This essay will focus on the deliberate termination of a pregnancy. In addition, this essay will outline the history of abortion in Canada, including varying access of care across the country, the barriers and challenges pregnant women face when seeking abortion services, social stigma attached to abortions and finally the physical and psychological effects an abortion has on men and women. This paper will attempt to lay a foundation for the basic understanding of the complexity surrounding abortion services. When looking back on Canadian history, abortion practices in its varying forms ere illegal and banned in 1869.
This meant that according to the Criminal Code, it was illegal for a physician to procure a miscarriage, and/or for a woman to self- induce an abortions (Harvests, 2012 peg 14). Any woman or physician found undertaking these actions was subject to life Imprisonment (Arthur, 1999). As a consequence, such prohibition resulted In women seeking Illegal abortions, often resulting In their death. In 1 969, one hundred years after abortions were banned In Canada, Pierre Elliot Trusted and his government presented a bill In Canadian Parliament with the alma of liberalizing Canadian abortion laws. Deer the only exempt as therapeutic abortions, once passed by a Therapeutic Abortion Committee (TACT) (Arthur, 1999). A therapeutic abortion was defined as an abortion performed under the motivation to save the life of a pregnant woman, prevent harm to the woman’s physical or mental health, terminate a pregnancy which indicates that the child will have a significantly increased chance of premature morbidity, mortality or would otherwise be disabled, or to selectively reduce the number of fetus to lessen the health risks associated with multiple pregnancies (Ruche, 2004 peg 1).
An abortion could be performed at an approved hospital if the TACT, a committee compiled of three physicians, determined a pregnant woman was at risk (Harvests, 2012) The Tact’s were merely an illusion in the advancement of abortion and women’s rights. The establishment of such committees benefited physicians instead of granting women seeking abortions greater autonomy. The Tact’s by providing legal protection, essentially served the purpose of making it very difficult to prosecute lone doctors for carrying out abortions (Harvests, 2012). In addition to this, the establishment of Tact’s had some fundamental flaws that created barriers.
For example, since not all hospitals were mandated to have Tact’s therefore, not all women had equal access. Further, many of the hospitals with Tact’s were located in Montreal or large cities. Thus, for women seeking approval from Tact’s, finding a hospital with an operating TACT which would perform a therapeutic abortion often meant traveling from rural areas to the city at their own expense. In addition to the problems of accessibility and added expenses, committees often took approximately 6-8 weeks to process an application, delaying the opportunity to obtain an abortion.
Lastly, the greatest dilemma was rooted in inconsistencies in the interpretation of the law. For example, because each TACT interpreted the law differently, the “health” of a woman was used conservatively by some and liberally by others, resulting in limited and varied access to lawful abortion from town to town and from province to province (Arthur, 1999). In 1969, a pro-choice physician, Dry. Henry Mercantile opened an abortion clinic in Montreal and began performing abortions that were not approved by the Tact’s. During this time, Dry.
Merganser’s practice was considered a criminal offence. Consequently, his clinic was raided by the police in 1970 and he was charged with performing illegal abortions. In 1973, in a public statement, Dry. Mercantile declared he had performed 5000 abortions outside hospitals, thus establishing that hospitals were not necessary in carrying out safe abortions (“Canadians for choice:,” ). During 1973-1975, Dry. Mercantile was tried three separate times for challenging the abortion laws, yet he declared that it was his belief that he had a duty to safeguard his patients seeking an abortion.
Dry. Mercantile argued that he was obligated to fulfill this duty rather than uphold the law. Each time he was charged, the Jury expedited its decision, resulting in faster acquittal with each attempt to charge him. Dry. Mercantile opened up clinics across the country to challenge the abortion laws over a period of fifteen years. The Supreme Court delivered a historic statement in (R. V. Mercantile, [1988] 1 SCAR 30 at 37), the Court stated: “The right to liberty… Guarantees a degree of personal autonomy over important decisions intimately affecting his or her private life.
The decision whether or not to terminate a pregnancy is essentially a moral decision and in a free and democratic society, the omniscience of the individual must be paramount to that of the state. ” (“Abortion in Canada,” 2013). Since 1988, Canada has been one of the few countries without restrictions on abortions and it is the one of the few countries that considers a woman and her fetus, one in the same under the law. However, this recognition it is argued, has not improved access to such services; there are simply not enough providers to perform abortions. This essay will now illustrate the spectrum of access and care across Canada.
According to the national findings from Canadians for Choice, a pro-choice ND non-profit organization that helps ensures reproductive rights for all Canadians, only 15. 9% of hospitals offer abortion services in Canada (Shaw, 2006). Prince Edward Island is deemed the worst province when it comes to accessibility (Arthur, 1999). It is argued that because the Catholic Church has a large presence in this region that the government refuses to offer abortions. Yet, ironically, the government will pay for hospital abortions that are performed in another Canadian province.
However, until recently, neighboring provinces such as Nova Scotia and New Brunswick did not reform hospital abortions on women belonging to another province. As a result, women seeking abortions from Prince Edward Island were forced to travel to private clinics in New Brunswick and Nova Scotia for at their own expense. In 2005, a hospital in Halifax started to accept PIE women seeking to terminate their pregnancy, but they were able to obtain a funded abortion only if it was deemed medically necessary by a PIE doctor who then requested it be covered by the Department of Health and Social Services.
Even with this relatively recent change in regulation, difficulties still intention to present themselves, where doctor in a conservative province such as Prince Edward Island are difficult to find. Women as a result, are ultimately left feeling defeated and are deterred from seeking out assistance and support (Shaw, 2006). New Brunswick and Manitoba are tied with the lowest rate of providing hospitals at a mere 4%. Abortion in Manitoba is extremely limited with lengthy wait times of almost three weeks. It is normal for the vast majority of pregnant women to travel at least ten hours to access the only two providing hospitals in the province.
Next to PIE, New Brunswick has enforced strict abortion limitations and has one lone providing hospital in the province. In July 2006, the provincial health minister had announced that two more hospitals would begin providing abortion services after the sole hospital closed its facilities in 2005. Due to the fear of harassment from anti-choice groups, threats and violence, only one hospital openly claims they provide abortions (Shaw, 2006). A hospital that is intimidated and afraid to clearly state that it can provide an abortion is completely worthless for pregnant women.
Once a woman is anally able to find the hospital and access the correct department, she must obtain twelve weeks before gestation by a gynecologist. New Brunswick is the only province to have strict abortion policies that are lingering fragments of the archaic Therapeutic Abortion Committees (Shaw, 2006). According to the CARLA, Canadian Abortion Rights Action League, report that was released in 2003, the lone providing hospital in Equality now provides abortion services to Canadian and Aboriginals living in Unapt.
This is a tremendous development because residents were forced to travel to Ottawa or Montreal to consult for these services. Women who are passed the thirteen week gestation period still need to travel to Ottawa to terminate their pregnancy but those women who have been pregnant for less than thirteen weeks are now able to make appointments on a self- referral basis. They have to wait up to three weeks in wait times but most importantly, they do not need to leave the territory to access basic abortion care.
Ontario has the largest population compared to the other Canadians provinces and territories with 17% of its hospitals providing accessible abortion care. The majority of these hospitals are located in Southwestern Ontario, with only five located Roth of Ottawa and one along the Trans-Canada Highway. As mentioned before, this unequal distribution of facilities leaves women living further north with the accessibility issues (Shaw, 2006). Women in such regions have to travel for hours while incurring personal expenses when seeking abortion care.
In 1995, a Conservative government was elected which initiated major funding cuts for new clinics. Other factors such as hospital closures, budget cuts, and the merger of the Catholic Church with hospitals led to a decline in accessible abortion services. Ontario is also the target of many anti-choice groups, harassment, threats and lenience. Consequently, Dry. Martingale’s clinic located in Toronto, Ontario was destroyed by a bomb in 1992. Furthermore, another doctor was shot in Ancestor, while many other have been victims of threats (Arthur, 1999).
Ontario is home to three hospitals with the longest waiting times in the country. In Ontario, waiting times can span up to six weeks due to the lack of providers and access to services. Ontario hospitals also rely on patients leaving vocalism messages to book appointments and inquire about services. Many women who are seeking abortions feel that the process of leaving a vocalism message is a breach of infallibility. These women as a result, do not feel comfortable leaving their personal information and medical concerns in the form of a recorded message.
In addition, certain sensitivities result in barriers, for example, some women seeking abortions may be the victims of cruel domestic situations where they don’t have access to phones and simply don’t want their family and friends to know they are consulting clinics to end an unwanted pregnancy (Shaw, 2006) Although Ontario may fall short in some areas of abortion accessibility, it is also is the home of the leading hospital provider for late-term abortion services performed p to twenty-two weeks after gestation. There are many women, for their own due to insecurities, lack of education and accessibility (Shaw, 2006).
Quebec is the home province of Dry. Mercantile and is one of two provinces that have the highest number of abortion providers (Arthur, 1999). 24% of Quebec hospitals and Centers locals De services communications (Class) offer abortion services that are accessible to the public (Shaw, 2006). Class are biblically funded clinics that are a great add-on to their healthcare system as they provide referrals, medical services and family planning assistance in addition to abortion services. Unfortunately, the province of Quebec does have a few limitations in place regarding overnight requirements for patients that have undergone an abortion.
If a woman is seventeen weeks pregnant when she has an abortion, she must stay at the hospital for three days. This is an inconvenience for most women who are taking time off work, paying for childcare and traveling from out of the province. Also, Quebec does not guarantee that a woman traveling from out of the province will have her medical costs covered, as the province has not signed a reciprocal billing agreement. A great tribute of Quebec however, is that is that women can call hospitals directly, make an appointment themselves, and potentially obtain an abortion within 24 hours.
This result in eliminating the “middle-man” doctor, allowing for direct booking, removing the need for referrals has shortened waiting times for the procedure. Yet, because many self-referrals are done using a vocalism system, which most women are not comfortable with, it is difficult to share an emotional and personal decision with a lifeless machine. Although, advance in many other mediums, the vocalism system is en a majority of women would prefer be replaced with an opportunity to speak with an actual person.
Yet, as a whole, Quebec is a good example of how abortion services should and can be conducted in Canada (Shaw, 2006). If all the provinces and territories did manage to provide equally accessible abortion services, it is possible that the stigma that surrounds abortions would still remain. Women who seek to terminate their pregnancy are often portrayed in a negative manner. Abortion is stigmatize because it is evidence that a woman has had “inoperative” sex and is seeking to exert control over her own reproduction ND sexuality, both of which threaten existing gender norms.
It also continues to blatantly defy the nurturing mother role and the concept that women have sex only for reproductive needs (Norris , Beset, Steinberg, Savanna’s, De Cord & Becker, 2011). Each of these barriers continues to be existing societal norms placed on women in society. Abortions have been stigmatize because they are viewed as “dirty’ or “unhealthy’. Regrettably, unsafe abortions are still conducted in some countries, often where abortions are illegal. Please see Figure 1 and 2 at the end of the essay that illustrates which countries have legalized abortion.
The stigma attached to abortion has institutional influences and can be located at the abortion clinic (Kumar, Hessian & Mitchell, 2009). Clinics are often segregated and separate from other medical services. This creates lost opportunities for women to meet with other health education or awareness regarding female physiology and health concerns such as HIVE counseling, screening for cervical cancers, SIT treatments and post abortion contraceptives (Kumar et al. , 2009). The abortion clinics often employ medical personnel who display Judgmental attitudes towards women who wish to end their pregnancies.
Women tend to internalize the stigma and feel less comfortable asking their providers relevant questions concerning the procedure, health risks and are more likely not to challenge poor quality care. They often feel that they “got what they deserved” when treated disrespectfully (Norris et al. , 2011). However, after shattering the barriers that have been set by society, culture and the law, obtaining an abortion is not the end of the Journey. Many men and women are not given adequate tools to cope with the potential and lasting physical and psychological effects that abortion can have on an individual.
Simply put, abortion is a permanent experience and once performed, cannot be undone. As a result, it is normal for men and women to go through phases of anger, anxiety, helplessness, guilt, regret and for some men, emasculation. Other psychological effects include, post-traumatic stress disorder, drug abuse, increased suicidal thoughts and actions and sexual dysfunction (“Abortion risks: A,” 2011). Each person’s experience is unique and shaped by their circumstances, finances, religious and cultural beliefs but it is expected that a majority of women exhibit signs of post-traumatic stress disorder (PETS) after an abortion.
PETS is a psychological dysfunction that develops after experiencing a traumatic event and overwhelms the body’s defense mechanisms. The “fight or flight” response becomes confused and manifests its confusion in various forms. Some women have no memory of the event but feel overwhelming emotions, while others may be able to remember every detail with no emotion and finally there are some that feel profound emotions, with flashbacks of their experience. Abortion is considered a traumatic event for many reasons.
Many are forced by their significant others and/or family to abort a pregnancy. Others are victims of domestic abuse and don’t want to carry a pregnancy characterized by abuse. For victims of sexual abuse, some women have reported that the pain that was inflicted upon them by a masked stranger during the abortion is identical to rape 2(“Abortion risks: A,” 2011). Studies have indicated that eight weeks after an abortion has taken place, several women have indicated they experience behavioral changes. 6% state they have trouble sleeping, 44% complain of nervous disorders and 11% report that they visited their family doctor to receive prescriptions for psychotropic drugs (“Abortion risks: A,” 011). Psychotropic drugs are drugs that are capable of changing the mind, emotions and behaviors of an individual. Consequently, post-abortion women are more likely abuse drugs and alcohol. Alcohol abuse has been linked to Job loss, violent behavior, motor vehicle accidents, separation and divorce. There are a number of significant risk factors which have been linked to increase psychological complications following an abortion.
Some of the factors include forced termination feelings of stigma, a history of mental health prior to the pregnancy, perceived need or secrecy, being an adolescent, late term abortion and prior history of abortion (“Abortion risks: A,” 1999). There are also several physical complications that can arise from an abortion which vary from woman to woman. Some complications can occur a few hours after an abortion while others may manifest weeks, months or years later (“For women’s lives,” 23-24 ). Most studies conducted have been on short term effects.
Some short term health risks include hemorrhages, endometriosis, cervical lacerations or injury, embolisms, anesthetic reactions, pelvic inflammatory disease and even maternal death. Heavy bleeding or a hemorrhage is a common side effect of an abortion that can be the outcome of an incomplete abortion, or the failure of the uterus to contract. Endometriosis is the infection of the uterine lining that is a risk for all women but particularly teenagers who are more likely to develop the infection.
The vigorous opening of the cervix by surgical tools can cause injury and fragments of fetal bone can perforate the uterine artery leading to severe bleeding. Another common side effect is pelvic inflammatory disease (PAID) where an infection occurs in the pelvic. PAID as long term health risks such as chronic pelvic pain, reduced fertility and pain during sexual intercourse (“Abortion risks: A,” 1999). The majority of this essay has been focused on a woman’s physical and psychological concerns after an abortion but men also undergo some psychological after-effects despite the limited research that has been conducted.
A masculine identity of a strong provider can be tainted when they are unable to keep their loved ones from harm. Some men may feel emasculated when they are not allowed to exercise their role as a guardian. Typically, a relationship weakens and possibly solves after an abortion, even if the men are in favor of the abortion. Many men support and approve of receiving counseling to help them sort through their feelings of anger, isolation and grief; however there are a limited number of services and programs that are geared towards men.
This clear lack of accountability continues to further men away from acknowledging their emotions (Coyly, 2008). The various stages of seeking, accessing, experiencing and finally recalling an abortion have been outlined in this essay. The progress from illegal abortions to legalized abortion has been illustrated. Abortion care and accessibility continues to vary from coast to coast resulting in unequal care for women. In addition, the social stigma that comes with abortions or being associated with someone seeking an abortion leads to internalizing feelings of guilt, shame and regret.
Internalizing such deep emotions lead to psychological strain on both men and women. Enduring an abortion also leads to physical risks. It is with great optimism that many pregnant women hope that abortion services and care continue to advance to help lift the stigma, help women take control of their reproduction and sexuality and offer more revise geared towards men and their emotional needs and psychological concerns.
