Kaitlin Pelletier: Only when reproductive care is truly accessible can we claim to be exceptional

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Every time women’s health and reproductive rights are further reduced south of the border, a conversation spreads across Canada. What about our rights? It couldn’t happen here, could it?

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While we are assured from all sides that our rights to reproductive health are guaranteed, a question does linger: What do we really mean when we talk about access to abortion?

While we solemnly tsk tsk over the situation in the US, applauding our Canadian exceptionalism is a distraction from the reality on the ground. Yes, abortion is legal and accessible. But community-based health centers that provide these services are financially and operationally stretched to the brim of closing their doors. Even within Vancouver city limits, clinics are struggling to survive (speak nothing of options for those living in rural locations).

Access means nothing if there is nothing to access.

Take Elizabeth Bagshaw Clinic, for example. This Vancouver-based health center provides reproductive and abortion care to women, trans, and non-binary people. The organization opened in 1990 to serve individuals in their first trimester of pregnancy who had few barriers and mostly adequate resources. It was one of a few community-based centers 30 years ago, forging a new path. It has evolved dramatically since — in terms of demand, breadth of services, and patient demographics. Its core funding, however, has remained the same for over a decade.

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Like all community clinics, Elizabeth Bagshaw has had no choice but to respond to the region’s growing health-care crisis resulting from the strains of COVID, combined with too few GPs for an ever-growing population who have more complex patient needs. For example, staff fielded more than 200 calls over a single weekend in January 2022.

To function, EBC relies on donations, grants, and a patchwork of government funding to fill the gaps. But the clinic doesn’t employ a fundraising team, or even a fundraising employee, to find and steward a reliable stream of non-profit-style funding. The small team and board are focused on operations and trying to keep up with demand — and not always successfully. A patient recently came to the clinic for an abortion, saying that she got pregnant while waiting for her IUD insertion appointment, which she was booking five months out.

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Much has been discussed lately about disproportionate and inequitable access, especially for women living in rural and remote communities. It is well-known that constraints over distance, cost, and time prevent true access to abortion and reproductive health care, with women in Indigenous communities more acutely impacted.

The province must absolutely create better access in rural and remote communities — this is key to upholding our reproductive rights, gender justice, and human rights. And we also need them to properly fund existing centers that are providing not just abortions, but also early pregnancy loss and miscarriage management; reproductive health testing; contraception; IUD insertion; colposcopy referrals; trans health services; and mental health services that include pre- and post-abortion counseling, plus decision-making and contraceptive counseling services. All of which EBC provides.

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The US Supreme Court has now overruled Roe v. Wade, meaning the US Constitution does not confer a right to abortion. Now that millions of American women are fully stripped of their rights for reproductive health care, clinics here must brace for further strain to accommodate those citizens traveling here for abortions. Our federal government has made it clear they will be welcome, but that same government is slow in doing out promised funding for exactly these services. Yes, the federal government recently dispensed $3.5 million on two projects to improve abortion access in Canada, but these funds were not allocated to service providing organizations and they represent a mere fraction of the $45 million announced in the 2021 budget, or the $16 million of which was promised to be allocated by now.

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We can no longer wait on unfulfilled promises, we need all levels of government to step up and urgently fund the community-based providers that are doing the complicated and necessary work of providing free, safe, essential services for women. Reproductive care, from contraception to abortion, is health care and only when these services are truly accessible can we claim to be exceptional.

Kaitlin Pelletier is executive director with The Elizabeth Baghsaw Clinic.

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