Saskatchewan

Snapshot

%
urban points of service |
%
rural points of service*
The Nova Scotia Centralized Abortion Network (NSCAN) can refer patients to primary care providers who can prescribe medication throughout the province, including in rural areas and through telemedicine. Primary care providers are not captured in Action Canada’s directory.
%
urban points of service |
%
rural points of service
66
% urban population |
34
% rural population*
Urban refers to census metropolitan areas and agglomerations (CMAs and CAs) in Canada. Rural refers to areas outside of CMAs and CAs
People living in the Kitikmeot region of Nunavut can also access abortion through the Northern Options for Women program.
4 points of service per 248,410 women of reproductive age
*
Women, aged 15-49 (reproductive age as defined by the WHO). Source: 2021 Canadian census. Not all people who can get pregnant are women, but the data available only includes two gender categories.
5
crisis pregnancy centre(s)*
Crisis pregnancy centres (CPCs) are anti-abortion organizations that present themselves as clinics or counselling centres.

Data from the Abortion Rights Coalition of Canada.

Access Overview

4
publicly listed point of service*
publicly listed points of service*
(both medication and procedural abortion offered)
Data on the points of service, which includes clinics and hospitals that provide abortion care, are gathered from Action Canada’s directory. These numbers are up to date, but do not include all primary care providers who prescribe medication abortion.
3
point(s) of service for medication abortion
3
point(s) of service for procedural abortion
Functional gestational limit of
18 weeks and 6 days
Functional gestational limit of
18 weeks and 6 days
*
Only 1 point of service offers abortion up to 18 weeks + 6 days in Saskatchewan.
No centralized system to assist the public in connecting with abortion services
Information about abortion is available on the
provincial/territorial website
Information about abortion is not available on the provincial/territorial website

Medication abortion

Cost coverage

Mifegymiso is fully covered for Saskatchewan residents with a valid health card.

Billing code

Billing codes are used by physicians to bill provincial/territorial health insurance plans for the different services that they provide. When there isn’t a billing code for medical abortion, physicians can be de-incentivized from providing it.

Saskatchewan's Physician Payment Schedule includes a billing code for medical abortion.

Telemedicine

Saskatchewan has billing codes for telemedicine in the Physicians’ Payment Schedule. Telemedicine abortion is offered by Saskatoon Sexual Health, the Saskatoon Community Clinic, and Regina Women's Health (occasionally).

The College of Physicians and Surgeons of Saskatchewan has established comprehensive practice guidelines for virtual care during the COVID-19 pandemic as well as a Practice Standard for Telemedicine. The Practice Standard states that the College can offer telemedicine licenses for out-of-province physicians wishing to provide services to Saskatchewan residents.

Telemedicine abortion has been found to be as safe and effective as medical abortions provided at clinics. Because telemedicine abortion allows patients to access care in their homes and often requires just one trip to a pharmacy or clinic, expanding its availability is critical to improving abortion access for people who live in rural communities, who can’t take time off work to go to appointments, or who are at risk of stigma or discrimination.

Legislation, policies, and regulations

1984: Regulation 84-20 is enacted

This regulation, initiated by the province’s Liberal government under Premier McKenna, prevented abortion from being covered by the provincial health care funding unless performed in a hospital by a specialist, and only after two doctors certified that the procedure was medically required. Clinic abortions were already prohibited under a private act, the New Brunswick Medical Act, which regulates the medical profession.⁷

1994: Morgentaler opens an abortion clinic in Frederiction

The McKenna government responded to the clinic opening by amending the Medical Act to include an offence provision that would find physicians guilty of professional misconduct if they were involved in performing an abortion out of a hospital setting approved by the Minister of Health. Immediately upon opening the clinic, Dr. Morgentaler’s medical license was suspended by Order of the Council of the College of Physicians and Surgeons for performing abortions outside a hospital, relying on sections 56(b.1) and 56.2 of the Medical Act.⁸ Morgentaler immediately challenged the constitutionality of the amendment.

Relying on the Supreme Court decision in R. v. Morgentaler (1993), the New Brunswick Court of Queen’s Bench found the impugned sections of the Act to be unconstitutional as they were beyond the jurisdiction of the New Brunswick legislature, and concluded that the legislature sought to prohibit abortions outside hospitals “with a view to suppressing or punishing what [it] perceived to be the socially undesirable conduct of abortion.” The court took into consideration the fact that the amendment dated from a point in time when abortion was considered a criminal offence. The court also stated that the creation of the amendment was not in the interest of ensuring the highest quality of care for women in the province, but that it was designed to “prohibit the establishment of free-standing abortion clinics and, particularly, the establishment of such a clinic by Dr. Morgentaler.”

The decision was upheld on appeal to the New Brunswick Court of Appeal, and leave to appeal to the Supreme Court of Canada was denied. Dr. Morgentaler’s license was reinstated and his clinic was permitted to remain open. The regulation was removed, but reinstated later into the Medical Services Payment Act, with the punishment for doctors no longer included.⁹ The exclusion of clinic-based abortions from Medicare remained in place for the entire time the Fredericton Morgentaler Clinic was in operation.

Dr. Morgentaler brought an action in 2004 challenging the legality of Regulation 84-20 that sought a declaration that Regulation 84-20 not only violates the Canada Health Act, but also is unconstitutional in that it violates rights guaranteed by sections 7 and 15 of the Charter.¹⁰ The province engaged in delay tactics for several years, challenging Dr. Morgentaler’s standing to even bring the case. Finally, the Court agreed in 2009 to grant Dr. Morgentaler public interest standing to bring his legal challenge. The Court found that there was a serious issue to be tried and that, while there were other classes of persons more specifically affected by this regulation, (namely patients who had undergone abortions at Dr. Morgentaler’s Fredericton Clinic), that there are many valid reasons why patients would not or could not bring this challenge and that Dr. Morgentaler was therefore “a suitable alternative person to do so.” However, by then, Dr. Morgentaler had exhausted his financial resources. Coupled with his advancing age, he decided not to continue with the suit.¹¹

In 2014, Liberal Premier Brian Gallant promised to remove all barriers to abortion in New Brunswick by amending Regulation 84-20, and removing the requirement that the procedure be conducted by a specialist after the certification by two doctors that the procedure was medically necessary. He did not remove the requirement that surgical abortion can only be funded by the province if conducted in a hospital.¹²

Access to abortion for minors

The Health Care Directives and Substitute Health Care Decision Makers Act states that anyone 16 years of age or older who has the capacity to make a health care decision may make a directive. The act doesn’t provide guidance on medical decision-making by minors under the age of 16, which means the mature minor doctrine would apply.¹ This means that a minor who can understand and appreciate the nature, purpose, and reasonably foreseeable consequences of a proposed medical treatment and its alternatives/refusal can give valid legal consent.

Bubble zone legislation

Bubble zone legislation aims to prevent anti-abortion protestors from harassing people within the vicinity of a facility that provides abortion care. Even though criminalizing individual people will not effectively curb the larger anti-abortion movement, these laws can be effective in deterring anti-choice protestors from harassing providers and patients entering and exiting abortion clinics.

There is no bubble zone legislation in Saskatchewan. However, federal Bill C-3, which makes it illegal to intimidate healthcare workers and patients or obstruct them from providing care or seeking treatment at locations where healthcare services—including abortions—are delivered, applies.

Belief-based care denial

Although abortion is an essential medical service, physicians and nurse practitioners can refuse to provide abortion care due to their personal beliefs under current legislation and policies set by regulatory bodies. This practice is often referred to as “conscientious objection,” although a more accurate term may be “belief-based care denial.”

Physicians

The Saskatchewan College of Physicians and Surgeons’ Guideline: Unplanned Pregnancy states that “any physician who is unable to be involved in the further care and management of any patient when termination of the pregnancy might be contemplated should inform the patient and follow the requirements of the College’s policy on Conscientious Objection,” which directs physicians to provide patients with full and balanced health information required to make legally valid, informed choices about medical treatment. The wording of the Unplanned Pregnancy Guideline and Conscientious Objection Policy suggests that an effective referral from the objecting physician is not required, since providing information to the patient is offered as an option.²

The Unplanned Pregnancy Guideline indicates that the physician will fully inform the patient of the options they may pursue and provide them with accurate information relating to community agencies and services that may be of assistance. It further indicates that the physician should inform the patient of the availability of abortion services in the province, or elsewhere, in accordance with any current law or regulation governing such services, and should ensure that the patient has the information needed to access such services or make the necessary referral. According to the guideline, the patient should be provided the information regarding the nature of termination options, to the best of the physician’s ability.

Saskatchewan’s Conscientious Objection Policy states that objecting physicians must “make an arrangement” for the patient to receive information or care from another physician. It also states that the physician must continue to provide care to the patient until the new provider assumes care of the patient. The wording of the policy enables the physician to avoid referring the patient for further care. Further, the requirement to give “full and balanced health information” is subjective, in that the physician may give inaccurate or incomplete information to the patient.³

Nurse practitioners

The College of Registered Nurses of Saskatchewan has Practice Standards for Nurse Practitioners that utilizes the principles in the Canadian Nurses Association’s Code of Ethics for Registered Nurses for professional judgement and practice decisions. The Code of Ethics obligates nurses to notify their employers or the patient receiving care in advance so that alternative arrangements can be made in cases of conscientious objection.

Further, the College released a resource called Ending the Nurse Practitioner-Client Relationship in 2023 that states it is not appropriate to end the nurse practitioner-patient relationship if the patient requests access to a service or seeks treatment the Nurse Practitioner has a conscientious objection to.

Out-of-country medical policy

In some instances, patients may have to travel outside of the country to receive abortion care currently not available in Canada.

Saskatchewan’s Health Benefits Coverage includes out-of-country coverage for patients referred for insured health services not available in Canada, as outlined in The Saskatchewan Medical Care Insurance Act.

A specialist must seek prior approval from the Medical Services Branch of Saskatchewan Health in order for a patient to be eligible for coverage. If approved, coverage includes the full cost of treatment at a rate that the Saskatchewan Ministry of Health considers “fair and reasonable” after taking into account the location where the insured service is provided.

Travel support

The costs of travel, accommodation and meals to access medical services are not covered under Saskatchewan’s health system.

court cases on abortion

No cases found.

References

¹ Department of Justice Canada. (2023, February 2). Article 12 of the Convention on the Rights of the Child and Children’s Participatory Rights in Canada. Department of Justice. https://justice.gc.ca/eng/rp-pr/other-autre/article12/p3a.html

² Canadian Policies and Laws on “Conscientious Objection” in Health Care. (2023b, August). Abortion Rights Coalition of Canada. https://www.arcc-cdac.ca/media/position-papers/95-appendix-policies-conscientious-objection-healthcare.pdf

³ Ibid

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