An Abortion Doula On Canada’s Problematic Lack Of Access

Photo: Courtesy of Carolyn Van Houten/The Washington Post via Getty Images.
As an abortion doula, Shannon Hardy spends her days driving people to appointments or taking care of them afterwards. That all changed when the pandemic started. Sharing a car with a stranger, not to mention helping them convalesce, has been out of the question since COVID-19, leaving many without access to this crucial healthcare service.
Getting an abortion in Atlantic Canada, where Hardy lives, was a challenge even before coronavirus. Though abortions have been decriminalized in Canada since 1988, provinces have jurisdiction over access. As a result, where and at what point in a pregnancy you can get an abortion is influenced by the local political climate, and varies widely. Mifegymiso, the pill that induces what's called a medical abortion, is available and covered by provincial healthcare, but not every doctor will prescribe it. In some places, there's access to surgical abortions, but parts or all of it are not covered or you have to pay up front and seek reimbursement afterward.
Because of strong anti-abortion sentiment in the region, it’s not always clear to people where they need to go — you can’t just Google it. So doulas like Hardy fill in the gaps. There are nearly 300 of them across the country. They are not an NGO: they’re a community-based group of volunteers funding this care with their own money and money they fundraise.
We talked to Hardy about her day-to-day (pre and post-COVID) and what needs to be done to ensure everyone in Canada has access to an abortion when they need it.
Can you give us a sense of how hard it is to get an abortion if you live in Atlantic Canada?
Geography is the biggest barrier. In Nova Scotia, people generally access services in Halifax. So if you live in Yarmouth or Cape Breton, you would have to drive all the way to Halifax. In P.E.I, geography is a problem too, because the only clinic is in Charlottetown. If we’d been having this conversation four years ago, it would have been a complete lack of services on the Island. [Before the Women’s Wellness Centre opened in 2017, there was nowhere to get an abortion on P.E.I.] Then in Newfoundland, it’s even worse because the only clinic is in St. John’s. So, if you’re in Cornerbrook or Labrador, you’re going to St. John’s. It’s incredibly problematic. In addition, in all of these places, you have to find a doctor who will either prescribe Myfegymiso [which they can refuse to do] so you don’t have to go all the way to the clinic, or help you get your bloodwork and ultrasound [prior to a surgical abortion]. The idea of conscientious objection is a barrier, too. We have Catholic hospitals here who are getting public funding, but still refuse to offer [this] healthcare.
So you can’t just pick up the phone and get an abortion?
We have a self-referral line in Nova Scotia, so you can call and make an appointment at the clinic, you don’t need your doctor. But you still have to get the bloodwork and the ultrasound [from your doctor]. In New Brunswick, they still don’t cover the procedure [in clinics, only in hospitals]. New Brunswick Premier Blaine Higgs just reaffirmed that he has no plans to change how abortion is funded or not funded there. He says it’s good enough. They’re still getting [federal] funding for their healthcare program, but they’re choosing which healthcare they decide to cover. Both the Green Party and the NDP jumped on the abortion discussion when Clinic 554 [N.B.'s only clinic] was about to close, but I haven’t heard anything from them after the election. They showed up in Fredericton for a photo op
How has COVID-19 made access worse?
In Nova Scotia, because of COVID-19, more people are choosing to have medical abortions. People want to avoid hospitals. Unfortunately, we had to discontinue in-person help for four months, so we couldn’t offer rides and that definitely stopped some people from accessing abortion care in Halifax. We have resumed rides as of this week. We’ve been… offering lodgings for people who don’t have a place to go. We sit with some people while their medical abortion resolves itself. We might drop off a care package with a heating pack and some ibuprofen, some magazines, some easy-to-eat food.
What are the implications of this lack of access?
Only people who can afford it can get an abortion. This keeps people marginalized because they won’t have a choice of whether or not to become a parent. I don’t want to say that having a child is detrimental to moving forward in the world. [But] the reality is, forcing somebody to become a parent takes them out of the workforce for at least a year. It can often lead to them not going to higher education. There are clear ramifications. People who get to choose not to become a parent, because they have money, continue to work or go to school. They get to plan their life, and that means they’re going to be further ahead in the long run. But I would never want a single parent to think that I’m saying "your life is shitty because of your kids" or that the only goal is to be a cog in capitalist societies.
I think the word “forced” says it. It needs to be a choice. 
How did you become an abortion doula? 
I became an abortion doula after being a birth doula for six years. When I found out that people could not access abortion in P.E.I, it was a natural move. I took facilitator training in 2011 and I have taken curriculum studies classes, but most of my “training” is by doing it. I’ve been training people for three years. Abortion doulas provide unconditional support, and it can look different depending on what the person needs. We don’t really have shifts, and there is definitely no typical day.
How can we better support people's access to abortion?
Write your Member of Parliament. If they don’t know that it’s on people’s minds, then they’re going to think it’s a non-issue. Say the word abortion. Talk to your kids about it. Abortion fits perfectly into a consent conversation. If somebody doesn’t consent to being pregnant, then they shouldn’t be pregnant. Their body belongs to themselves, just like it does when you’re kissing or touching them. Talk to people around you about it if it’s safe to do so. If you don’t tell people your views on abortion, they’re just going to assume you’re not safe. You may not know who in your circle needs to know you’re a safe person, but somebody does. So let people know.

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