The Future of Abortion Rights
An Interview on Sexual Health with Sandeep Prasad
Sandeep Prasad is the Executive Director of Action Canada for Sexual Health and Rights (Action Canada). After speaking at the October 11-12 Abortion Beyond Bounds Conference, hosted by the Mcgill Institute for Gender, Sexuality and Feminist Studies (IGSFS) and the Centre for Research on Gender, Health, and Medicine (CRGHM), Prasad sat down with the Daily to talk about the state of abortion care in Canada, and his work in the sexual health and rights field.
The Daily: Now that 30 years have passed since the decriminalization of abortion in Canada, how easy or difficult is it today to access abortion care in Canada?
Sandeep Prasad: Practical access to abortion care in Canada, despite thirty years of decriminalization, is still difficult. There are numerous barriers that still [...] hamper the abilities of those seeking abortion services to actually access them. Things like uneven distribution of services, the concentration of services in urban centres, creates large distances that people still have to travel to access these services; these are of course compounded by other factors of oppression such as poverty or young age, making it even more difficult to access care. Fortunately, there have been steps in the right direction of expanding abortion access primarily through the role of mifegymiso [the Canadian trade name for the abortion pill mifepristone] within Canada, which is the [World Health Organization] gold standard of medical abortion. But at this point, there is a lot more work to do in terms of achieving an effective rollout of mifegymiso that would transform access to this drug. So there is promise in that, but at the same time, we also have to confront the realities of anti- choice actors who create barriers to access through misleading information, biased counselling practices, and through activities that stigmatize abortion. These make it far more difficult for those seeking abortion care to actually find the information they need to terminate an unwanted pregnancy.
MD: What is the role of Action Canada in this situation?
SP: Action Canada is Canada’s national sexual and reproductive health rights organization. As such, we have a number of issues that we focus on in the sexual and reproductive health and rights field, and abortion care is one of the key areas of this focus. Abortion work relates to both helping to ensure that accurate information related to abortion is out there for the public, and that through our access line, members of the public seeking to terminate pregnancy are supported with accurate, unbiased information about abortion procedures as well as referrals to the appropriate care nearest to them. We’re helping to connect people seeking to terminate pregnancy to services that they want. Furthermore, our organization is also engaged in policy work on abortion. We see that advocacy is critical to changing the landscape of abortion and have been prioritizing within that advocacy the universal cost coverage of mifegymiso, [and] ensuring that restrictions relating to mifegymiso are removed.
MD: Action Canada in its current form has evolved out of prior organizations like the “Canadian Federation of Societies for Federation Planning” or “Planned Parenthood Federation of Canada” that carried a different language in their names. Why should we be talking about sexual health and rights rather than reproductive health and rights?
SP: When we come down to it, it’s all the same issue. Whether we’re talking about abortion, or sexual orientation, same-sex sexuality, trans rights, issues around contraception, we’re all talking about, on the one level, the right to bodily autonomy; the right of each person to do with their body as they want and to have the information and education services to support their decisionmaking around their body. [...] In a very practical way, abortion rights are sexual rights. Abortion stigma is also stigma related to sexuality. So all of these issues are fundamentally connected and we use “sexual rights” as a shorthand to describe all of these issues because we see that, traditionally, when we look at definitions of reproductive health and reproductive rights, the sexual is defined through the reproductive. We intentionally want to change that paradigm. Reproduction is an aspect of sexuality. There are numerous aspects of sexuality, but our broader frame is sexual rights which is inclusive of reproductive rights.
MD: The Abortion Beyond Bounds conference focused on self-managed abortion. How is self-managed abortion widening access to abortion care and which barriers remain?
SP: It is important that we work towards expanding options for how individuals interact with their body, how they manage the care of their body, whether that’s about methods of contraception, methods of terminating pregnancy, we want to expand the frontiers of possibilities for them to do that and to support them in doing that, and to have the control over the level of support they want in doing that. The autonomy needs to rest with that individual who is making the decision on their own in relation to their bodies. In terms of self-management of abortion care, we need to be looking into options that remove abortion care from the medical system. There is ample evidence that self-managed abortion is safe and effective. And there are a lot of examples in many other countries that we can point to that have been using medications through community access for abortion, which we need to look at in Canada.
MD: In health care systems that are not accessible to all, how does self-managed abortion widen access to underserved communities?
SP: The geographic circumstances of the country are such that it is very difficult for individuals who live in rural or geographically remote areas to access care. [...] Expanding the scope of practice for different types of providers is one important step [...] but what is also important is more self-managed models of abortion care as well. So we need something that is inclusive of these parts, because we need to get to a place where access to abortion is community-based and is accessible to communities which are remote.
MD: You were instrumental in starting the Sexual Rights Initiative, an intersectional Global South-north coalition of organizations that work towards advancing sexual rights in the United Nations. What is the place of a Global North organization in global sexual health activism?
SP: That is a great question, thank you for asking that. There are a few places for a Global North organization. First of all, as a merged organization, we also have in our organizational history the work of Action Canada for Population and Development (ACPD), which did a lot of formative work initially within the intergovernmental human rights system on sexual and reproductive rights. Quickly, we saw the need for a Global South-global North coalition and for that coalition to actually be of national and regional organizations doing work on these issues. Where ACDP was different though, was that it didn’t actually do domestic advocacy. So one of the appeals for ACPD for entering into this merger is that we need to be more like our partners in the Global South that are doing effective national work and that come together with us to do that kind of work as well. We wanted to model that. So our engagement with partners in the Global South fundamentally changed the structure of our organization. As Action Canada, we have lent our ability to act as coordinators. Our job has been to ensure that resources are pooled together for this work, but also to ensure that each partner is bringing its analysis from its national and regional context to that work at the global level, so now we are able to participate on that more fully, doing national work like our other partners within the coalition.
MD: Where do you see your place in a sexual health organization?
SP: I’m very fortunate because I went to law school to do human rights work globally with my law degree. And while there were a lot of individuals like me in my law school, there aren’t that many jobs within the human rights field [after graduate school]. I’m one of the lucky ones who actually gets to do human rights work in Canada and globally as a professional. My own interest in wanting to go to law school to do that [comes from when] as a young queer guy I did a lot of organizing on campus at Queen’s University, which is quite conservative and quite white as well, that was particularly focused on LGBTQ issues. When you start looking at some issues, often times you can see the relationship to other issues of social justice. That compelled me to have a broader perspective on how sexuality and gender are fundamentally interrelated, but also to go to law school to work on these broader issues professionally.
This interview has been edited for clarity and accuracy.
We have to confront the realities of anti-choice actors who create barriers to access through misleading information, biased counselling practices, and through activities that stigmatize abortion. — Sandeep Prasad
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