The United States and Canada have a unique relationship. The two nation-states share the world’s longest undefended border, rely on each other for trade and security, have similar cultures and values, and a deep shared history. They diverge, however, when it comes to abortion law and the history of reproductive rights—to access abortion later in pregnancy, Canadians rely on our neighbor to the south, which leaves us vulnerable to changing U.S. abortion policy.
The 1988 Canadian Supreme Court decision, R v. Morgentaler, decriminalized abortion when it found the country’s existing law to be unconstitutional. Since then, Canada’s legal system has treated abortion like any other medical procedure, and anti-abortion extremists have not had the same success here as they have in the United States. Canada’s culture of choice is the result of grassroots feminists’ campaigning in the 1970s and ‘80s. They organized alongside Dr. Henry Morgentaler to show Canadians the dangers of denying women the right to choose. Attempts to recriminalize abortion in Canada since 1988 have failed as a result of their collective efforts.
Canadians are worried about Amy Coney Barrett’s confirmation and what it means for abortion access. We are deeply worried about the U.S. election on November 3. I write this piece, however, from my position as a feminist activist, abortion doula, and professional working in Canada’s pro-choice nonprofit sector. So while every race and ballot measure feels imperative this year, the one that is keeping me up at night is Colorado’s Proposition 115.
Most Canadians and Americans do not realize that Colorado’s proposed 22-week abortion ban would impact abortion access across North America. While abortion in Canada is free from legal restrictions, it is nonetheless impossible to get an abortion in Canada if your pregnancy is beyond 23 weeks and six days—a guideline set by the Society of Obstetricians and Gynaecologists of Canada. Simply put, providers in Canada are not trained to do these abortions. While our hospitals can manage complications that would harm the pregnant person, they are not able to provide abortion care.
If you live in Canada and need an abortion after 24 weeks, you must travel to one of a handful of sites in the United States. The most frequently used, flexible, and widely known of the compassionate providers offering later abortion care to folks across North America is located in Boulder, Colorado. Dr. Warren Hern and his team there do incredible lifesaving work every single day.
Part of that work involves supporting Canadians who are forced to travel far from home to get the care they need. Colorado’s anti-abortion lawmarkers deliberately designed Prop 115 to target Hern’s practice. Colorado voters therefore need to understand that their decision next week affects pregnant people across North America.
Legal does not mean accessible
Given the structure of Canada’s publicly funded health-care system, the Canadian Supreme Court’s 1988 decriminalization of abortion theoretically should have resulted in the equal establishment of abortion services across provinces and territories. In practice, this never happened.
At present, only three provinces offer abortion care up to the gestational limit of 23 weeks and 6 days. In my work as an abortion doula, folks often tell me how shocked they are to find out how difficult getting an abortion in Canada can be in practice. Leadership in Canada’s medical community remains very male and very white. Decision-makers have not treated abortion care as a vital part of our reproductive health services. The responsiblity for finding training opportunities to become an abortion provider often falls on medical students themselves, and hospitals have allowed politics to dictate their level of service since decriminalization.
Impact of Prop 115 on our access to abortion
These realities mean Canadians have to regularly travel out of country to access later abortion care. Others have written about the devastating effect Prop 115 would have on abortion access in the United States; the consequences would be similar for those of us across the border.
The Canadian Institute for Health Information found in 2017 that 3.4 percent of abortions in Canada occur after 21 weeks of pregnancy. This may seem like a small number, but abortions during the second and third trimester happen under exceptionally devastating circumstances.
Imagine needing an abortion and learning that the care you need is not available in your country. You might not even have a passport. You will need a doctor to sign off on paperwork before you leave the country, or else the Canadian government may not cover the cost of the procedure. You will first have to book an appointment. You will have to get a hotel for the multiday procedure and cover the cost of the flight. Organizations like Action Canada for Sexual Health and Rights and the National Abortion Federation of Canada might be able to help cover some of these costs, but you are responsible for connecting with them. Time is of the essence.
These barriers are insurmountable for many folks, especially those from marginalized communities. How do you take a week off work to travel to Colorado when you don’t have paid sick days? How do you keep it a secret from people in your life who may not be supportive of your decision? What if you are not a Canadian citizen and cannot afford the cost of the procedure on your own? Can you even afford the $230 rushed passport fee? These are questions I help pregnant people grapple with. If abortion access in Colorado is restricted, these hurdles will become even higher.
Prop 115’s 22-week abortion ban may seem like a reasonable compromise to some Colorado voters. It most definitely is not.