Doctor shortages, conscientious objection, and limited surgical clinics: impact on abortion access in southern AB

Although Canada has no laws outlawing abortion, access is far from easy for many Albertans, particularly for people who are financially disadvantaged, or geographically disparate from clinics.

Chantal Parkinson, president of the board for the ProChoice Society of Lethbridge and southern Alberta said the organization, “look(s) at connecting individuals who are looking for information on birth control, family planning and contraception and abortions.”

“If (clients) are needing an abortion, we act as a referral source so that they can connect with a physician who does prescribe the abortion pill or help them with planning and getting to Calgary if they’re required to get a surgical abortion.” Parkinson said, “We also work at educating physicians, primary care practitioners, and really, anybody who’s in the field who can refer others or who are a source of information.”

Parkinson explained the organization, “Does not get a huge amount of calls, probably get about 10-15 calls a month,” but added,“the vast majority of them, probably about 80 per cent, are asking about how to get connected with (the) Mifegymiso pill.”

Mifegymiso, or the medical abortion pill, can be prescribed up to the nine-week point and does not require in-clinic surgical interventions intervention.

Parkinson explained there are a select number of physicians in southern Alberta able and willing to prescribe patients the pill without them needing to connect to an organization such as Pro-Choice YQL, but given the physician shortage, not everyone in need of the service has access to a physician, period, let alone one willing to prescribe the pill for a medically-induced abortion.

“I think our snapshot is very small as to the actual need just because not a lot of people don’t know about our organization and so we’re still in that space where we’re trying to develop those connections so that people are more aware of us and are aware of the resources that are available to them,” said Parkinson.

She added although patients are also able to contact Kensington clinic to get connected as well, “Kensington’s booking a month to six weeks out, currently, which is problematic, and Peter Loheed is similar.”

Parkinson explained that IUD, contraception, and abortion training is not a prerequisite for physicians, which results in a percentage of doctors who are not able to provide the service even if they would like to undergo training, the volume of patients makes it difficult to access additional training. This issue of access was compounded by the pandemic and subsequent closure/ limiting of walk-in clinics, and further exacerbated by the doctor shortage in the southern part of the province.

However, while the issue of access is one piece, Parkinson said with respect to ”physicians who strongly disagree with any sort of abortion care, we’ve had reports that individuals have has gone to their physician asking for an abortion, and then later on return to go see their family doctor and that doctor has said that (the patient’s) needs have become too complex for them to care for.” Without having to provide additional context, support, or care, physicians can technically legally deny abortion care by deeming the needs of their patients beyond their scope of practice.

Doctors are able to deny medical care to patients through a loophole called, conscientious objection, and although this impacts other areas of medical practice, patients seeking sexual healthcare, contraception, and abortion care can be impacted disproportionately.

“It’s a sneaky way of doing it because they’re not saying ‘I disagree with your belief,’ but it seems very fishy that after this individual has requested, (an abortion) that all of a sudden, they become too complex of a patient,” she said. “...it’s that whole conscientious objection piece where they are not required to provide care.”

Although Canada is in a much different position than the United States, even with vocal opposition from government leaders and officials, Parkinson predicts Canada is, “going to see an influx of individuals from the States coming up,” because of the Supreme Court’s recent decision to overturn Roe vs. Wade.

“We are constantly fighting for our rights,” said Parkinson.

“Many of our MLAs and our cabinet ministers are very openly anti-choice,” she said adding, “there are people in the States who do not have access to that care that they need, and when our system is already, so backlogged; that is going to be horrendous.”

Parkinson said, “there has been no direct confrontation from the anti-choice side,” on the Pro Choice YQL society, but said, “what we are finding is that there is a lot of money going to the anti-choice organizations and there’s a lot of backing to them and they’re able to advertise a lot bigger. So when you’re in distress or when you’re in a position where you don’t know where to get the information that you need, and you connect with some of these organizations that are funded by anti-choice organizations,” which are much more visible than comprehensive resources offering referrals and information about abortion. These centres are known as crisis pregnancy centres or CPCs.

“We’ve had individual volunteers call in (to CPCs) and say, ‘I’m looking at getting an abortion’ and then they’re like, well these are options and the abortion is not provided as an option. When you say, well, ‘I need to go to Kensington the support kind of backs away,” adding a layer of stigma to the process of obtaining care. “We have to pay attention to this because they have this big backing of people that are speaking on behalf of the other (side) (…) I think a lot of people (are) like, ‘oh it’s not in my backyard, it’s not gonna happen here,’ but the reality is we regularly have bills brought forward by our MLAs in the provincial legislature that are looking to restrain those reproductive rights.”

Alberta has two abortion clinics, Manitoba has one, and Saskatchewan has none.