Three decades since Morgentaler, stigma still restricts access to abortion

In Ontario, there are no legal restrictions to accessing abortion — but observers say that shame, fear, and a lack of information can be as much of an impediment as any statute
By H.G. Watson - Published on Nov 05, 2019
abortion protest
People protesting abortion take part in the March for Life rally on Parliament Hill, in Ottawa, in May 2019. (Sean Kilpatrick/CP)

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This is the first instalment in a three-part series on access to abortion in Ontario. Read Part 2 and Part 3.

The day after Progressive Conservative MPP Sam Oosterhoff attended an anti-abortion rally at Queen’s Park and pledged to make abortion “unthinkable in our lifetime,” Laura Ip decided it was time to share her story.

“Dear @samoosterhoff, my abortion *was* unthinkable,” the Niagara Region councillor wrote on Twitter the morning of May 10.

In 35 threaded tweets, she explained that, having already experienced difficult pregnancies, she couldn’t risk her health, finances, or mental well-being to have another child. “With my daughter — just to sort of put this in perspective — the only thing that I was actually able to eat and keep down for any length of time [was] French fries and potato chips,” she tells TVO.org. “That’s all I ate my entire pregnancy, and I still only gained 28 pounds.”

Ip didn’t think she was going to change Oosterhoff’s opinion, but she felt that it was important to speak up. “The reason that women don’t admit [to having had abortions] is because of the shaming that goes on,” she says.

After her Twitter thread went viral, Ip received messages from people across the country. “The vast majority of it was extremely supportive,” she says. “But there was a percentage of absolutely vile messages. And that’s why people don’t tell their stories.”

In Canada, there are no legal restrictions to accessing abortion. But, for people who seek to undergo the procedure, stigma and fear can be as much of an impediment as any statute.

According to data analyzed by the Abortion Rights Coalition of Canada, the annual abortion rate for women aged 15 to 44 was 13.1 per 1,000 in 2017. In the United States, one in four women will have an abortion before the age of 45. “It’s a very common [medical procedure],” says Frédérique Chabot, director of health promotion at Action Canada for Sexual Health and Rights.

But it’s not treated as one.

Rachael Johnstone, an associate professor at Queen’s University’s Bader International Study Centre and author of the 2017 book After Morgentaler: The Politics of Abortion in Canada, notes that it has often been treated as a “hot-button or stigmatized topic,” to the benefit of the anti-abortion movement. “By artificially separating abortion from more expansive discussions of women’s equality and their roles as citizens,” she writes, “it seems possible to reduce the abortion debate to one concerning morality, or the nature of services — a matter of health, best dealt with between a woman and her doctor.”

And, while Canadians broadly support abortion rights — 53 per cent of respondents to a 2017 Ipsos survey said that women should have access to the procedure whenever they want it, whereas only 12 per cent thought it should be banned — there are a number of organizations that want to see them curtailed. The anti-abortion group RightNow, for example, targeted ridings with supportive candidates. “RightNow is the first Canadian anti-abortion organization to knock on doors between election cycles,” wrote Anne Kingston in a Maclean’s article last year.

Such groups not only seek to impede people’s access to abortion services; they work to further stigmatize the procedure. After numerous incident and complaints, in 2017, Ontario made it illegal to protest outside or near abortion clinics. Providers have also faced violence: In 2000, Garson Romalis, a Vancouver-area gynecologist, survived wounds from a stabbing that took place in his clinic — the second attempt on his life in a six-year span. In the United States in 2015, a gunman entered a Planned Parenthood clinic in Colorado Springs and opened fire, killing three people and wounding nine.

However, Jill Doctoroff, the Canadian director of the National Abortion Federation, says that, in Canada, stigma may represent a larger barrier to access than safety concerns. “We’re involved with something that is often stigmatized,” she says. “So we don’t want to talk about it, and lack of talking about it can’t help normalize the procedure.”

Doctoroff knows of at least one hospital that offers the procedure but that doesn’t publicize it. There could be various reasons for this, she says, including concerns about stigma and safety, especially in small communities where everyone knows one another. (As part of TVO.org’s research on access to abortion services in Ontario, we worked with the Humber College’s storyLAB team to collect data about what abortion services hospitals provide. Surveys were sent to more than 200 hospitals. Only two responded.)

But while secrecy may keep some patients safer, it can lead others into harm’s way.

Action Canada for Sexual Health and Rights operates a hotline for people who have questions about their pregnancy options. Chabot remembers one call from a young couple who were located in a community north of Toronto and wanted an abortion. They had found three clinics in the area and called the hotline to see which one Action Canada recommended.

“I had to tell them that none of them were actual clinics,” Chabot says. “If they had not called us, they would have been showing up at a crisis pregnancy centre.”

The Abortion Rights Coalition of Canada defines crisis pregnancy centres as “anti-choice agencies that present themselves as unbiased medical clinics or counselling centres.” In 2016, the organization found that, of the 166 crisis pregnancy centres in Canada with websites, a large majority presented their missions deceptively or had posted misleading information about abortion. As of that year, more than 80 crisis pregnancy centres were operating in Ontario.

Chabot says it was unusual that this couple even called her: people rarely vet clinics, because they tend to assume that something advertising itself as a crisis centre will offer support.

Issues of gender, race, religion, and immigration status can all exacerbate the stigma that surrounds abortion. In a recent Vice Canada piece, Sarah Krichel tells the story of one young woman who tried to terminate her pregnancy by hitting herself in the stomach with a five-pound dumbbell. “She knew she couldn’t tell her parents — two Saudi Arabian immigrants, both conservative-minded Muslims,” Krichel writes.

Trans and non-binary people also seek access to abortion — but that comes with complications. “Though awareness about trans health care has evolved in the past few years, very few medical professionals are used to dealing with pregnant men, so they’re often challenged every step of the way,” Juno Obedin-Maliver, an assistant professor in the department of obstetrics and gynecology at the Stanford University School of Medicine, recently told Mel Magazine.

Many abortion-rights advocates say that more clarity is need. Chabot notes that Action Canada has called for provincial ministries of health to post clear information about abortion services on their websites. “Health information is crucial for people to make decisions about their health care, and there are a lot of myths out there that are circulated because people have an agenda as to what choice they want you to make,” she says. “So to have ministries of health have really clear information about abortion on their website that they communicate in an open, non-judgmental way kind of sets the tone, too — this is health care.”

Chabot says that another way that people can fight the stigma around abortion is to keep telling their stories, much as Ip did when she sent out those tweets in May. “If it’s talked about in a way that is kind of matter of fact,” she says, “it becomes a national conversation.”

With files from Brendan Pietrobon and Alisha Mughal

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