In the aftermath of the Supreme Court's decision to overturn Roe v. Wade, Canadian abortion advocates and activists have not stopped worrying about what's next.
"It's like a horror show. We're all going through the shock and trying to just grapple with what the consequences will be," said Joyce Arthur, Executive Director of the Abortion Rights Coalition of Canada.
Arthur, whose work focuses on protecting legal abortion rights and access to services, says abortion clinics haven't started booking appointments yet from Americans but have received increased inquiries about if they'd have the capacity to make room for them.
Kemlin Nembhard, executive director of the Women's Health Clinic in Winnipeg, told the they won't be turning people away, "but as a country that has 10 per cent of the population of what the U.S. has, it's unrealistic to think we could fulfill the needs of what could potentially be flowing north."
Although Canada decriminalized abortion in 1988, Arthur said there's still work that needs to be done before extending our services across the border.
"We still have these access issues and an abortion stigma," She said. "So, we really feel strongly that we need to fix that first and make sure that Canadians are helped before we can really help any number of Americans coming up."
The Canada Health Act is meant to ensure equitable access to health care services across the provinces. However, Insiya Mankani, Public Affairs Officer with Action Canada for Sexual Health and Rights, says the Act varies from province to province.
For example, there's a lack of universal cost coverage for medical abortion in Nunavut. In New Brunswick and Nova Scotia, the provincial governments will not cover the cost of surgical abortion services outside of hospitals.
Accessing those services is really hard in those provinces, particularly because most of them aren't within the urban centers. So if you're in a more remote community, it's really hard to get access to abortion.Insiya Mankani, Public Affairs Officer with Action Canada for Sexual Health and Rights
Most times, as Arthur puts it, people travel from rural areas because the access is mostly concentrated in major cities.
"The Supreme Court Decision has caused us to reflect on access issues in Canada. For many people living outside of large urban cities, access to abortion care is limited," explained Jill Doctoroff, Executive Director of the National Abortion Federation Canada. "When people have to leave their home communities to access care they can face financial expenses, travel and accommodation, privacy concerns, logistic issues like child or elder care, time off from work, school and other responsibilities, and miss their support networks."
Another gap, Arthur points out, is that nurse practitioners in Canada can prescribe the abortion pill, but not midwives. She says allowing midwives to prescribe the abortion pill would help remote communities.
Other cracks to fill include incentives for doctors to practice in rural areas, having more hospitals provide abortions, making the abortion pill more available in pharmacies, and increasing providers in remote areas.
Americans wanting abortions could face difficulties coming to Canada
While there's no data collection yet on the number of Americans who will cross into Canada, there will also be barriers waiting for them. Mankani says crossing the border will be a financial hurdle for the travel and abortion procedure expenses.
"There are financial barriers, there are geographic barriers, and in some areas, it takes a few weeks to get an appointment to access an abortion. So there's some time sensitive barriers as well," she continued.
As many abortion advocates have said, it's going to be the more privileged ones that will be able to afford to come to Canada.
"What we do know is that this decision will have a disproportionate impact on women, people of colour, non binary, trans folks, on members of the LGBTQ plus community, younger people, poor people and disabled people," Mankani told Yahoo Canada.
Action Canada stands with our colleagues in the U.S. who are facing the aftermath of the Supreme Court’s decision to overturn Roe v. Wade. This ruling is an attack on human rights and will have devastating and inequitable repercussions that ripple beyond the American border.
— Action Canada (@actioncanadashr) June 24, 2022
If a wave of Americans crosses the border and nothing has changed, Arthur fears it will increase waiting times for Canadians and reduce access for them even more.
"I really, really don't want to see that."
For these abortion non-profits, there's work that needs to be done.
In the last , the federal government promised up to $10 million to develop a website portal that has accurate information about abortion, and another $10 million over three years for youth-led grassroots organizations that respond to the reproductive health needs of young people. All of which have been untouched.
Beyond funding, Mankani says we don't need further legislation in Canada for abortion.
"Introducing any new legislation would mean taking it out of health care and creating it into a unique situation open for debate, which it isn't."
Instead, what is needed, and Arthur agrees, is better access and enforcement of the Canadian Health Act to ensure access to abortion in Canada remains strong. Funding that expires after a short amount of time is not enough.
Arthur encourages Canadians to look at the silver lining— even though the Supreme Court's decision will have adverse effects worldwide, it should be used as an incentive to try and improve things in Canada.
"Finally, it's a wake up call, right?"