It seems that not a day goes by without our reading yet another story about yet another creative way George Bush Jr. is attempting to eradicate an American woman's right to have an abortion. Listening to talk of Supreme Court stacking, and Roe vs. Wade in peril, it is easy to think that it is the law which dictates who has access to an abortion. In truth, the law is only one piece of the puzzle.
Kate Greenaway is the Canadian director of Medical Students for Choice. Like any pro-choice group, they are picketed by anti-choice groups who favour signs emblazoned with graphic pictures of "abortions"."
"Yes." Greenaway nods. "They do demonstrate outside of our meetings with these photographs of dismembered babies. Do they not realize we're medical students? We know what it looks like, and it doesn't look like that. That's not reality."
I'm interviewing Greenaway in our mutual home-base of Halifax, Nova Scotia, the day before her impending trip to Edmonton, a trip she is taking in order to spend the latter half of her summer -- what should be her time away from studying and interning -- learning how to perform an entirely common procedure not covered by her medical student curriculum. Abortion. I'm hoping she'll be able to tell me what is and isn't currently happening to Canadian women's right to choice.
What's the biggest news in reproductive freedom for Canadian women right now?
The bad news is that all trials working towards legalizing mifepristone (a.k.a. RU-486) have stopped here, placing us way behind in providing women with medical abortions. The US legalized mifepristone years ago - it seems incredible that we could be behind one of the most conservative nations in the west. I think the best news we have right now is the acceptance of emergency contraception in Canada as a back up for birth control. Most doctors are willing to prescribe this method of pregnancy prevention, and we are looking towards having it available over the counter as well.
Is a woman's legal right to abortion at risk in this country?
I don't think the legal status of abortion in Canada is going to change any time soon. Public opinion strongly supports abortion remaining legal.
Should we be concerned about access to abortion, then?
It is not the legality that is at risk, it's the availability of services.
In many cases, our medical schools and hospitals are not offering abortion training for future physicians. This will make legal right to abortion will meaningless, as there will be no providers. This is the real problem that I see facing Canadian women at this time. Women in rural areas may have difficulty finding a pro-choice doctor, let alone a provider. The shortage of trained providers and/or facilities which will not perform abortions results in women having to travel long distances to obtain care. Often, she will often have to pay to obtain services once she has travelled, since some provinces won't allow billing for abortion services. Women often discover that their family physicians are pro-life, and won't refer them to the appropriate doctors.
Isn't a doctor obligated to refer a patient for an abortion?
The simple answer is yes, but there are ways around it. The Canadian Medical Association has a policy that says if a doctor has an objection to counselling and referring women for an abortion s/he has to inform the patient and send her to some one who will make the referral. So doctors have to at least tell women what their options are. Its appalling what some doctors will do to trick their patients though. Some will say that abortion is not legal, or that they have referred them for an abortion when in fact their files have been hidden. This is totally illegal - but very few women who have been through a run-around like that would want to go through a court-case as well. The Physicians for Life group like to pretend that this issue of referral is only a matter of competing rights - the woman vs. her doctor. Somewhere along the line it got forgotten that doctors actual have a DUTY to serve their patients, and they are not in a position to impose their reality, which isn't so real.
If medical students are not being trained in this are, then how does one become an abortion provider?
I'm still working on that. The skills of medical providers are often learned through apprenticing, so the idea would be to find someone to teach us the techniques. Currently, we have to seek this out ourselves because it is not included in our gynaecology rotations in undergraduate medicine. Medical Students for Choice has developed a program of month long internship for medical students in the US and Canada who want to learn abortion techniques. This program matches up interested students with physicians who are willing to teach. This is the first step for us in becoming providers. From there, we can continue our training by seeking out pro-choice residencies.
What is Medical Students for Choice, and why is it important?
Medical Students for Choice is a group of 7000 medical students across the US and Canada who are working towards improving school curriculums to include reproductive health training, especially abortion training. Until this group was formed 10 years ago, there were almost no medical schools in North America offering abortion training. This is changing through the work of the group, as each campus group challenges its own administration to include women's health in the curriculum. This group makes me think that change is possible. It is extremely frustrating to be faced with a largely unsupportive administration and apathetic student body. Medical Students for Choice has shown me that there are a number of activists out there who are determined to keep women's reproductive freedom top-priority. It is very inspiring.