TORONTO — The Women’s Health Clinic of Winnipeg is stretched thin. The facility is one of a handful of abortion clinics in Manitoba, a Canadian province of 1.3 million people. It fields about 100 inquiries each week and says it provides up to 30 percent more abortions than it receives government funding. Even before the US Supreme Court struck Roe v. WadeThe nearly 50 years of precedent protecting abortion rights throughout the United States, some of these abortion investigations came from Americans. Now the clinic — 70 miles from the North Dakota border, where an activation ban goes into effect this month — is watching more. “It’s too early to tell” if inquiries from Americans will increase and by how much, said Blandine Tona, the clinic’s director of programs. But even a small number could tax the clinic, “so one of the things we do is organize, prepare,” including considering whether to offer abortions more days each week. Prime Minister Justin Trudeau and other Canadian leaders have condemned the US Supreme Court ruling. His administration has said it won’t turn away Americans who can’t get abortions at home. But with long distances between many clinics, providers were limited, and barriers to cross-border travel, this may not be much of a solution. Abortions are now banned in these states. See where the laws have changed. Canada decriminalized abortion in 1988, and abortion rights draw widespread political support here. However, although access has improved over the decades, it remains limited outside major metropolitan centers and depends on the individual’s ability to travel. “We’ve supported people where the nearest abortion provider is several days’ drive away,” said Jessa Millar, who manages the sexual health and rights hotline for Action Canada. Some Women’s Clinic patients travel to Winnipeg from Kenora, Ontario, about 130 miles away. TK Pritchard, executive director of the Shore Centre, which provides medical abortions in Kitchener, a city in southwestern Ontario, said he has clients from northern Ontario. He makes appointments for three to four weeks. The center has received calls from a small number of people in Michigan since the rollover Roe who are curious about abortion access in Canada, Pritchard said, but “are not being heard from people who actually want to make an appointment.” “One of the challenges we have is that … it’s really hard to try to keep up with the demand that’s already there,” Pritchard said. When abortion pills became commercially available here in 2017, there was hope that they would help improve access, particularly in remote and rural areas. But advocates say it’s still patchy. “Most family doctors won’t prescribe it and will just refer to an abortion clinic,” said Mohini Datta-Ray, executive director of Planned Parenthood Toronto. Jill Doctoroff, executive director of the National Abortion Federation of Canada, said about 600 people have signed up for her training on prescribing the abortion pill since it was launched in April 2021. Last weekend, after the Supreme Court’s decision US Court, 70 people signed up. “What it shows is that one of the effects of the decision is that people recognize that there are access problems in their country and that they wanted to be able to do something,” he said. Canada’s Trudeau will take on Pence’s crackdown on abortion in the US Several states bordering Canada have banned abortions or will soon. In other border states, such as Michigan and Montana, the status of abortion rights is uncertain. Even if access to Canada were improved, advocacy groups said, there are other barriers — including the need for a passport and the cost of the process, which could be as high as $600 — that would likely prevent Americans from crossing the border and would make them more likely to travel to other US states. Those costs “would put it out of reach for many Americans,” said Joyce Arthur, executive director of the Abortion Rights Coalition of Canada. “It’s still early and we don’t know how it’s going to go.” There were more than 74,000 abortions in Canada in 2020, according to the Canadian Institute for Health Information. Most abortions in the country are performed during the first trimester of pregnancy. Each province and territory has different gestational limits for medication and surgical abortions, as well as rules governing if and when parental consent is required. Is the US a liberal abortion hotbed, as the Supreme Court opinion says? In Prince Edward Island, where government policy kept the island abortion-free for more than three decades until 2017, surgical abortions are not provided after about 12 weeks. Islanders are often referred to in other Atlantic provinces, including neighboring provinces New Brunswick, where the procedure is only covered if performed at one of three hospitals. Abortion after 24 weeks is limited in Canada, sending a small number of people to the United States each year — cross-border travel that advocates worry could be jeopardized by the court’s decision. Analysts and advocates are watching for other potential cross-border ripples, particularly as some federal and state lawmakers signal intentions to prevent women from getting abortions in other states, punish out-of-state doctors or stop the flow of abortion pills by making them illegal to mail. What if these bans were extended to other countries, or if people prosecuted for obtaining or providing abortions in the United States sought refuge in Canada? A key test under Canadian extradition law is “double criminality” — whether the conduct for which someone is wanted is also illegal in Canada. Since neither obtaining abortions nor prescribing the abortion pill is illegal in Canada, such requests are unlikely to meet the test, said Robert Currie, a law professor at Dalhousie University in Nova Scotia. However, in some cases, he said, the dual criminality analysis could involve “carrying over” the US legal framework. In a case in which prosecutors tried to extradite a Canadian who prescribed the abortion pill to an American, “we can imagine the court saying that the ‘gist of the offense’ was selling prescription drugs in a market where it was illegal to their sale. Currie said, “and the fact that it was an abortion drug is just ‘background.’ “That could be a major issue.” Abortion decision in US prompts cheers, horror abroad The Supreme Court of Canada decriminalized abortion in the 1988 case R.v. Morning Tales. “Forcing a woman, under threat of criminal penalties, to carry a fetus to term, unless it meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with the woman’s body and, therefore, a breach of security of the person”. the court said in a 5-2 decision. The decision did not establish the right to abortion in Canada, and there is no federal law enshrining it. Before the decision, abortion was limited to those who received approval from an “abortion therapeutic committee” of doctors at an accredited hospital. A majority of the panel had to agree that continuing the pregnancy “would endanger or be likely to endanger [the woman’s] life or health”. Some hospitals did not have enough doctors for a committee. Others saw only patients who lived in a certain geographic area or imposed quotas on the process. All other abortion providers, or the women who performed them, faced criminal penalties. A Canadian woman crossed the border for an abortion. In 1984, more than 3,480 Canadians obtained legal abortions in the United States, according to a Statistics Canada report at the time. In the trial at R.v. Morning Talesthe director of a women’s health center in Minnesota testified that many Canadian clients experienced delays at home. Arthur, of the Abortion Rights Coalition of Canada, noted that the story. “The clinics have been very welcoming and I know there is expression up here that the tables have turned now,” he said. “We want to help the Americans who come here. We want to give back, but also recognize that it’s going to be a challenge for us and we’re not going to be able to help as many Americans at the end of the day.”
