New Brunswick health authority says ‘no need’ to increase abortion services

New Brunswick’s English language health authority says its current level of abortion service is adequate.

A letter sent by Horizon CEO Karen McGrath to the province’s deputy health minister says that demand for surgical abortions at their Moncton clinic are falling and that they aren’t receiving requests for abortion services elsewhere, other than in the Fredericton area.

But an offer to a physician for surgical time at the Oromocto Hospital to provide surgical abortions for the region was “not pursued.”

“Based on this information and given that we have no received any recent request to establish a surgical abortion service in Fredericton, Saint John or Miramichi, it is our position that there is no need to establish another service,” McGrath wrote in the letter obtained by Global News.

“The Moncton clinic sees a stable volume of referrals and has been able to meet the service demand. We will continue to monitor this situation and we will open discussions with our physicians and nurse practitioners to determine if access to abortion services requires modification.”

Health minister Dorothy Shephard had previously said that it is up to Horizon and Vitalite to assess whether greater access to abortions services is needed. Surgical abortions are only available at three hospitals in the province, two in Moncton and another in Bathurst.

“Our position has always been, and we’ve been very public about it, that the (regional health authorities) are responsible to deliver the health-care services in this province, to deem whether or not they are appropriate,” Shephard said in question period on June 2.

“That is their responsibility. They will deliver the services as they see they need.”

1:58 N.B. health minister says abortion access is responsibility of health authorities, not province

Clinic 554 in Fredericton had been performing surgical abortions, but is all but closed. The clinic is still performing some abortions, but the family practice is no longer seeing patients and is up for sale.

New Brunswick is the only province in Canada that does not fund surgical abortions performed outside of hospital. Premier Higgs has said that doing so would create a two-tier health-care system.

The federal government says that the province’s unwillingness to fund out-of-hospital surgical abortions is a violation of the Canada Health Act. The Canadian Civil Liberties Association has launched a legal challenge based on the offending regulation that prevents out-of-hospital abortions from being covered under Medicare.

Reproductive rights advocates say they are puzzled by Horizon’s statements and that abortion access in the province remains limited.

“We know that actually there have been many requests for expansion of service,” said Tasia Alexopoulos, a national spokesperson for the Abortion Rights Coalition of Canada.

“I’m quite confused by the letter, I’m quite disappointed and I think that it doesn’t speak to what’s been happening in the province for decades where people have been consistently asking, not only for better abortion access, but the access they are entitled to under the Canada Health Act.”

In her letter to the health department, McGrath writes that the demand for surgical abortions at the Moncton Family Planning Clinic has fallen by 20 per cent over the last five years. The health authority believes this is due to the introduction of the so-called abortion pill Mifegymiso in 2017.

“Since medical abortions can be prescribed by a number of practitioners we are unable to offer an objective measure of the use of Mifegymiso for medical abortions, but we believe this is the primary reason for the reduction in the number of surgical abortions performed in our clinic,” McGrath writes.

1:51 New Brunswick follows through on promise to universal access to abortion pill

Alexopoulos says it makes sense that the recent introduction of medical abortions in the province would lessen demand for surgical abortions, but says that’s no reason to limit access to the surgical option. In fact, it’s important to provide patients with options, she says.

“We have to remember that before 2017 you couldn’t have medication abortion, it was not offered, it wasn’t legal. So it’s no surprise that since 2017 people have been using that option when it works for them,” Alexopoulos said.

“That doesn’t make surgical abortions any less essential and in fact when we limit surgical abortions because medication abortion is available we’re doing a disservice to patients because medication abortion is not for every patient — it’s not the best option for every patient.”

The ongoing debate around abortion access in New Brunswick has seen renewed focus over the last week. On Friday, deputy prime minister Chrystia Freeland toured Clinic 554 with Fredericton MP Jenica Atwin, who has been outspoken in her support for the clinic. While taking questions from media Freeland said that the government would have more to say in the near future of how it intended to force the province to cover out-of-hospital abortions, but declined to give further details.

“Every Canadian has the same rights to access essential health services and sexual and reproductive services, including abortions,” she said. “We all have the right to access those services.”

It’s not the first time the federal Liberals have made that promise.

At a Fredericton stop during the 2019 election campaign, Prime Minister Justin Trudeau said he would ensure that the province properly funded Clinic 554.

“We will ensure that the New Brunswick government allows access, paid-for access, to clinics that offer abortion services outside of hospitals,” he said.

Trudeau then re-upped that two-year-old promise during a visit to Moncton on Tuesday, saying he would “impress upon” the province the importance of ensuring out-of-hospital abortion access.

He went on to say that the feds have already withheld “millions” in health transfer funds to the province over the dispute. The actual number withheld in this year’s budget was $140,216, the amount of costs incurred performing abortions at Clinic 554 in 2017. The feds threatened to withhold that amount in 2020, but quickly refunded the amount in recognition of the COVID-19 pandemic. A spokesperson for the prime minister’s office clarified that Trudeau had misspoken during the Moncton event.

But Alexopoulos says that advocates are used to hearing promises from governments, noting both NDP leader Jagmeet Singh and former Green Party leader Elizabeth May both toured the clinic last election.

“During the election, New Brunswick got a lot of promises from all of the candidates. Everybody visited Clinic 554, everyone said they were going to do something about this, everyone said it was a top priority and when they got those votes and moved on, well we didn’t really see anything substantial happen,” she said.

“Abortion clinics aren’t tourist destinations, we don’t need to give tours of abortion clinics to prove that we need abortion services. It’s clear, it’s the law. We have the right to these services.”