Liberals would also take aim at those spreading misinformation.
In recent years, there has been increasing scrutiny on the networks of so-called “crisis pregnancy centres” operating across Canada that refuse to refer clients for abortions and that sexual health advocates say frequently offer misinformation about abortion to dissuade people from getting one.
This frequently focuses on claims of “post-abortion syndrome,” which is not medically recognized, or that abortions can lead to breast cancer.
Roughly two-thirds of those centres in Canada operate with charitable status — something Trudeau said on Wednesday he would revoke for anti-choice organizations if re-elected.