Access to abortion in Canada

Abstract

The study in The Lancet Public Health by Erin Brennand and colleagues¹ looking at abortion care in Alberta, Canada, tests an optimistic hypothesis held by many, that the 2017 implementation and deregulation of mifepristone for medication abortion would substantially improve access to care. Until 2017, abortion in Canada was almost exclusively available through procedures carried out by physicians in urban centres.² Using Ontario population-based administration data from 2012 to 2020, Schummers and colleagues³ found that after its introduction, medication abortion increased rapidly as a proportion of abortion overall. In 2019, Renner and colleagues⁴ surveyed Canada's abortion workforce and found 83% of the 465 respondents reported providing first-trimester medication abortion. Furthermore, nurse practitioners constituted 6% of respondents, and 44% of abortion in rural areas was through medication abortion. These studies pointed to the effect that medication abortion was swiftly making on practice. By 2022, the Canadian Institute of Health Information reported that 39·5% of abortion across the country was by medication.⁵ But was that effect equal across populations? Brennand and colleagues provide an overview of changing abortion care in Alberta specifically.