Location, location, location: Documenting women's abortion experiences in Canada

Objectives: Although Canada decriminalized abortion in 1988, there continue to be significant disparities in access to services and the geographic distribution of providers is uneven. Through in-depth, open-ended interviews with 180 Anglophone and Francophone women in six provinces, this study aimed to 1) document women’s experiences obtaining abortion care; 2) identify the financial and personal costs associated with obtaining abortion services; and 3) explore women’s perceptions as to how access to services could be improved.

Methods: We conducted telephone interviews with women who had obtained an abortion in the five years before the interview and who were residents of one of the study provinces at the time of the abortion. We analyzed interviews for content and themes content using both a priori (pre-determined) categories and codes and inductive techniques.

Results: In general, women reflected positively on their experiences obtaining abortion care. However, provincial level regulations have created significant barriers to timely access to high quality services. With the exception of those residing in Quebec, many participants described scheduling delays, traveling long distances, and incurring significant out-of-pocket expenses to obtain abortion care. Our participants consistently reported that they would have been open to considering the use of mifepristone, had it been available.

Conclusions: Efforts are currently underway to introduce mifepristone into Canada. Our study documents a number of ways in which service delivery could be improved in Canada and suggests that mifepristone could serve an important role in expanding timely access to abortion care.