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Thursday, September 28, 2006


NAF Communications Department

Improving Women's Access to Reproductive Health Care in New Brunswick

Speech by Vicki Saporta, President and CEO, National Abortion Federation, at the "Ensuring Equal Access to Abortion: Affecting Change in New Brunswick" information evening Thursday, September 28, 2006, in Fredericton, New Brunswick

We are here tonight because women in New Brunswick lack the same access to reproductive health care services as women in the rest of Canada.

It is disappointing that during the recent election, the parties were completely silent on the important issue of reproductive choice for women. In the debates, no candidate mentioned that the Medical Services Payment Act creates barriers for women to access reproductive health care and that the Act is in direct violation of the 1988 Supreme Court ruling legalizing abortion.

Politicians in New Brunswick should stop playing politics with women's health. Under the current policies, the province is not meeting the reproductive health care needs of women.

As some of you know, the National Abortion Federation sets the standards for quality abortion care in Canada and the United States, and we have played a leading role in advocating for increased access to quality abortion care here in New Brunswick. For example, earlier this year NAF raised the issue that publicly funded abortions in New Brunswick were routinely being provided under general anesthesia. This involves greater risk to the woman with no increased medical benefit. We discussed our concerns publicly and with the Ministry of Health and are pleased to report that publicly funded abortions in New Brunswick are now being provided using local anesthesia, which is the standard of care in Canada. We hope to work with the new government to continue to improve women's access to quality abortion care-in the province. In fact we will be seeking a meeting with the new Minister of Health once the person is named at the cabinet swearing-in on October 3rd.

In New Brunswick, archaic and unsound provincial policies imposed by the province's Medical Services Payment Act and corresponding regulations mean that women must often pay out of pocket for abortion care. Women who have a funded abortion can only do so if provided by an obstetrician-gynecologist, in a hospital and only after two doctors have approved that it is medically necessary. This unfair treatment of New Brunswick women cannot continue to be tolerated.

Indeed, New Brunswick's approach in this area is outdated and is not in keeping with standard medical practice and the provision of health care in the rest of Canada. The Society of Obstetricians and Gynecologists of Canada, the National Abortion Federation and other health care organizations agree that abortions do not need to be provided exclusively by obstetrician gynecologists in hospital settings, and that the requirement of two doctors' approval is not medically necessary.

Across Canada, provinces and territories allow family doctors as well as obstetricians and gynecologists to provide funded abortion care. Additionally, abortion care is provided by outpatient clinics as well as hospitals.

And, nowhere else in Canada is there a requirement that two doctors must approve and agree that an abortion is medically necessary to be eligible for coverage through a medical services plan. This is because the rest of the country respects the landmark 1988 Supreme Court ruling in Morgentaler v. The Crown, which eliminated the requirement for approval of abortions and stated that the decision to have an abortion was between a woman and her physician. Yet New Brunswick stands alone in continuing to subject women to this unjustified, unconstitutional restriction.

In no other aspect of health care delivery in New Brunswick do politicians dictate the terms of the doctor-patient relationship. It is only with abortion that a provincial policy, in violation of the Canada Health Act, imposes medically unjustified restrictions on a health care procedure.

As a result, women lack access to abortion care in most of the province. With the Dr. Everett Chalmers Hospital no longer providing abortions, there is no publicly funded abortion care here in Fredericton. And with only two hospitals providing publicly funded abortion care for the entire province, many women must travel long distances, which results in increased travel costs, more time lost from work, and more difficultly in securing childcare.

These unnecessary burdens may force women to delay an abortion until later in their pregnancy, possibly leading to increased risks. Also, with only two hospitals providing abortion care for the entire province, the issue of wait times becomes a barrier to accessing care. The earlier a woman has an abortion, the safer it is. Therefore, it is important that women who decide to have an abortion can do so without unnecessary delays. Additionally, if the wait becomes too long, then a woman could be denied a publicly funded abortion in New Brunswick because her pregnancy has progressed more than 14 weeks.

Of the approximately 1,000 abortions that are provided annually in New Brunswick, more than half are provided by the Morgentaler Clinic in Fredericton, one of the many National Abortion Federation member accredited facilities providing quality abortion care throughout Canada. Abortion care is more readily accessible at this facility because they do not require two doctors' approval and abortions are provided by family doctors are who trained to do the procedure. However, New Brunswick will not provide public funding for abortion procedures at this facility and instead women are forced to pay for their abortion care. Dr. Henry Morgentaler is currently suing the province to ensure that the women the clinic cares for are able to receive publicly funded care. Ironically, the Province could even save taxpayers dollars by funding abortions at the clinic since it currently costs approximately four times more to pay for the facility cost in a hospital.

As most of you know, New Brunswick isn't the only province where abortion restrictions are being challenged. In a suit over publicly funded abortions in Québec, the Québec Superior Court recently ordered the Government of Québec to pay more than $13 million to women in Québec who had paid to obtain abortion care since May 2, 1999. The Court concluded that the Government of Québec violated its own legislation by only partially paying for abortions when obtained in certain women's or private clinics, a service covered under Quebec's Health Insurance Act. The Government of Québec has decided not to appeal the court's decision.

New Brunswick should learn from Québec's experience. It shouldn't take a law suit for New Brunswick to stop its unconstitutional, inequitable policies.

Abortions in New Brunswick, whether provided at a hospital or a clinic, or by a family physician or obstetrician-gynecologist, should be publicly funded. There should be more than two hospitals providing abortion care and the regulation requiring two doctors' approval should be eliminated.

The current situation treats women unfairly and interferes with their freedom of choice and access to care. New Brunswick needs to revise their arcane and unfair policies to come into compliance with the Canada Health Act and to meet the reproductive health care needs of women in the province.

Isn't it time that common sense prevailed over politics?

We are calling on Premier-elect Shawn Graham and the New Brunswick Liberal Party to show leadership and bring about the necessary changes to the Medical Services Payment Act. In order to ensure that these changes are made, NAF is leading an effort to bring together the foremost constitutional legal experts from across the country to determine the appropriate course of action. We aim to make sure that New Brunswick stops its unconstitutional practices so that women in New Brunswick receive the same quality care and respect as women in other provinces.

You can play a critical role in bringing about these necessary changes. It is important that you speak out publicly, build support in the community, and contact your elected officials, so that they hear loud and clear that the status quo is no longer acceptable. Working together we will prevail.


The National Abortion Federation (NAF) is the professional association of abortion providers in Canada and the United States. Our mission is to ensure safe, legal, and accessible abortion care to promote health and justice for women. Our members include health care professionals at clinics, doctors' offices, and hospitals, who together care for more than half the women in both countries who choose abortion each year. For more information, visit our website at www.prochoice.org

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