One year after the New Brunswick government eliminated the last legal limit on access to surgical abortions, the situation for patients seeking these services remains complicated. Important regulatory changes have occurred since then. For example, a provincial regulation that allowed Medicare to cover surgical abortions outside of hospitals was just recently rescinded. Access to these services still hasn’t improved much at all.
Health Minister John Dornan admitted there had been no substantive change in the availability of surgical abortion services. This is the reality that has existed since the policy change. At present, only three hospitals—in two cities, Bathurst and Moncton—provide surgical abortion services. But even after these regulatory changes, no clinics beyond the scope of hospitals have opened up to leverage these new funding opportunities.
With an eye toward increasing access, Premier Susan Holt took the leap of goodwill by repealing this restrictive regulation effective November 7, 2024. Unfortunately, the response from medical practitioners has been all too tepid. Reports indicate that doctors who previously considered offering surgical abortions in their practices appear to be “less interested” than before. This drop in interest is mostly due to the increasing reliance on medication abortions instead of surgical procedures.
Mifegymiso, a combination of two pills that effectively terminate a pregnancy, is funded by the province. This approach is considered less invasive than traditional surgery. Mifegymiso is not available for patients beyond the ninth week of pregnancy. This leads to the necessity of residents in need of surgical procedures having to travel to hospitals in Bathurst and Moncton.
In the past few years, the demand for medication abortions has skyrocketed. Between 2020-21, the province covered 724 claims for Mifegymiso prescriptions. That number exploded to 1,224 last year and is projected to go over 1,300 this year. A primary care clinic in downtown Fredericton has begun offering Mifegymiso prescriptions through its team of doctors and nurse practitioners.
Despite these developments, challenges remain. Martha Paynter, a leading pro-choice activist in New Brunswick, worried that there wouldn’t be any immediate improvements in access.
“We didn’t expect there to be a new clinic right away,” – Martha Paynter
Paynter especially noted the year-over-year decline in demand for procedural abortions. He argued that it would take a lot of resources to set up a separate clinic. This feeling aligns with a growing anxiety over whether existing health care infrastructure is able to serve the needs of patients that will be pursuing a surgical abortion.
Dornan acknowledged that there is still a lot of confusion about how to access these services. He observed how lost many patients are, not knowing where to turn for assistance.
“They might not know where to turn,” – John Dornan
On its end, the provincial government is attempting to better communicate options that already exist. We’ll be rolling out a toll-free phone line in the very near future. It will ensure that patients can receive more information and support in navigating the healthcare system to access abortion care.
Furthermore, Health Minister Dornan mentioned plans to explore whether more data on patient travel to Moncton and Bathurst can be made available. This data would go a long way to shed light on how existing policy is affecting residents’ access to surgical abortions.
In her address, Premier Holt framed her government’s approach by emphasizing their continuing commitment to fair and equitable access to healthcare.
“We believe that abortion is health care and that everyone deserves access to the care that they need, when and where they need it,” – Susan Holt
Advocates like Paynter stress the importance of having more detailed and robust data. This data is critical for understanding how recent policy changes are working to improve outcomes.
“We think we’ve improved things but we really need that data … to be able to answer that in a really precise way,” – Martha Paynter
