ABORTION PILL ACCESS REMAINS AN ISSUE
Advocates say obtaining medication still an issue in Nova Scotia
Advocates say Nova Scotians’ access to the abortion pill remains a major issue, with one student saying she had to wait nearly three weeks because of barriers including finding a doctor to prescribe the drug, testing delays and billing issues.
The woman, from the Toronto area, says she was five weeks pregnant when she took a home pregnancy test.
But she was almost eight weeks by the time she obtained the abortion pill Mifegymiso — a wait she describes as excruciating, and advocates say fails to realize the potential of the two-drug combination used to terminate early pregnancy.
“I was having severe morning sickness and on top of that feeling a lot of shame. Trying to go through this whole process was daunting and intimidating,’’ she said.
The student says she booked an appointment at Cape Breton University’s health clinic at the Sydney campus, as soon as she found out she was pregnant and asked for the abortion pill.
Instead, she was told to call an abortion clinic in Halifax.
“It’s very overwhelming trying to figure out the health-care system when you’re facing an unwanted pregnancy,’’ she said.
Inquiries by The Canadian Press have revealed that only one of six university health clinics contacted across the province will prescribe Mifegymiso, a combination of mifepristone and misoprostol tablets available in Canada since 2016 and publicly funded in Nova Scotia since last November.
The only Nova Scotia university that currently offers medical abortions — via the abortion pill, rather than a surgical procedure — as part of its primary care is St. Francis Xavier University in Antigonish. Students at other universities are referred elsewhere, potentially delaying access.
That’s despite data that shows people aged 18-29 are the most likely to obtain an abortion, according to the Canadian Institute for Health Information.
Perhaps surprisingly, even the Halifax Sexual Health Centre — formerly Planned Parenthood — does not yet offer Mifegymiso, citing a physician shortage, funding issues and inadequate nursing support.
“The biggest issue continues to be that this is considered a specialized service instead of the primary care that it is,’’ said Martha Paynter, a Halifax-area nurse and women’s health advocate. “We as clinicians need to step up.’’
She adds: “Medical abortion is very time dependent. When you’re eight weeks pregnant with an unwanted pregnancy ... that’s a really difficult moment to become an advocate.’’
Shannon Hardy, an abortion doula and co-ordinator of Atlantic Abortion Support Services, says despite recent improvements there remains an “underground’’ element to accessing an abortion in Nova Scotia.
“People will share by wordof-mouth which doctors will prescribe Mifegymiso and which pharmacies will even stock the medication,’’ Hardy says, pointing out another potential barrier women may face filling the prescription.
A series of stories by The Canadian Press in 2017 shone a national spotlight on barriers to abortion access in Nova Scotia, as multiple women described facing “agonizing’’ and “cruel’’ hurdles. The stories helped prompt a number of changes, including a new toll-free information line, the removal of a historical practice requiring women to obtain a referral before booking an abortion, and provincial funding for the abortion pill.
But it appears women are still facing delays in some cases.
The CBU student was told to call Nova Scotia’s only abortion clinic — the Women’s Choice Clinic at the QEII Health Sciences Centre in Halifax.
It offers both surgical and medical abortions, and can also refer women to a provincewide network of health professionals that are willing to prescribe Mifegymiso.
There are currently nine family doctors, three gynecologists and one nurse practitioner on the list — though Lianne Yoshida, the medical director of the clinic, says it’s possible others are prescribing Mifegymiso to their own patients but are not part of the clinic’s network.
The slow pickup could be attributed in part to early restrictions on the drug — including a training requirement for prescribers that has since been dropped, and the lack of a billing code in Nova Scotia until last spring.
Still, demand for the abortion pill has been steady, with 670 Mifegymiso prescriptions logged in the provincial Drug Information System from Nov. 1, 2017, to Oct. 31, 2018, according to provincial data. That’s nearly two women terminating early pregnancies using medication every day in Nova Scotia.
Meanwhile, the CBU student called the Halifax clinic as directed by the university health clinic, and she says she was then referred to a prescriber in Sydney.
But she faced further delays obtaining an ultrasound and blood work, and ran into billing issues as a student from out-ofprovince.