The overturning of Roe v Wade on June 24 has had a ripple effect on the social fabric of America. Since Roe v Wade was overturned, 13 states have completely banned abortion, while thousands of Americans continue to advocate against the Supreme Court’s decision. This justifiable outrage isn’t only prevalent among Americans, but also extends across the border to Canada.
The landscape of abortion in Canada is very different from that in the US. In 1988, the Supreme Court of Canada’s decision on R v Morgentaler decriminalized abortion across the country. The landmark case went on to gain the reputation of being the Canadian equivalent of Roe v Wade. But unlike some of our neighbours to the south, no laws prohibit pregnant people from getting an abortion in Canada, and the cost of both surgical and medical abortions is covered federally.
The central problem in Canada is access. From the long distances that pregnant people have to travel to the long wait times that often follow, access to reproductive health care is a puzzle, and Canada has yet to put the pieces together. On top of that, parts of the sexual health system in Canada and the US are still deeply interconnected, and so the US Supreme Court’s decision to overturn Roe v Wade may further aggravate the shaky foundation of abortion accessibility in Canada.
Although access to abortion has become a politically contested issue, the World Health Organization calls induced abortions “a simple and common health-care procedure.” Amnesty International also affirms that the procedure is “a basic healthcare need.” In places with a shortage or absence of safe access to abortion, pregnant people may seek out unsafe abortion procedures, leading to preventable deaths and injuries.
Issues of abortion access are issues of health care, which will directly affect universities in particular. Abortion is tied to university graduation rates: if a student experiences an unplanned pregnancy, they may struggle to complete their studies. This creates a barrier to accessing education that uniquely targets a subset of women and trans students — particularly racialized students, who face additional barriers to accessing health services.
So, it’s more relevant than ever before that U of T students can easily access the health care they need. It’s why we’ve been working on pieces like “The Breakdown: Accessing abortion as a student,” which we’re running in News this week. Abortions are time-sensitive medical procedures; in order to properly support the university community in accessing sexual health care, we all need to pitch in to make sure the pathways to this procedure are clear.
But as our reporters looked into abortion access at U of T, they ran into a wall. And then another one. And another. According to a spokesperson from the university, clinicians at university-run health clinics are, in fact, able to provide abortion-related prescriptions to students. But that information isn’t present in the university’s public-facing health care documentation. Instead, it’s buried behind directly contradictory statements from organizations that U of T students might rely upon to access sexual health care.
U of T’s pathways to abortion access are twisty and opaque, and it feels impossible to glean any information on them from the outside. And that’s a problem — especially when it comes down to such time-sensitive and stigmatized procedures, where access could have long-lasting effects on seekers’ health.
So, this week, we’re not just going to break down what U of T says it offers its students. We’re going to break down what it doesn’t do, why it needs to be doing better, and what it will need to offer if it wants to provide functional sexual health care.
Accessing abortion services
First things first — we have to define our terms. When you hear the word “abortion,” it may not always be clear what that refers to. In a medical sense, though, the term “abortion” refers to the early termination of a pregnancy.
In some cases, abortion may refer to a surgical procedure, which is considered relatively safe. Surgical abortions are permitted up to approximately 24 weeks of pregnancy, after which Canada doesn’t allow abortion. Canadians who require an abortion after 24 weeks often travel to the US — but that may change with the overturning of Roe v Wade.
However, someone seeking to end a pregnancy during the first 11 weeks can also access a medical abortion, commonly known as ‘the pill.’
Medical abortions, which involve taking a pair of federally approved medications collectively called Mifegymiso, are relatively simple to administer, and serious side effects are rare. Mifegymiso can be prescribed directly by family doctors who have undergone the requisite training. Given the additional pressures on reproductive rights and the Canadian health care system now that Roe v Wade has been overturned, the pill has become more important than ever in safeguarding access to abortion.
For university students in Ontario, abortion accessibility has come a long way. Currently, any Mifegymiso prescriptions and surgical abortions that take place in a hospital or clinic are covered by the Ontario Health Insurance Plan (OHIP). For out-of-province and international students, Ontario’s University Health Insurance Plan (UHIP) covers student medical services, including medication abortions.
Whether or not you can use the pill, however, is a time-sensitive question. Currently, the pill cannot be prescribed after 11 weeks of gestation. This creates a relatively short window of time, given that symptoms of pregnancy often may not emerge for a couple of weeks. To add to this dilemma, U of T’s framework for accessing the pill is far from transparent.
According to a university spokesperson, university clinicians, including doctors at Health & Wellness, can offer Mifegymiso prescriptions in-house through virtual and in-person appointments. In addition to prescribing the pill, Health & Wellness doctors can also refer students to non-U of T clinics where they can access a surgical abortion.
None of this information is available to students on the Health & Wellness’ page on sexual and reproductive health, or on the corresponding pages from UTM and UTSC health services. Furthermore, students have expressed frustration at the long wait times and inaccessibility of appointments at university health centres like Health & Wellness — which may represent a particular barrier to abortion access, given the time-sensitive nature of the procedure.
Additionally, miscommunication between different centres at U of T adds to the confusing and difficult process of accessing abortion through the university. Contrary to the university’s statement, the Sexual Education Centre (SEC) — a peer support and education centre for UTSG students — stated that the doctors at the Health & Wellness Centre do not provide abortion services to students and that the SEC does not refer students seeking abortions to Heath & Wellness. This inconsistent information could pose a problem to students seeking sexual health information from the university.
How U of T can improve
U of T health services can provide medical abortion prescriptions to students — that’s something that the university absolutely should be doing.
But U of T needs to streamline its system. We’re calling on U of T to make abortion a safe and transparent process for students. The university reports that it is already providing medical abortion prescriptions and surgical referrals, but there is so much more required to actually make abortion accessible for students.
Making abortion accessible means clearly stating what abortion services the university offers on its health services websites, which students are likely to visit when seeking health care.
It means providing students with a precise breakdown of the timeline and costs surrounding an abortion. It means regular outreach and feedback systems to make sure students are familiar with campus services.
It means organizing communication between offices and campuses across the university, so students can approach sexual health centres and receive consistent and accurate information about their options.
Improving access at U of T, especially, matters because, for many students, the university may already serve as the first stop for health care. Students who are not from Toronto may be seeking health care away from home for the first time at U of T health centres, and may find it difficult to navigate options outside the university.
Without an obvious gateway to find information and get access to abortion-related health care, students may encounter additional barriers that have been deliberately constructed to hinder abortion access. In Canada, there are more crisis pregnancy centres (CPCs) — which The Globe and Mail describes as “anti-abortion organizations that provide counselling and other prenatal services” — than abortion providers.
Action Canada, a Canadian abortion advocacy group, has identified 77 CPCs in Ontario — the highest number across Canada — and only 38 abortion providers. Pro-choice organizations criticize CPCs for “deceptive” practices, stating that they sometimes spread harmful myths about the consequences of abortion, and often seek to deter pregnant people from accessing abortion care.
CPCs do not always have the words “crisis pregnancy centre” in their names, so they may be difficult to identify. In Toronto, the Pregnancy Care Centre states that they “help women with unexpected pregnancies,” but also that they “offer all the support we can so that babies are not aborted.” Some students, particularly from outside Canada, may not know the difference between CPCs and abortion clinics. If faced with an unplanned pregnancy, students may waste precious time and energy navigating this confusing off-campus system.
Bolstering reproductive care access at U of T can help demystify the process of seeking an abortion, eliminate the task of traveling to off-campus clinics, and reduce the number of steps necessary to receive care. Ultimately, if U of T students know they can rely on university-affiliated primary care providers to prescribe abortion pills in a timely manner, these students will face fewer barriers to receiving the care they need and deserve.
At U of T, the SEC reports that it hasn’t seen a high number of students coming in for information on abortion — but the reason for that is unclear. Perhaps few students require abortions, or perhaps they don’t believe on-campus options will help.
This is untenable. It’s hard to navigate a confusing and uncommunicative system at the best of times, let alone during a medical emergency.
So if U of T wants to provide safe and supportive medical care to students, it’s time to step up. The path to abortion access at U of T may be like a maze, but the path to improving it is pretty straightforward. Now, it’s just a matter of demonstrating that the university cares enough about student health to take the first step.
The Varsity’s editorial board is elected by the masthead at the beginning of each semester. For more information about the editorial policy, email [email protected]