Inside the Battle for Better Abortion Access In New Brunswick

Angie Deveau had planned to spend Boxing Day of 2013 lounging in front of the Christmas tree with her family. Instead, she had morning sickness and found herself rushing back and forth to the bathroom. That evening, after she read her three-year-old son his favourite bedtime story, cuddled him, and kissed his forehead goodnight, Deveau took a pregnancy test. She’d already guessed what it would say: positive.

At the time she was 34 and lived in a house in Fredericton, New Brunswick. Though she shared custody with her son’s father, she was the boy’s primary caregiver and had only her part-time income as a researcher to sustain them both. She made $25 per hour, working 15 hours per week, and had all the bills that everyone does: housing, groceries, clothing, utilities, and on it went.

Being pregnant made every day a struggle. At seven weeks, she had unbearable nausea. Nibbling on saltines, she tried to work while her son napped. Most days, she had to return to her computer again at night, working into the small hours. Deveau was exhausted and conflicted about having another child. She didn’t have the time or the desire for another kid. She didn’t want a bigger family and knew that she couldn’t afford one.

The path forward was clear to her: she had to schedule an abortion. That’s when she cursed the fact that she lived in New Brunswick. In her province, making the decision to terminate a pregnancy and being able to act on it are two very different things.

Adequate reproductive health care is not uniformly available across Canada. In New Brunswick, where religious stigma against abortion is strong, it’s even harder to access. According to a 2011 Statistics Canada report (the most recent year the agency collected this data), nearly 85 per cent of the province is Christian—compared to about 67 per cent of all Canadians at that time. Here, church parking lots still fill up on Sundays. Traditionally, many in the province feel strongly that pregnancies should be carried through to term.

The province offers four places, in total, to get an abortion: three hospitals, where the cost of the procedure is covered by provincial health care, and one independent clinic, where it is not. Still, while provincial health care may cover the fees of an abortion at each hospital, it doesn’t mean the process is cost-free for everyone—or easily accessible.

Both the Moncton Hospital and the Georges Dumont Hospital are located in Moncton; the Chaleur Regional Hospital is in Bathurst, 220 kilometres north of Moncton. This means 76 per cent of the province’s population is hundreds of kilometres away from any access at all. When these people need abortions, they must take time off work and pay to travel not once, but twice: first for an ultrasound and again for the abortion itself. Add to that the costs of accommodations and potentially also child care, and the procedure is easily out of reach for many New Brunswickers, whose median income in 2015 was $28,107 after tax.

A patient may also opt to go to Fredericton’s Clinic 554. It was originally founded in the mid-1990s as the Morgentaler Clinic. The facility provides sexual and reproductive health services alongside other health care, with 3,000 patients currently on file. Under provincial healthcare laws, the clinic is not reimbursed for ultrasounds or abortions, so it charges between $700 and $800 for the procedure. In fact, New Brunswick is the only province in Canada where abortions aren’t covered outside of hospital settings.

Premier Blaine Higgs has repeatedly defended the province’s current system. “If we felt that we weren’t providing the service in reasonable manner, I mean, it would be a different story,” Higgs told The Globe and Mail in 2019 when asked why he wouldn’t extend abortion funding.

To Deveau, the challenges of getting an abortion at a hospital felt insurmountable. Without her own car, she’d have to take the bus to Moncton, 177 kilometres away, or Bathurst, 254 kilometres away. Plus, at the time, New Brunswick also required that two doctors sign off on the medical necessity of all abortions offered at hospitals. (This requirement was later lifted in 2014 and never applied to Clinic 554.) Getting an appointment with her family doctor usually took weeks. If her doctor signed off, they’d likely refer her to the second required doctor, which would take more time.

Coupled with the wait to schedule the abortion, Deveau was afraid she wouldn’t be able to have the procedure in time to meet the hospitals’ gestational limit of 13 weeks and six days. She decided her best option was Clinic 554 (then still named the Morgentaler Clinic). They were able to see Deveau right away, and her abortion was scheduled for roughly a week later, on a Tuesday. Still, she couldn’t afford the $800 fee—especially not after Christmas—and in the end, her dad loaned her the cash.

Over the years, Clinic 554 has arguably played the role of both saviour and last resort for many. It’s staffed by one full-time employee and about 10 contract staff. That it has also managed to avoid being closed down is no small miracle. Lack of provincial funding most recently drove it to the brink of closure in September 2019, when its medical director, Dr. Adrian Edgar, was forced to put it up for sale. A swell of community support, as well as small donations, helped keep it afloat—but just barely. It had to drastically reduce services over the next year. In October 2020, it was forced to cease providing all non-provincially funded services, including ultrasounds and abortions. By early 2021, Clinic 554 seemed destined to close for good.

In a 2014 Maclean’s interview, Dr. Wendy Norman, a professor of family medicine at the University of British Columbia, said her research shows 31 per cent of women over age 45 report having had an abortion at some point in their lives. It’s likely many women faced barriers in securing that right. While the procedure is common enough, abortion remains taboo and the subject of lobbying and protests by anti-abortion advocates. Politicians of all parties, meanwhile, generally prefer to distance themselves from the issue. Canada has been without an official abortion law since 1988. That year, the old laws, which required a “therapeutic abortion committee” to approve each individual abortion, were struck down by the Supreme Court as unconstitutional.

Dr. Henry Morgentaler fought for abortion rights for nearly two decades before it was legally made more accessible for Canadians. In reality, access is scarce not only in New Brunswick but in parts of every province and territory. Fewer than 17 per cent of Canadian hospitals provide abortions. Those who live in rural and northern areas, or even smaller cities and towns, must travel long distances if they want the procedure. In Alberta, Saskatchewan and Manitoba, for example, abortions are offered only in cities, even though 18 per cent of Canada’s population is rural. The Yukon, P.E.I. and Northwest Territories are home to one provider each.

Access varies so widely because health care is a matter of provincial jurisdiction. When Canada’s restrictions were struck down, the provinces were left to dole out access—or prevent it—as they saw fit. In some provinces, doctors are still able to deny care based on moral grounds. Gestational limits also vary by province. In P.E.I., the limit is 12 weeks and six days, but in specific locations in Ontario, Quebec and B.C., abortions are performed well into the second trimester. Of all the regions, Atlantic Canada is the most restrictive.

From 1988 until 2016, for example, Prince Edward Island offered no abortion services, with both the province’s government and hospitals refusing on moral grounds. People had to travel at their own cost to New Brunswick or Nova Scotia—provided they were first able to secure the necessary two-doctor referral. In 2016, advocates eventually threatened to sue the government for a violation of their Charter rights, citing unequal access to health-care services. By the end of January 2017, a reproductive health clinic had opened in Summerside, P.E.I., and the first abortions in 35 years were performed on the Island.

Meanwhile, from 1988 until now, eight different New Brunswick governments, both Liberal and Conservative, have refused to fund clinic-based abortions. Joyce Arthur, executive director of the Abortion Rights Coalition of Canada, describes New Brunswick politicians as having their heels “dug in.” Deveau wraps up her feelings on the matter in two sentences: “A few years ago, my husband got a vasectomy, and taxpayers paid for that. The onus is on women, then, to keep our legs closed.”

As a specialist in reproduction, trans health care and addiction medicine, Dr. Adrian Edgar is a firm believer in equal access to health care. His belief was solidified during time spent volunteering in Mae Scot, Thailand. There, Edgar volunteered twice at a refugee health centre, and what he experienced there committed him to this line of work. “We routinely saw people who had tried to self-abort,” Edgar explains. “If you try to obstruct abortion access, a pregnant patient will find a way to control their body, and that might lead to their death.”

Edgar didn’t set out to be a spokesperson for abortion access in the Maritimes. At 38, he is shy and soft-spoken. But he was fired up when he returned to New Brunswick in 2014 and discovered that lack of funding after Morgentaler’s death threatened to close the Morgentaler Clinic in Fredericton. Fearing Maritimers would lose access to much-needed sexual health care and could resort to self-abortion, he helped the community to raise more than $131,000. The facility was renamed Clinic 554 in January 2015, after its street number.

The clinic stands out: one side of the building is painted in the colours of a rainbow. It’s centrally located and by the river. Across the street is the Boyce Farmers Market, where many Frederictonians congregate on Saturday mornings for breakfast.

Since the clinic reduced service offerings last October, Edgar has continued to perform abortions—some are paid by the patient, and some he does for free. But he can’t keep doing it forever. For now, Edgar is taking a wait-and-see approach. In June 2021, a judge gave the green light for the Canadian Civil Liberties Association to sue the New Brunswick government. CCLA argues that the province’s lack of access is against the Constitution. (And, indeed, the Canada Health Act does stipulate that it’s illegal to make Canadians pay for their health care or to pose barriers to that health care. Abortion is included under this umbrella.) Edgar hopes the results will work out in the clinic’s favour and the government will be forced to repeal the delisting of ultrasound and abortion outside of hospital.

“People need access to reproductive health clinics that are local, in their communities, and have on-site staff who understand not just reproductive rights, but also the need for women to be reassured in their decision,” says Melanie Vautour, who works with Fresh Start in Saint John, N.B., an organization that provides housing to women and families. She and three other people volunteer many hours to help women get essential services. This includes driving to and from appointments, securing lodging for women as they undergo or recover from a medical abortion, and providing basic comforts like food and pain medication.

“We are not counsellors or social workers, but we are trying to fill that gap,” Vautour says. She worries about how desperate many women can become when that gap isn’t filled. The WHO estimates that about 68,000 women worldwide die each year from unsafe abortions. That’s about eight per hour. Edgar has repeatedly warned the province that if his clinic closes, some in New Brunswick may try unsafe methods, and people will die. There are no Canadian stats on unsafe abortion, but P.E.I. professor of psychology Colleen MacQuarrie’s research covering her province’s own access deficit suggests several self-induced abortions took place on the Island each year the province refused to provide the service.

At the end of September 2020, just before Clinic 554 reduced its services, Deveau gathered on the front lawn of the New Brunswick legislature with a group of about 30 other reproductive rights activists for a candlelight vigil. Since her abortion in January 2014, she has protested on the lawn many times. Each time there’s an election, or an added barrier to abortion—like, say, a national pandemic—the calls for better access start again, and each time Deveau is there. She doesn’t want other women to go through the same stress and uncertainty and helplessness that she did.

She is now 41, and her son is 10. Deveau doesn’t hide her activism from him; to her, it’s all about equal access to health care. They talk openly about abortion and the importance of choice. He recently chose to write a school report on the 1970s book How to Care for Your Husband and talked about how gender roles have changed since the time it was written. Deveau has now lived through 15 different governments, the Morgentaler decision and countless pushes for better access, and she says that something, eventually, has to give. She keeps going because she knows she’s not alone in her desire for better access to health care.

In some ways, things have started to give. The two-doctor approval is gone. In 2017, New Brunswick also became the first province in Canada to cover the cost of Mifegymiso, a medication containing the ingredients of mifepristone and misoprostol that, together, induce what’s called a medical abortion. The former blocks progesterone, a hormone needed for pregnancy. The latter helps empty the contents of the uterus. It isn’t a perfect solution. In Canada, Mifegymiso can be prescribed only up to nine weeks gestation.And while New Brunswick foots the bill, in some provinces it can cost up to $450.

In the meantime, the lobbying continues. Around the same time as the candlelight vigil, protesters from across the province met to demand better access. They took over the sleepy town common in Rothesay, N.B., then-health minister Ted Flemming’s district, on a sunny Thursday afternoon. About 50 people, most of them young, sporting buttons and carrying signs, camped out for hours, even as Flemming refused to speak with them. He’d barely addressed the issue at all during his term. The protest ended at Flemming’s suburban house. It was just hot enough to break a sweat on the way up the hill from the common. Each protester carried a sign. My body, my choice. One by one, they stepped up to Flemming’s door and laid their signs to rest, for him to find.

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