A woman who had to drive hundreds of kilometres for a medication readily available to most Canadians at their neighbourhood pharmacy learned the hard way this winter just how challenging abortion access can be in Labrador.
After completing a school program and while looking for work, Jane — whose name CBC News is shielding for privacy and security reasons — learned that she had become pregnant.
She said the news came at a time when she and her boyfriend didn’t want a child.
“The decision at that time to terminate was the best for us, even though it was really hard,” said Jane, who lives in the Upper Lake Melville region in central Labrador. “But it also helps knowing that I know I made the right decision for myself.”
Jane’s pregnancy was less than the nine week limit put in place by Health Canada for the abortion medication Mifegymiso.
But when she phoned the Labrador Health Centre in Happy Valley-Goose Bay to book an appointment for the blood work needed for the medication, she was told the next appointment was three weeks away.
Jane did not want to wait those weeks. Instead, she decided to see a doctor hundreds of kilometres away in her hometown. She drove for the appointment and within a week, she had the medication.
Along the way, no one told her that Mifegymiso is actually covered by MCP, the medical care plan in Newfoundland and Labrador. She paid $375 for the medication.
While abortion in Labrador is as legal as anywhere else in Canada, access to it is far from straight forward.
‘I know I’m not the only one’
Months later, Jane says the fact that she had to make a long trip did not bother her. The stigma surrounding it, though, does.
There shouldn’t be a stigma around it.– Jane
Jane’s friends helped her through it but she said she didn’t know anyone who had had one.
“I felt like I couldn’t really talk to anybody who didn’t go through it because they wouldn’t understand. And I felt like I wasn’t allowed to feel guilty to be sad because it was my choice, even though it wasn’t one that I would have done the same if I was ready for a baby,” she said.
Jane said there should be a support group in the Upper Lake Melville area to help women know what to expect.
“I know I’m not the only one who’s going through this. Like I can guarantee that,” she said. “There shouldn’t be a stigma around it.”
CBC asked Labrador-Grenfell Health to disclose what information it provides to health-care staff to ensure patients know the abortion medication is covered by MCP. In response, the authority said it regularly shares information about its policies and programs with physicians.
On Wednesday, the Department of Health and Community Services issued a statement saying anyone with a valid MCP card will have Mifegymiso covered. If someone with a valid card paid for it, they can send the receipts, within a year, to the Newfoundland and Labrador Prescription Drug Program’s claims department for reimbursement.
The department also said the pharmacy where it was purchased may be able to process the claim, but it’s at the discretion of the pharmacy. It also says it will do more to ensure pharmacies and prescribing physicians are aware of the universal coverage.
‘They’re the hardest hit’
With a massive land mass — larger than the three Maritime provinces and Newfoundland put together — but a relatively small population in both coastal and inland communities, Labrador has always faced struggles with the provision of health care.
Accessing an abortion makes things that much more complicated, and solutions must often be sought far to the south, in St. John’s.
Rolanda Ryan is no stranger to helping Labrador people trying to access abortions. Ryan started working at the Athena Health Centre in St. John’s in 1999 and took over in 2010. As owner and manager, she said the clinic sees people from Labrador regularly, either through distance care or helping them travel to St. John’s.
When a person has to travel, there are often hurdles to be overcome, such as the expense of travel and the risk of cancelled flights, Ryan said.
People living paycheque to paycheque are affected the most, she said.
“They’re the hardest hit and it’s sometimes devastating,” Ryan said. “Unfortunately, I’m sure there’s been times when it just hasn’t happened, where they haven’t been able to access care”
Ryan said some immediate changes could improve access. One would be if a health provider in Labrador contacted Athena Health Centre — publicly or privately — to handle the medication requests in Labrador.
“For those who had to travel, if there was some sort of provincial funding, like earmarked specifically for travel, for abortion care, that would be a huge help as well,” she said.
Ryan said another improvement would see Eastern Health opening its hostel to patients travelling for abortion care. Ryan said the health authority had allowed patients to use the hostel for decades and only stopped such bookings about five months ago without warning.
Eastern Health told CBC News in a statement that its policy on access to the hostel has not changed, but noted that it is available to patients and clients receiving services at a Eastern Health facility. Athena Health Centre said in response that it cannot arrange bookings.
Local clinic could help access, says abortion doula
An abortion doula in Labrador West is hoping to help people through the process in her community.
Jennifer Byrne is the Labrador West Status of Women’s abortion doula, a role in which someone is trained to emotionally and physically help people through their abortion.
We need to get people talking about this topic. We need to take away the taboo of people accessing abortion.– Jennifer Byrne
Through hearing from women in Labrador City and Wabush, Byrne said not all doctors are willing to prescribe medications, although the introduction of nurse practitioners has been helpful.
Byrne, though, said more can be done.
“Ideally, in a perfect world, we would love to see a clinic within Labrador, whether that be here in Labrador West or in Goose Bay, so that people had a practical option to travel,” said Byrne.
The provincial Medical Transportation Assistance Program can help people, but it doesn’t cover the full cost of a trip, she said. No matter what stage of the abortion process a person is in, Byrne said, her services are free through the Labrador West Status of Women. She’s available even just to chat.
“This conversation has needed to happen,” she said in an interview.
“We need to get people talking about this topic. We need to take away the taboo of people accessing abortion,” she said. “The fact that it’s in the light and we’re having these conversations, I think that’s so important.”
Ryan said that in an ideal world, an abortion clinic in Labrador would be great. She said people would still have to travel but for smaller distances.
However, she said it’s “a pipe dream” because of the equipment and training needed to run a clinic.
She said hospital-based access would make more sense.
“If you had a willing provider and they had access to, you know, the hospital facility where most of the equipment is there anyway, then certainly it would be ideal,” Ryan said.
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