Almost thirty years of struggle by women for reproductive freedom ended with the 1988 landmark Supreme Court Morgentaler decision striking down the abortion law — total victory, or so we thought.

Last month, the Canadian Abortion Rights Action League (CARAL), one of the groups that fought hardest for that 1988 victory, released a report, Protecting Abortion Rights in Canada , that reveals serious threats to women’s access to abortion. The CARAL study shows only 17.8 per cent of hospitals in this country provide abortion services at all. And even among those hospitals, there can be serious roadblocks to women’s access.

Access is highly uneven across the country in violation of the Canada Health Act, which promises universality and portability. In the Prairie Provinces less than five per cent of hospitals provide abortion services. In PEI and Nunavut there is no access at all. Nearly half the provinces refuse to pay for abortions done in private clinics under health insurance.

“Abortion providers and the women they serve have become demonized by the anti-choice movement,” says the CARAL report, “and abortion has remained politicized and marginalized within our health care system — nowhere is this more evident than when a woman tries to obtain an abortion from a hospital in or near her community.”

Two-thirds of all abortions are provided in hospitals. Abortion clinics, which we had hoped would provide better access to women, have had to struggle to get fully covered by provincial health care plans and are not easily accessible to women living in rural or smaller communities. But procedures provided in hospitals have been steadily declining over the last decade as well.

The CARAL study also shows an active sabotaging of the system by anti-choice doctors and hospital staff. They found hospital staff referring women to anti-choice agencies rather than giving them information on abortion services provided in that hospital.

What women won in a very public battle in the courts, in the streets and in Parliament, we risk losing through intimidation and infiltration of the medical system by a small but determined number of anti-choice activists. The anti-abortion movement lost every legal or political battle in the 1980s. Out of frustration, a small minority resorted to harassment, violence and then in the mid-1990s someone started shooting abortion providers.

“The main problem of access is a combination of lack of willingness from hospitals to provide facilities, a lack of trained providers because universities are unwilling to make it part of med school curriculum, and current providers’ fear of anti-choice violence,” says Kate Greenaway, a medical student from Halifax and a national co-ordinator of Medical Students for Choice, a group trying to improve training for medical students in abortion procedures.

At a recent conference of Medical Students for Choice in London, Ontario, a panel entitled “Why I Provide Abortions” illustrated the problem with intimidation. Of five panellists, three were over sixty and two under thirty. Each of the older doctors had been hospital residents before abortion was made partly legal in 1969. It was their emergency room experience treating women with septic uteruses from back-street abortions that made them determined to provide abortions, despite intimidation.

When I noted the thirty-year gap in age between the older and younger doctors and asked if any doctors in between were providing abortions, the answer was a simple “No.” An entire generation of doctors has been intimidated. With older doctors getting ready to retire, the decline in abortion services risks becoming a crisis in the coming years.

There is plenty of anecdotal evidence of the declining number of abortion providers, but the only study was produced in July 2000 by the B.C. Women’s Equality Ministry showing a twenty per cent decline in doctors providing abortion since 1994. That’s the year that Dr. Gary Romalis was shot by a sniper through his kitchen window.

Women in Canada expect their right to choose an abortion is protected by the Charter of Rights and Freedoms and by the Canada Health Act. But like women in the United States who won the right to abortion thirty years ago through the Supreme Court decision Woe v. Wade, only to see access decline through relentless campaigning and harassment by anti-abortion forces, Canadian women are going to have to increase their vigilance or the victory we won fifteen years ago will quietly slip away hospital by hospital, doctor by doctor.

Judy Rebick

Judy Rebick

Judy Rebick is one of Canada’s best-known feminists. She was the founding publisher of rabble.ca , wrote our advice column auntie.com and was co-host of one of our first podcasts called Reel Women....