In Canada, the majority of abortions happen in the first 12 weeks of pregnancy.28 That said, ensuring access to abortion care after the first trimester is crucial for advancing reproductive health equity. Many barriers to abortion access can prevent a person from accessing care earlier in their pregnancy. Delays can be caused by:
- The lack of available services nearby
- Not having access to a transportation
- The inability to pay for travel costs or needing more time to save money
- Not having access to paid leave or the risk of losing a job if time off is taken
- Experiencing family or intimate partner abuse where the ability to make and attend appointments can be limited
People who are experiencing homelessness, severe drug addiction, who are undocumented or uninsured, or who face constant emergencies because of single parenthood, poverty, or family violence are also all more likely to have difficulty accessing timely care. People should not be denied their right to make informed and autonomous reproductive choices because of the stage of pregnancy, especially since those who have been delayed are often in vulnerable and precarious circumstances. However, these are the people who are most often denied their right to abortion and bodily autonomy when access to abortion services after the first trimester is limited.
Because of limitations to residents of certain regions, as well as overwhelming demand while being severely under-resourced, there is low availability of abortion care after 20 weeks in Canada. This increases the likelihood that those who are already vulnerable and have less resources will face increasingly complex logistical issues, more out-of-pocket expenses, farther travel distances, and longer wait-times. This in turn results in delays which increase the likelihood of being denied an abortion and therefore, being forced to carry an unwanted pregnancy to term.
In recent years, a number of hospitals in Canada have started to offer abortion services after 24 weeks. Prior to this, people in Canada had to travel to the United States to access services after that functional gestational time.
Every year, it is estimated that hundreds of people travel across the border to access services that are unavailable in Canada despite being covered by universal healthcare.29 Accessing care in the United States is still the most accessible option for many people seeking abortions over 24 weeks, though the Dobbs decision that reversed Roe v. Wade and the subsequent banning or severe restriction of abortion in over half the states has overwhelmed the points of services where Canadians travel to for care.
While provinces are required to cover the procedure costs of all medically necessary services, including abortion care, delivered outside of Canada, not all provinces have the infrastructure and processes necessary to do so. Traveling outside of Canada to access care is often limited to those with the means and ability to travel. In practical terms, this excludes undocumented people or migrants without the authorization to travel, those needing visas, people with severe mental illnesses, those who have criminal charges, many people needing to carry methadone or with severe addiction, youth, people in abusive relationships, and other vulnerable individuals.
