RT Journal Article
SR Electronic
T1 Abortion health services in Canada
JF Canadian Family Physician
JO Can Fam Physician
FD The College of Family Physicians of Canada
SP e209
OP e217
VO 62
IS 4
A1 Wendy V. Norman
A1 Edith R. Guilbert
A1 Christopher Okpaleke
A1 Althea S. Hayden
A1 E. Steven Lichtenberg
A1 Maureen Paul
A1 Katharine O’Connell White
A1 Heidi E. Jones
YR 2016
UL http://www.cfp.ca/content/62/4/e209.abstract
AB Objective To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers.Design An international survey was adapted for Canadian relevance. Public sources and professional networks were used to identify facilities. The bilingual survey was distributed by mail and e-mail from July to November 2013.Setting Canada.Participants A total of 94 abortion facilities were identified.Main outcome measures The number and location of services were compared with the distribution of reproductive-age women by location of residence.Results We identified 94 Canadian facilities providing abortion in 2012, with 48.9% in Quebec. The response rate was 83.0% (78 of 94). Facilities in every jurisdiction with services responded. In Quebec and British Columbia abortion services are nearly equally present in large urban centres and rural locations throughout the provinces; in other Canadian provinces services are chiefly located in large urban areas. No abortion services were identified in Prince Edward Island. Respondents reported provision of 75 650 abortions in 2012 (including 4.0% by medical abortion). Canadian facilities reported minimal or no harassment, in stark contrast to American facilities that responded to the same survey.Conclusion Access to abortion services varies by region across Canada. Services are not equitably distributed in relation to the regions where reproductive-age women reside. British Columbia and Quebec have demonstrated effective strategies to address disparities. Health policy and service improvements have the potential to address current abortion access inequity in Canada. These measures include improved access to mifepristone for medical abortion; provincial policies to support abortion services; routine abortion training within family medicine residency programs; and increasing the scope of practice for nurses and midwives to include abortion provision.