Research Summary
Trials and Trails of Accessing Abortion in
PEI[1] (Executive Summary)
Reporting on the impact of PEI’s Abortion Policies on Women, January
2014
Colleen
MacQuarrie[2], PhD, Associate Professor
and Chair Psychology Department, UPEI
Jo-Ann MacDonald,
PhD, Associate Professor School of Nursing, UPEI
Cathrine
Chambers, M.Ed., PhD
student, Institute of Women’s Studies, University of Ottawa
Purpose: How have women living in PEI been affected by PEI’s abortion policies?
Provincial
billing records in the period 1996 to 2013 show illegal abortions are a factor
in women’s health concerns (Lewis, 2014). Our project extends this
understanding. We get underneath the numbers to expose the implications of the
policies on access to abortion in PEI.
We
used participatory action research methods to understand the various impacts on
women’s lives of PEI’s abortion policies. We have conducted 45 research
conversations[3]
ranging between 1-2 hours in our community to document the experience of trying
to access abortion services in PEI. We spoke with women who have tried to
access abortion and with friends, family, professionals, medical personnel, and
advocates who have tried to assist women. Participants often filled various
categories, however 22 participants had personally sought abortion services
between 1979 and the present day.
Using
qualitative approaches, the researchers and the project advisory group analyzed
the data for themes to communicate the impact of PEI’s abortion policies. The
findings were taken to feedback focus groups with participants to verify the
interpretations.
Results
& Discussion
There were 3 main findings in the
project with several subthemes for each. The data structure is depicted in
Figure 1 along with exemplary quotes for each finding.
The
first main theme concerns the PEI context for the research and depicts the
various information and resource barriers that women experienced depending upon
the year of their abortion. Subcategories for this elaborated on the
anti-choice structures operational within the province which sought to entrench
silence around the concept of abortion.
The
second organizing theme concerns the patterns of access to abortion services
which were characterized as a maze of intersecting trails. The maze had 4
intersecting trails which characterized several barriers that threatened to
entirely block their access to a safe abortion. The barriers consisted of both
information and resource barriers. Trail 1 is the “Surgical Abortion Paths
through the Public Health System”; The “Medical Abortion Path” is an off shoot
of this. Trail 1 has multiple loops connected to the other paths. Trail 2 are a
number of “Dead End Paths” which cross other trails and serve to deter the
woman from her goal. Trail 3 are the attempts to “Self (Harm) Induce at Home
Paths”. Trail 4 are the “Self Referral Surgical Abortion Paths Outside the
Public Health System.”
The
third organizing theme was to reorient the oppression of women in the denial of
access to safe abortion services as a political issue. Participants spoke about
the intense resilience and fortitude they required to navigate the oppressive
structures in search of bodily autonomy but also how access to reproductive
justice was fragile. Some women were eloquent in how their families held coercive
power to enforce their idea for abortion when it was not an idea the woman
wanted at the time. A salient point is that all participants in the project
were adamant that reproductive justice was absent from PEI and they were
participating so that women’s bodily autonomy could be conserved and their
constitutional rights embraced.
Figure
1: Thematic structure of the impact of
PEI’s abortion policies on women
|
|
PEI Context
Anti-choice structures
Silencing
the concept of abortion
Self Silencing
|
…people
who have the money, and can go over (Mainland for an abortion) say, “Yeah,
I’d prefer to do that, because it’s more private,”…, but there are some
people who don’t have that option, and those are the people that are probably
the most desperate (P28)
|
Maze Trail 1: The Surgical Abortion Paths
through the Public Health System
Abortion outside of a hospital:
medical abortion
Maze Trail 2: The Dead End Paths
Carried
unwanted pregnancy to term
Unsupportive doctors
Unsupportive Family and friends
Intimate Partner violence
Outcomes
of Dead End Paths
Adoption
Maze Trail 3: At Home Paths
Desperation
& Self inducing practices
Maze Trail 4: Self Referral Surgical
Abortion Paths outside the public health system
|
I looked into abortion and seen
how much it was going to cost and that I would need to find a way to Frederiction…I
couldn't find a way to without telling like my parents that, "hey, can
you take me here cause I need to get an abortion" Like I didn't have my
vehicle or my license or any money. So now I have a five year old (P6)
he's
been my OB-GYN every time I had my kids and so I called and asked, and she
just said we, we deliver babies not kill them - I was just like oh my god
(P29)
Just
things like—thinking about walking out into traffic, like, “Maybe if I just
cross onto this jaywalk, maybe I’ll just get hit.” Or fall down the stairs in
my house—I’m on the third floor of my apartment building. But I didn’t want
to hurt me. I just wanted to be out of the situation I was in. [crying] (P30)
|
Political Issue: Women’s Resilience and
Strengths Developed
Resilience
Persuaded by Family- limited
options
|
I’m definitely stronger for it
now, I think. Since I went through that, I kind of feel like I can get
through anything. At the time, for a while, I felt very weak. Yeah. (P23)
|
Taken
together, the first voice accounts and the advocates’ stories described the
situation in PEI in recent historical and present day contexts. This
understanding will continue the feminist project of promoting women’s health
and will be used to inform and influence abortion policy in PEI in particular
and to address reproductive justice policy in general.
Conclusion
Equality
requires reproductive justice. In fact, equality cannot exist without
reproductive justice. More than two
decades after women in Canada gained better access to abortion services, women
in PEI witnessed their access diminish. This project has illustrated that diminished
access is coexistent with unsafe practices and risks to women’s health. All
women who participated in the project encountered some barriers and many
experienced access to abortion as a needlessly complicated and intensely
punishing regime; some were totally blocked so they are currently parenting
children they did not want and others self-induced through painful procedures
at home. All women were later in accessing their abortion than they wanted,
sometimes delaying while funds could be scraped together. Health and financial
costs were ubiquitous with the delays to access and hurdles to be jumped. Most
expressed frustration with their lack of personhood in PEI and all offered
ideas about how to change the system for the better.
At
a minimum, women in the project expressed hope for future generations to have
improved access to abortion as part of a reproductive health program. It is no
longer a question of whether we should provide safe access, but how? The first
recommendation from this project honours that hope.
Recommendations
Local
access matters. We recommend the
Minister of Health establish a Reproductive Justice Task Force to implement
changes to systemic barriers and to create local access to safe surgical
abortions. Our research illustrates the WHO finding that restrictions on
abortions do not reduce abortions, they reduce safety. Public policy must
address local access to safe surgical abortions in keeping with the Canada
Health Act and women’s constitutional rights to autonomy of the person. The
most innovative approach in this regard is through a coalition of government
policy and decision makers and community advocates and researchers involved in
reproductive justice options. Involving non-governmental bodies as well as
professional associations connected to abortion care in the action group will
improve the process of collaboration and integration into health structures and
regulations. A systematic approach to addressing the various existing barriers
to access and placing a time line to this work is important.
Women’s
safety is at risk where physicians turn them away from abortion care without
referral. We recommend proactive action by The PEI Medical Society to redouble
its leadership role in this regard.
Other health care providers and technicians are also implicated in
women’s access experiences. Professional associations such as the Association
of Registered Nurses of PEI as well as professional bodies regulating
radiologists need to communicate ideals of non-judgmental care in women’s
abortion decision as an ethical standard. Violations of the ethic should have
consequences for professionals. We recommend professional associations take a
lead in ensuring women’s access is not blocked, marred, nor otherwise hindered
by their members.
Eliminate
silence and stigma. Our research excavated the pain of our community’s
stigmatization of abortion as a woman’s choice.
The intense silencing of abortion needs to be addressed in creative and
inviting ways. An enduring and sustained series of community events to support
and to empower women’s reproductive choices would undermine the stigma and
address some of the silence. Finding community outreach possibilities is the
purview of the community. Strategic funding from government as well as
non-governmental agencies can facilitate community mobilization projects to
address abortion stigma.
[1] Funding
for this project from the University of Prince Edward Island Office of Research
and Development Major Research Grant
[2] Copies
of the report can be obtained by contacting the first author, Dr. Colleen
MacQuarrie, by mail: 203 Memorial Hall UPEI, 550 University Ave. Charlottetown,
PEI, C1A4P3; or by email cmacquarrie@upei.ca; or by visiting this site:
http://colleenmacquarrie.blogspot.com/2014/01/research-report-understanding-for.html
[3] Our
project owes a debt of gratitude to the many women and their allies who spoke
eloquently and passionately about their abortion experiences. Your candor has
added immeasurably to our work and to the vision of women’s reproductive
justice in PEI.
