Abortion: a service still difficult to access in the regions

In Bas-Saint-Laurent, women have benefited from this service through the health system for about forty years, but even today access to it remains precarious.

The first family planning clinic opened in the region was in Rimouski, in 1979. The clinics were then set up throughout the province by Denis Lazure, minister under the government of René Lévesque.

If women could ask for an abortion in these clinics, they weren’t the ones who had the final say on terminating the pregnancy.

There was a committee that looked at the women’s requests and decided whether they could have an abortion or not. It was like this.

A quote from Jocelyn Bérubé, physician at the Rimouski birth planning clinic

Dr Bérubé, who at the time worked at the Rimouski clinic and still works there, however, points out that in this clinic – of which he was also director – the commission’s assessments were only an administrative formality. We have always said that it was up to the woman to decide, it was her choiceHe said.

There are two birth planning clinics in Bas-Saint-Laurent, in Rivière-du-Loup and Rimouski (archives).

Photo: Associated Press / Tony Gutierrez

Those Committees for therapeutic abortion it gradually disappeared in the first half of the 1980s. Abortion – which was allowed in Quebec when performed in a safe and controlled environment – was subsequently decriminalized throughout Canada in 1988.

Hundreds of miles to go

Quebec is the Canadian province with the largest number of family planning clinics. However, women who wish to have an abortion often have to travel hundreds of miles to do so. There are three family planning clinics in Bas-Saint-Laurent and Gaspésie, in Rivière-du-Loup, Rimouski and Gaspé.

If I stay for example in Causapscal, Rimouski is the closestexplains Geneviève Royer, development agent at the consultation table of the Bas-Saint-Laurent women’s group. It’s at least an hour, an hour and a half by car, so it’s three hours there and back, plus time to meet the doctor. You need to take a day off, in a situation where not everyone necessarily has access to transportationhe points out.

Accessibility is fragile.

A quote from Geneviève Royer, head of development at the Table de concertation des groups de femmes du Bas-Saint-Laurent

Additionally, abortion clinics in the region do not offer this service beyond 14 weeks of pregnancy, after which women must travel to major centers or to the United States.

The abortion pill, a profit

For the past five years, however, the abortion pill has been allowed in Quebec, which facilitates access to abortion for women living away from clinics. But not every doctor can prescribe it, as they must first have undergone training in this regard.

% des avortements au Bas-Saint-Laurent sont des avortements médicamenteux. Les patientes doivent se déplacer la plupart du temps. Dans certains endroits, il y a des médecins qui sont habilités à donner cette pilule-là et à faire le suivi”,”text”:”Autour de 15 à 18% des avortements au Bas-Saint-Laurent sont des avortements médicamenteux. Les patientes doivent se déplacer la plupart du temps. Dans certains endroits, il y a des médecins qui sont habilités à donner cette pilule-là et à faire le suivi”}}”>About 15-18% of abortions in Bas-Saint-Laurent are medical abortions. Patients have to move most of the time. In some places, there are doctors licensed to administer this pill and follow themsays Doctor Bérubé.

Mifegymiso, better known as the RU-486 abortion pill.

The abortion pill has been licensed in Quebec for five years, but a limited number of doctors can prescribe it (archives).

Photo: Charlie Neibergall

Midwife Mélina Castonguay, who is also an abortion support trainer, believes this situation is unfair, since the constraints imposed by the College of Physicians are more restrictive than those of Health Canada regarding this drug.

Furthermore, as women have to travel to be prescribed, this tends to lengthen the delays, deplores Geneviève Royer.

Waiting times have an impact on mental health, including physical health. Termination of pregnancy by drugs, the earlier it is requested and administered, the lower the risk of complications, bleedinghe points out.

Telemedicine is one of the solutions that could improve women’s access to abortion in the regions, Mélina Castonguay points out, but in these cases it is rarely used, she complains.

In Bas-Saint-Laurent, just over a dozen doctors watch over abortions, according to the latest figures from the Ministry of Health.

Regulate the right to abortion

Faced with the furious debate in the United States on abortion, the Trudeau government plans to strengthen its legal framework in Canada. Currently the right to abortion is not protected by law, but by jurisprudence, more precisely by a decision of the Supreme Court of 1988 which decriminalizes it.

There is a fund of fear that still remains [quant au droit à l’avortement]. It depends on the government in place.

A quote from Genevieve Royer

If there were legislation that really provided a better picture, we would be better protectedshe believes.

Conservative MP from Montmagny – L’Islet – Kamouraska – Rivière-du-Loup, Bernard Généreux, believes, however, that Prime Minister Justin Trudeau is taking advantage of the situation to raise capital. Although several members of his party are pro-life, he believes the right to abortion will remain acquired.

[Justin Trudeau] he uses women for political purposes. […] Anyway, the majority of Conservative MPs, if there was a bill on the table [pour protéger l’avortement]we would vote for.

A quote from Bernard Généreux, MP from Montmagny – L’Islet – Kamouraska – Rivière-du-Loup

Bernard Généreux believes his political opponents used the situation in the United States to put the Conservative Party in a bad light. Two thirds of our cuckolds, we are against the bills against abortion, we will never vote for it, he argues. For others, they have the right to their opinion, he says, even if it is appropriate that the issue remain delicate within his party.

For his part, Dr Bérubé points out that the most important thing is that women continue to have access to abortion if they so wish.

In terms of abortion, you never win. We must always be on guard and continue to work to develop services and try to protect them as much as possible.he says.

In Bas-Saint-Laurent, the number of abortions has been falling for over 10 years. The presence of services in schools and the fact that pharmacists can now prescribe birth control pills have contributed greatly to this decrease, says Dr. Bérubé.

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