Beth Palmer discusses the potential for improved access to abortion with Mifepristone
Last month, Health Canada approved RU-486, also known as Mifepristone or, more colloquially, the abortion pill. Canada’s approval of the drug, a safe hormonal alternative to a surgical procedure that alleviates the burden on our health care system and provides women with a simpler option for terminating their pregnancy, has been called “long overdue.” RU-486 is currently available in 57 other countries, including France since 1988, Britain since 1991, the United States since 2000, Serbia and Montenegro since 2001, Portugal since 2005, and Italy since 2009.
RU-486 is listed on the World Health Organization’s Model List of Essential Medicines, where it is the only medicine ascribed the caveat of “where permitted under national law and where culturally acceptable.” There are no national laws restricting RU-486 in Canada’s criminal code, and abortion has been available in Canadian hospitals since 1969 and in free-standing clinics since 1988, so it is difficult to make the case for any legal or cultural barriers to permitting the drug.
The approval of the drug will dramatically improve access for Canadian women to abortion services in several ways. First, RU-486 has the potential to provide abortion services to women who would otherwise lack access to those services. Though abortion is legal in Canada – meaning it is not restricted by the Criminal Code of Canada – access remains uneven. There are no laws requiring abortion service to be provided, and so some women find themselves facing substantial barriers to access. For example, geographic barriers often prevent women from accessing abortion, as many non-urban centres simply lack doctors willing to perform the procedure or they lack the appropriate facilities. This is especially true for women living in rural areas, in the north, and in provinces where there are no or very few centers that offer abortions. Women from these communities who need abortions are forced to travel extensively in order to obtain a safe and legal medical procedure.
In addition, ensuring that RU-486 is readily available without a prescription from a pharmacy or administered by a nurse practitioner could further reduce barriers to access, particularly in those areas where abortion services are limited. This is the current practice with the morning-after pill, which (with the exception of Quebec, where a prescription from a pharmacist is needed) is available in all provinces. However, at present, some sources suggest that the drug will only be available through physicians.
Canadian approval for RU-486 has been undeniably slow. Health Canada now has the opportunity to make the drug available in a way that will address identified gaps in health care provision while also alleviating the burden on our health care system. There is no reason not to follow international best practices. Health Canada should ensure that all Canadian women have access to the best quality of medical care possible.
Beth Palmer is a Director on the Board of Planned Parenthood Ottawa. @KnowPPO