Abortion: a service that may still be difficult to access in the regions

In Bas-Saint-Laurent, women have been benefiting from this service through the health system for about forty years, but even today, access to it remains precarious.

The first family planning clinic to open in the region was in Rimouski, in 1979. Clinics had then been set up all over the province by Denis Lazure, who was minister under the government of René Lévesque.

Although women could request an abortion in these clinics, they were not the ones who had the final say as to the termination of their pregnancy.

” There was a committee that looked at the women’s requests and decided whether they could have an abortion or not. It was like that. »

Dr. Bérubé, who worked at the Rimouski clinic at the time and still works there, specifies however that in this clinic – of which he was also director – the evaluations of the committee were only an administrative formality. We always said that it was up to the woman to decide, it was her choicehe said.

Those therapeutic abortion committees gradually disappeared in the first half of the 1980s. Abortion – which was permitted in Quebec when performed in a safe and supervised environment – ​​was subsequently decriminalized across Canada in 1988.

Hundreds of miles to go

Quebec is the Canadian province with the most family planning clinics. However, women who wish to have an abortion often have to travel hundreds of miles to do so. In Bas-Saint-Laurent and Gaspésie, three family planning clinics exist, in Rivière-du-Loup, Rimouski and Gaspé.

If I stay for example in Causapscal, Rimouski is the closestexplains Geneviève Royer, who is a development agent at the Bas-Saint-Laurent women’s group consultation table. It’s at least an hour, an hour and a half drive, so that’s three hours round trip, plus time to meet the doctor. You have to take a day off, in a situation where not everyone necessarily has access to transportation eithershe points out.

” Accessibility is fragile. »

In addition, clinics that perform abortions in the region do not offer this service beyond 14 weeks of pregnancy, after which women must travel to major centers or to the United States.

The abortion pill, a gain

For the past five years, however, the abortion pill has been permitted in Quebec, which facilitates access to abortion for women who live far from clinics. But not all doctors can prescribe it, since they must first have undergone training in this regard.

Around 15 to 18% of abortions in Bas-Saint-Laurent are medical abortions. Patients have to move around most of the time. In some places, there are doctors who are authorized to give this pill and follow upsays Dr. Bérubé.

Midwife Mélina Castonguay, who is also an abortion support trainer, believes that this situation is unfair, since the constraints imposed by the College of Physicians are more restrictive than those of Health Canada with regard to this medication.

What’s more, since women have to travel to get it prescribed, this tends to lengthen the delays, deplores Geneviève Royer.

Wait times have an impact on mental health, on physical health as well. Interruption of pregnancy by medication, the sooner it is requested and given, the less there is the risk of complications, bleedingshe points out.

Telemedicine is one of the solutions that could improve women’s access to abortion in the regions, underlines Mélina Castonguay, but it is rarely used in such cases, she laments.

In Bas-Saint-Laurent, a little more than a dozen doctors supervise abortions, according to the latest figures from the Ministry of Health.

Regulate the right to abortion

Faced with the raging debate in the United States concerning abortion, the Trudeau government plans to strengthen its legal framework in Canada. Currently, the right to abortion is not protected by law, but by case law, more specifically by a decision of the Supreme Court handed down in 1988 which decriminalizes it.

” There is a bottom of fear that still remains [quant au droit à l’avortement]. It depends on the government in place. »

If there were legislation that really would provide a better framework, we would be better protectedshe believes.

The Conservative MP for Montmagny–L’Islet–Kamouraska–Rivière-du-Loup, Bernard Généreux, believes, however, that Prime Minister Justin Trudeau is taking advantage of the situation to make capital. Although several members of his party are pro-life, he believes that the right to abortion will remain acquired.

” [Justin Trudeau] uses women for political purposes. […] Anyway, the majority of Conservative MPs, if there was a bill on the table [pour protéger l’avortement]we would vote for. »

Bernard Généreux believes that his political adversaries have used the situation in the United States to make the Conservative Party look bad. Two-thirds of our cuckolds, we’re against anti-abortion bills, we’ll never vote for that, he argues. For the others, they are entitled to their opinion, he says, even if it is appropriate that this question remains delicate within his party.

For his part, Dr. Bérubé emphasizes that the most important thing is that women continue to have access to abortion if they wish.

In terms of abortion, nothing is ever won. We must always be on our guard and continue to work to develop services and try to protect them as much as possible.he says.

In Bas-Saint-Laurent, the number of abortions has been declining for more than 10 years. The presence of services in schools and the fact that pharmacists can now prescribe birth control pills have greatly contributed to this reduction, says Dr. Bérubé.