| Reproductive choice is a sleeper issue in the upcoming election. Health Canada’s recent decision to recommend the distribution of emergency contraception by pharmacists without a doctor’s prescription may just wake it up. The CBC national news reported that this change would likely take place within the next few months, "barring a change in government." Rob Merrifield, Conservative health critic has also stirred the pot with his call for mandatory third-party counselling for women seeking abortions. A quick check up on choice indicates many voters may want to pinch themselves awake.
"Choice," in its most simplistic form, often boils down to the ability to access abortion. Even this limited definition of choice cannot be taken for granted by Alberta women. Urban women have the easiest access to all services. In Alberta, the Peter Lougheed hospital and the Kensington Clinic provide abortions in Calgary, and in Edmonton women can go to the Royal Alexandra Hospital or the Morgentaler Clinic. Although the Kensington Clinic and the Morgentaler Clinic are private, services are paid for by Alberta Health and Wellness with no additional cost to the patient.
If you are a rural Alberta woman, your situation is markedly different. Unless you have a pro-choice doctor with hospital privileges willing to perform an abortion, you will have to travel. Travel, with its associated cost and additional time that must be taken from work or school, remains the single most significant barrier to access for women. In addition, anything that may widen the circle of "people who know" infringes on privacy and forms another significant barrier.
For example, at the Peter Lougheed hospital, women must bring with them the results of blood work and an ultrasound sought elsewhere. The private clinics do everything necessary on site, meaning women need make only one appointment and run no risk of running into a well-meaning lab or ultrasound technician who may ask how the nursery is going to be decorated.
Any new requirement for third-party counselling will introduce another barrier for women, and inherently questions women’s right to self-determination. Third party counselling is not required for other procedures and it will create another delay.
According to a recent survey by the Canadian Abortion Rights Action League (CARAL), only 17.8 per cent of general hospitals in Canada provide abortion services. Many women seeking information and referrals find themselves stonewalled by anti-choice doctors and hospital staff. Some agencies that advertise as places of help and support for women who are "pregnant and undecided" are anti-choice. They offer information and support for parenting and adoption, but not abortion, and have been known to use delay tactics to ensure a woman grows beyond gestational limits set by local abortion providers. The CARAL survey finds that anti-choice doctors and medical staff are the second greatest barrier to access next to travel.
Violence and harassment directed at providers have led many to simply stop performing the procedure. As providers retire, new doctors are not replacing them. Not all doctors get trained in performing abortions, in spite of the fact that the College of Physicians and Surgeons deems them a medically necessary procedure. This issue is being addressed by Medical Students for Choice, an organization with a 7,000 strong membership in Canada and the United States, including a chapter at the University of Calgary.
Laura Wershler, executive director of Planned Parenthood Alberta, describes choice as much more than merely having the ability to access abortion.
"It is a complex issue that goes to the root of sexual health matters," she says. "Choices can’t be made without information, education and easy access to services. For example, if youth in small town Alberta have no place in their community to purchase condoms, then they have been denied the right to choose to be sexually responsible by using condoms."
Even the provision of comprehensive sexuality education remains contested in Alberta, despite the fact that it is mandated in provincial curricula. "Abstinence only" programs are the sole source of sexuality education in some schools.
True choice means ensuring everyone has access to the full range of sexual and reproductive health services and education that meets individual needs within a social, political and economic context and enables self-determination. The decision to make emergency contraception available through pharmacies without a doctor’s prescription is a positive step towards making this possible, according to Wershler. Thorough education combined with ready access to condoms, birth control, sexually transmitted infection testing and other sexual health services would be another.
In this wider context, investing in social programs and education becomes part of enacting choice. In Canada, the greatest indicator of poverty among women is the presence of children. Women still earn less than men, are more likely to have minimum-wage jobs and to work part time. Factor in the lack of affordable day care, the judgment women face if they choose to mother while working outside the home or as a single parent, cuts to social welfare programs and a host of other economic and political issues, and it quickly becomes clear that "choice" is not fully realized yet.
Voters will have to decide if these issues matter as much as taxation, sponsorship scandals, or any of the other issues that typically capture our attention at election time. |
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