Monday, September 24, 2007

Why women face agonizing waits for abortions in Ottawa

By Jenn Gearey, The Ottawa Citizen
Published: Monday, September 24, 2007
click here for article


PHOTO: Morgentaler Clinic counsellor Samantha Wood says she refers four or five women a day to Montreal or Toronto to get abortions, where the wait is much shorter.
Julie Oliver, the Ottawa Citizen


In less than five minutes, Jennifer will be called in from the Morgentaler Clinic's waiting room to have an abortion. It can't happen soon enough for her: She's been waiting six weeks, watching her belly grow and feeling her hormones go berserk.

Twenty-year-old Jennifer is 13 weeks pregnant. She's been on a waiting list to have an abortion since the end of July and by now it's Sept. 11.

"The wait has been extremely straining on me and those around me," says Jennifer, moments away from the procedure. "I couldn't believe I had to wait so long. ... I became so anxious and impatient about my situation."

Jennifer, who did not wish to have her real name used in this story, is one of thousands of Ottawa women every year who believed that if they needed an abortion they could get one on demand. It's a wake-up call when they find out otherwise.

Canadians for Choice, an Ottawa-based non-profit organization that tracks the accessibility of abortion, says women in Ottawa face the longest wait times in the country for the procedure.

The average wait for abortion in Canada is an estimated two weeks, the group says. And in Toronto, a woman can usually have the procedure within about eight days. The average wait time in Ottawa is generally at least four weeks.

Patricia Larue, executive director of Canadians for Choice, says that in contrast to Ottawa, she can count at least 11 places in Toronto and 11 in Montreal where abortion is accessible -- and some clinics on a full-time basis. In Ottawa, abortion is only offered at the Bank Street Morgentaler Clinic and The Ottawa Hospital -- two days and one day a week, respectively.

Shayna Hodson, spokeswoman for the Morgentaler Clinic in Toronto, says Ottawa has a different history than Toronto on this issue.

"Looking at the history of Ottawa, it was more difficult to set up abortion facilities there than in Toronto -- there were more petitions," Ms. Hodson says. "But it's not because of a lack of will from doctors or lack of demand. The thing is, the subject is still very much taboo, so you're not going to have droves of women rallying about this because who wants to be the woman publicly saying 'I want an abortion'?"

Ms. Larue says the six-week wait time that Ottawa women encountered this summer was too long.

"By the time a woman knows she's pregnant, makes a decision on what she wants to do, and finds out where to go to get an abortion, sometimes it's too late," she says, explaining that some women have to carry their unwanted pregnancies to term as a result.

Ms. Larue says at The Ottawa Hospital, the time limit to have an abortion is 18 weeks gestation; 17 at the Morgentaler Clinic. And, she says, most doctors in Canada won't perform abortions beyond 22 weeks.

"Abortion law in Canada is unique," says Ms. Larue. "Here, abortion is a decision that's made between a woman and her doctor. There are no restrictions whatsoever. It's up to the clinic or hospital to say at what point they won't give them anymore, and at what point the doctor feels it's unethical for them."

Since some women don't have the luxury of time for a six-week waiting list, Samantha Wood, telephone counsellor at the Morgentaler Clinic, says she refers women to Montreal or Toronto, where the wait is considerably shorter.

"I would say I refer four or five patients a day to different clinics, but there's no way of knowing whether they actually follow up with them," says Ms. Wood. "To be quite frank, I think it's somewhat inhumane to make women wait -- the physical and emotional effects are unnecessary."

Ms. Wood, 22, had the procedure herself in 2005 in her second year of university. She was fortunate that she didn't have to wait as long as many others.

"I always knew what my choice would be if I became pregnant, but I was pretty naive of how the system worked before I got into the situation myself," she says. "I was extremely lucky. I only waited 20 days back then. A couple of weeks ago, the wait was the worst I've ever seen. People get pretty upset."

Summer months and just after Christmas are the worst times to need an abortion in Ottawa.

"The reason wait times go up in the summer is because the hospital's centre closes down for a month in August and they don't do any (abortions) at all during that time -- but the need is always constant," says Ms. Larue. "After Christmas isn't as bad because they only close for two weeks."

One Ottawa abortion doctor, who asked to remain anonymous to prevent harassment and threats, explained some of the dynamics of having an abortion at The Ottawa Hospital's Women's Health Centre. Women who opt to go there, she said, are sent to the hospital's birthing ward for a pre-abortion ultrasound, where they sit with expectant mothers and posters that read "Congratulations on Your Baby."

The Ottawa doctor says there are better alternatives, but she feels proper access to abortion is being ignored.

"Abortion just doesn't get any attention anymore; people think it's solved and not an issue," she says.

She says that with only two abortion clinics operating part-time in Ottawa, the city is still expected to perform abortions for women from the Valley, Belleville, and even Kingston to some extent, since there are no doctors there who are able to perform abortions over 14 weeks -- Ottawa takes in women from Nunavut for the same reason.

"After 12 to 14 weeks, the procedure changes," says Ms. Larue. "So a GP wouldn't be able to do it anymore, they'd need to have surgical training."

Overall, abortion actually appears to be on the decline in Canada, although only slightly. In 2003, the most recent year for which statistics are available, 103,768 abortions were performed in Canada, down almost 1,500 from 2002 and down 2,500 from 2001.

But in Ottawa, abortion doctors and facilitators say they are frustrated that they can't provide the abortion services they say women need.

Since The Ottawa Hospital independently decides how many abortions its doctors will perform every year, the issue rests with its board. A spokeswoman for the hospital said board members would not comment on that decision-making process.

In the case of the Morgentaler Clinic, it's up to the Ontario government to decide how many abortions it can perform -- based on the funds it's willing to give the clinic.

"Every year I apply for more money and every year I get a letter saying I'll get exactly the same amount as I did the year before," says Joan Wright, manager of Ottawa's Morgentaler Clinic, who said she wishes the clinic could operate on more than a part-time basis.

A.G. Klei, spokesman for the Ontario Ministry for Health and Long-Term Care, says the ministry provided enough money for the clinic to perform 2,350 abortions this year.

"Last year, the Morgentaler Clinic requested increased funding for its services that was not approved at the time, but they can continue to request in the future," says Mr. Klei.

But while additional funding for an existing abortion clinic has been turned down for the Morgentaler Clinic, the ministry says there's another reason behind why there are so few clinics in the Ottawa area.

"There have been no other applications to the ministry from interested groups wanting to obtain an abortion clinic licence in Ottawa," says Mr. Klei.

Ms. Hodson says she can't understand why the ministry would consider funding new abortion clinics, but not increase funds for an existing one to deal with the shortage of abortion services in the city.

"Why not expand the existing clinic, which has a great reputation, an excellent safety record, already established infrastructure and overhead, rather than spend taxpayers' money on a new one? It's all circular talk when you break it down."

Ms. Wright is also skeptical.

"If you ask the government for more money for abortion you get kicked," she says. "Health care is dying and (Dalton) McGuinty isn't going to 'up' the money for abortion -- that would have people screaming. And the government certainly doesn't want that during an election ... so it falls between the cracks."

When asked about lengthy abortion wait times in Ottawa, Ben Chin, spokesman for the Ontario Liberal Party, says the party's focus is on hospital lineups: for cardiac procedures, cancer, MRI/CTs, hip and knee surgery, and cataract procedures. He also said the party would work toward wait-time progress for emergency room visits, children's surgery and general surgery. There is no mention of abortion in his response.

When asked the same question, Mike Van Soelen, spokesman for Ontario Progressive Conservative leader John Tory, also responds without mentioning abortion.

"It's shocking that Ottawa is lagging behind provincial wait time averages in many areas--everything from hip replacement to cataract surgery," says Mr. Van Soelen. "Ottawa is the province's second largest city and the premier's home town. Health care has to do better."

As it is, there is no shorter wait time in sight for abortion in Ottawa. And there appear to be several other factors that contribute to that.

"A lot of doctors who fought along with Dr. Morgentaler are now retired and there simply aren't as many people doing abortions now," says Ms. Larue. "These days it's hard for medical students to get access to learn how to do the procedure. Often, they have to fight for it."

To reduce wait times for abortion procedures and accommodate more women, Ms. Wright suggests that in the future an alternative may be drug-induced abortions, which can be done in a general practitioner's office. Surgical abortion is the dominant method of abortion in Ottawa and Ms. Larue says that only one doctor in the city performs drug-induced abortions.

Abortion doctors in Ottawa, meanwhile, aren't optimistic for the future.

With a deteriorating health care system, they recognize that abortion surgery is not on a high-priority list, which leaves women like Jennifer no choice but to wait through an unwanted pregnancy for sometimes months, trying to ignore the physical and emotional signs that just won't go away.

© The Ottawa Citizen 2007

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