Abortion in Canada


Abortion in Canada is legal at all stages of pregnancy and funded in part by the Canada Health Act. While some non-legal barriers to access continue to exist, such as lacking equal access to providers, Canada is the only nation with absolutely no specific legal restrictions on abortion. Medical regulations and accessibility vary between provinces.
Prior to 1969, all abortion was illegal in Canada. In 1969, the Criminal Law Amendment Act, 1968–69 legalized abortion, as long as a committee of doctors certified that continuing the pregnancy would likely endanger the woman's life or health. In 1988, the Supreme Court of Canada ruled in R. v. Morgentaler that the existing law was unconstitutional, and struck down the 1969 law. Most abortions are performed in the first trimester.
In 2017, 94,030 abortions were reported in Canada; it is estimated that this number "represents approximately 90% of all abortions performed in Canada involving Canadian residents". The ambiguity of these statistics is due to incomplete reporting measures. For example, clinics are not required to report to the province, and provinces are not required to report federally.

Early history

Prior to Confederation, the British North American colonies followed British laws that had restricted many abortion rights with the Malicious Shooting or Stabbing Act 1803, followed by full prohibition with the Offences Against the Person Act 1837. Abortion was formally banned in Canada in 1869.. That prohibition was continued in the Criminal Code until 1969. Anyone who procured a miscarriage for a woman was liable to imprisonment for life, while a woman who procured a miscarriage for herself was liable to imprisonment for two years.
As in other countries, illegal abortions were still performed, and some cases charged that this led to the deaths of women. The abortion trial of Emily Stowe is one early example. Another such case, Azoulay v. The Queen, reached the Supreme Court in 1952. In both cases, the alleged abortion provider was ultimately acquitted of responsibility for the woman's death. Abortion rights activists like Marilyn Wilson, former executive director of the Canadian Abortion Rights Action League, say, "Illegal abortions were common, but often of poor safety. Several hundred women per year died from botched abortions."

Liberalisation of abortion laws

Chief Coroner Schulman

The movement to liberalize Canada's abortion laws began in the 1960s. Former Chief Coroner of Ontario Morton Shulman recalls that in the Sixties, abortion could be legally performed only to save the life of the woman, so there were practically no legal abortions. He stated that the pregnant daughters of the rich were sent to reliable physicians who did abortions for cash. He estimated that these physicians did twenty to thirty abortions per week. Women who were not rich were left to perform an abortion on themselves or go to what he called a "nurse" abortionist. Their method was commonly pumping Lysol into the woman's womb. The mortality rate was high and the infection rate over 50%. He added, "By the time I became Chief Coroner, I had had the unpleasant experience of seeing the bodies of some dozens of young women who had died as a result of these amateur abortions."
Chief Coroner Morton Shulman decided to publicize deaths from illegal abortions. He instructed his coroners to call a public inquest into each abortion death. He describes one case that he believes was the turning point, that of 34-year-old Lottie Leanne Clarke, a mother of three children, who died of a massive infection in 1964 after an illegal abortion in spite of medical treatment and antibiotics. At the inquest into her death, the jury recommended that the laws about therapeutic abortion be revised. Dr. Shulman added that a federal government committee should review the question of abortion and the law. Newspapers published editorials recommending the reform of the abortion law. In 1965, the Minister of Justice, Guy Favreau, wrote to Dr. Shulman that the recommendation would be considered in the program to amend the Criminal Code. The eventual amendment closely followed the recommendations of the coroners' juries.

Partial de-criminalisation

In 1967, Justice Minister Pierre Trudeau introduced a bill which included an amendment to the provision of the Criminal Code which prohibited abortions. The bill, known as the Criminal Law Amendment Act, 1968–69, continued the basic prohibition on abortions, with the potential life sentence. However, the bill made an exception for abortions performed in a hospital with the approval of that hospital's three-doctor therapeutic abortion committee. The committee would have to certify that the pregnancy would be likely to endanger the life or health of the pregnant woman. The term health was not defined, and therapeutic abortion committees were free to develop their own theories as to when a likely danger to "health" would justify a therapeutic abortion.
This same bill also legalized homosexuality and contraception, and would be the subject of one of Trudeau's most famous quotations: "The state has no business in the bedrooms of the nation."
When he introduced the bill in 1967, Trudeau was Minister of Justice in the government of Prime Minister Lester Pearson. In 1968, Pearson retired and Trudeau succeeded him as prime minister. The bill did not pass before the 1968 election, but was re-introduced by John Turner, Minister of Justice in the Trudeau government. Parliament passed the bill in 1969. In the 1970 federal statute revision, the provision was re-numbered as s. 251 of the Criminal Code.

Badgley report

In 1975, a Committee on the Operation of the Abortion Law was appointed "to conduct a study to determine whether the procedure provided in the Criminal Code for obtaining therapeutic abortions operating equitably across Canada", and to make recommendations "on the operation of this law rather than recommendations on the underlying policy". The Committee, known as the Badgley Committee after its Chair, Dr. Robin F. Badgley, reported in January 1977. It found, quite simply, that "the procedures set out for the operation of Abortion Law are not working equitably across Canada". In large part, this was because the intent of the law was neither clear nor agreed upon. Access to abortion as set out in the Criminal Code was not available for many women due to variations in distribution of hospitals and doctors, and in whether Therapeutic Abortion Committees were set up and in doctors' interpretations of "health" for women, ages of consent, and parental notification requirements. The report recommended better family planning to reduce the number of unwanted pregnancies; but their main conclusion was that abortion services were not being delivered as required.

Continued difficulties in access

By 1982, there were 66,319 legal abortions in Canada. Interpretation of the 1969 law varied widely between doctors and hospitals, leading to uneven access. The standard was the physical or mental well-being of the woman, to be decided by a hospital's Therapeutic Abortion Committee. However, there was no requirement for a hospital to have a TAC to evaluate women. Only about one-third of hospitals had one. Some committees took a liberal stance and allowed most requests, while others blocked almost all requests. Access to legal abortions was easy in major metropolitan areas, but much harder outside large cities. In the province of Prince Edward Island, the lone Therapeutic Abortion Committee shut down, and there were no legal abortions in the province after 1982. The Therapeutic Abortion Committees often took days or weeks to make their decisions, pushing a pregnancy further along than it would have been otherwise. The women were not seen by the committee, and had no right to appeal a decision. Advocates for abortion rights believed that the choice should be made by the woman, rather than a panel of doctors.
Because of the lack of facilities in smaller provinces and rural areas, women were often forced to travel to major cities at their own expense. In Newfoundland, there was only a single gynaecologist who performed abortions. Many women had to buy expensive plane tickets to Toronto or Montreal to get an abortion. Other women chose to travel to the United States, where abortions became available at many private clinics after the Roe vs. Wade decision. In 1982, 4,311 Canadian women travelled to the United States for an abortion.

Legal challenges to the abortion law

Morgentaler challenges the law

In defiance of the law, Dr. Henry Morgentaler began performing abortions at his clinic without approval of a Therapeutic Abortion Committee and in contravention of the law. In 1973, Morgentaler stated publicly that he had performed 5,000 abortions without the permission of the three-doctor committees, even going so far as to videotape himself performing operations.
The Attorney General of Quebec prosecuted Morgentaler twice, and both times juries refused to convict him despite his outright admission that he had performed many abortions. The Attorney General appealed one of the acquittals. In 1974, the Quebec Court of Appeal overturned the jury's verdict, and Morgentaler was sentenced to 18 months in jail. Morgentaler then appealed to the Supreme Court of Canada from the overturning of the jury verdict. He also challenged the constitutional validity of s. 251 under the division of powers. In 1975, the Supreme Court dismissed his appeal. Public outcry over the decision caused the federal government to amend the Criminal Code preventing appeal courts from substituting a conviction for a jury's not-guilty verdict. Morgentaler was again acquitted at a third trial, causing the Quebec government to declare the law unenforceable.
Morgentaler's struggle prompted a nationwide movement to reform Canada's abortion laws. In 1970, as part of the Abortion Caravan, 35 women chained themselves to the parliamentary gallery in the House of Commons, closing Parliament for the first time in Canadian history.
Upon his release from prison in Quebec, Morgentaler decided to challenge the law in other provinces. Over the next ten years, he opened and operated private abortion clinics across the country in direct violation of the law. Following a fourth jury acquittal in 1984, the Ontario government appealed the decision. The Ontario Court of Appeal set aside the acquittal and ordered a re-trial.
Morgentaler, in turn, appealed to the Supreme Court of Canada.

Supreme Court decision

In a landmark decision, the Supreme Court declared in 1988 the entirety of the country's abortion law to be unconstitutional: R. v. Morgentaler. By a 5-2 decision, the Court held that section 251 of the Criminal Code was of no force or effect because it violated section 7 of the Canadian Charter of Rights and Freedoms. Section 7 states that: "Everyone has the right to life, liberty, and the security of the person, and the right not to be deprived thereof, except in accordance with the principles of fundamental justice." The Court also held that the infringement could not be justified under s. 1 of the Charter, which in some cases allows a government to provide a reasonable justification for the infringement.
There was no single majority judgment. Chief Justice Dickson, Justice Beetz, and Justice Wilson all wrote decisions finding the law to be unconstitutional, but for varying reasons in support. Justice McIntyre wrote the dissenting opinion.
Chief Justice Dickson held that "orcing a woman, by threat of criminal sanction, to carry a fetus to term unless she meets certain criteria unrelated to her own priorities and aspirations" infringed the woman's right to security of the person, as protected by s. 7 of the Charter. Justice Wilson found that the law "asserts that the woman's capacity to reproduce is to be subject, not to her own control, but to that of the state" which similarly breached the right to security of the person.
Having found that law infringed the right to security of the person, the majority then considered whether that infringement was consistent with the principles of fundamental justice, which is the second branch of s. 7 of the Charter. The judges in the majority agreed that the procedural requirements to obtain an abortion, as set forth in the law, were especially troublesome. Only accredited or approved hospitals could perform abortions, which imposed a barrier to local access. The law also specified that women wanting an abortion were required to obtain approval from a "therapeutic abortion committee" in a hospital. The committee was composed of at least three physicians appointed by the hospital's board of members, and did not include the practitioner who was to perform the procedure. The court found that the committee requirement was deeply flawed, in part because of the long delays caused by the committees and that in many hospitals, the committees were merely committees on paper and did not actually approve abortions.
Chief Justice Dickson held that "the structure -- the system regulating access to therapeutic abortions -- is manifestly unfair. It contains so many potential barriers to its own operation that the defence it creates will in many circumstances be practically unavailable to women who would prima facie qualify..." Noted barriers included a lack of hospitals with committees, doctors who did not wish to refer matters to committees, the lack of a standard meaning for "health" leading to inconsistent standards among committees, and geographical and financial differentials in treatment. He concluded the provision violated the principles of fundamental justice.
The majority of the court in Morgentaler did not find it necessary to consider whether there was a substantive right to abortion under Section 7. Justice Wilson was of the opinion that such a right existed, but the other judges in the majority made their decision on procedural grounds, relating to the insufficiencies in the committee process.

Attempts at a new law

Following the Supreme Court decision, the Mulroney government made two attempts to enact a new abortion law.
In the spring of 1988, the government first attempted to find a compromise solution that would give easy access to abortion in the early stages of pregnancy and criminalize late term ones. The motion in the House of Commons was defeated 147 to 76, voted against by both MPs who opposed easy access to abortions and those who opposed adding any abortion rules to the Criminal Code.
The Supreme Court decision became an important issue in the 1988 federal election later that fall. Both the Progressive Conservative and Liberal parties were sharply divided on the issue and neither party advanced a concrete platform on the abortion issue. Prime Minister Brian Mulroney declared he was opposed to "abortion on demand", but gave no details on what that meant legally. Liberal leader John Turner stated that MPs should be allowed to vote their conscience, but refused to give his own opinion on the issue. NDP leader Ed Broadbent had a firm position that abortion is a medical matter, not a criminal one, and should be left to a woman and her doctor. The Mulroney government was returned in the 1988 election.
In 1989, the government introduced a much stricter bill in the House of Commons. If enacted, it would ban all abortions unless a doctor ruled the woman's life or health would be threatened. Anyone found in violation of the law could be imprisoned for up to two years. The House of Commons passed the new bill by nine votes, with the cabinet being whipped in favour and most anti-abortion members supporting it. In June 1990, a teenager from Kitchener, Ontario, was injured during a botched abortion performed in a man's home. Several days later, a Toronto woman, Yvonne Jurewicz, died from a self-induced, coat-hanger abortion.
These cases were reported in the news and the latter case was discussed at multiple levels of government. Speaking in the Legislative Assembly of British Columbia, New Democratic MLA Darlene Marzari pointed out:
For our purposes, though technically speaking the bill has not been proclaimed, Bill C-43 is, in the minds of the public and in the minds of women, now law. In fact, while we're dancing on the head of a pin and counting ourselves as angels, a woman in Toronto has died—she bled to death—three weeks ago. Her name was Yvonne Jurewicz, she was 20 years old and was probably afraid to go to the doctor and afraid to go to the hospital after she tried to abort herself. This is the sad fact of Bill C-43. While we debate the minor points of whether or not the Lieutenant Governor or the Governor-General of Canada has picked it up, we know that young women in this country are under the impression they will be considered criminals if they show up in an emergency ward door hemorrhaging.

Reform Party MP Deborah Grey, who supported the bill, denied that this death, the first known death from illegal abortion in Ontario in twenty years, could have anything to do with the publicity surrounding the passing of Bill C-43. But in Ontario, the connection was made. Richard Johnston, MPP suggested to Premier David Peterson that Ontario announce it would not start any third-party prosecutions against women or doctors, to prevent any further tragedies and to reassure doctors that they could go on providing services to the women of Ontario.
A few months later, the bill failed in the Senate on a tie vote. Under the rules of the Senate, a tie meant the measure was defeated. The defeat was somewhat unexpected since it was the first time since 1941 that the Senate, whose members are appointed, had outright defeated legislation passed by the House. Eike-Henner Kluge the director of the Canadian Medical Association ethics and legal affairs viewed that the bill was flawed ethically. Eike-Henner Kluge drafted an analysis for a Senate committee about Bill C-43 and his presentation may have swayed two votes to change resulting in a tie vote which resulted in the Senate not passing the Bill C-43.Eike-Henner Kluge#cite note-%3A0-5|
In the wake of the controversy surrounding passage of the Goods and Services Tax the Progressive Conservative government did not wish to provoke a contest of wills with the Senate and announced it would not re-introduce the legislation. The fact that no subsequent government has re-visited this decision has been what has led to the unique situation of Canada having no abortion law whatsoever. Abortion was now treated like any other medical procedure, governed by provincial and medical regulations.

Later cases

The court in Morgentaler did not consider the question of whether the unborn were included in the "everyone" who have the right to life. At that time, another case before the courts would have raised that issue; it was brought by Joe Borowski, a Member of the Legislative Assembly of Manitoba. However, after the Morgentaler decision, the Court held that the Borowski case was moot since Morgentaler had struck down the provisions it was challenging.
Two further cases, Tremblay v. Daigle and R. v. Sullivan, relied on the born alive rule, inherited from English common law, to determine that the fetus was not a person: Sullivan could not be charged with murder of a fetus and Daigle could not seek standing in court as the guardian of a fetus. The 1989 Supreme Court of Canada case of Chantal Daigle is one of the most widely publicized cases concerning abortion in Canada after the law prohibiting abortions was overturned by the Supreme Court of Canada. Daigle's ex-boyfriend obtained a restraining order against her having an abortion. While the restraining order was issued in Quebec, it was legally restricting Canada-wide. The Supreme Court of Canada ruled that only the woman could make the choice; the man had no legal say in a woman's choice to terminate a pregnancy or carry it to completion.
Daigle had already had a late second-term abortion before the Court ruled on her case. While the case was fast-tracked, the progress was so slow that Daigle would have been in the third-trimester had she waited for the ruling to be handed down. Daigle had an abortion in the United States while the case was before the Supreme Court of Canada. This was not made public until after the ruling, although it was not unexpected. This is in contrast to the Roe v. Wade case in the United States where Roe had carried the pregnancy to term. That case, however, was different from the Tremblay v. Daigle case in that it was about whether abortion was legal. In the Tremblay v. Daigle case, the question was whether a male partner has a say in whether a woman can obtain an abortion. ruling
Two further cases addressed the "interest in the fetus". In Dobson v. Dobson, a grandfather attempted to act on behalf of a child born with cerebral palsy, supposedly resulting from a car accident in which the mother was the driver. He attempted to sue the mother with negligence in driving. The mother was in favor of the suit succeeding as it would have provided her with funds to raise her disabled child; her insurance company was defending the suit through subrogation. Citing the Kamloops v. Nielsen, the Court decided that courts cannot impose a duty of care on a pregnant woman toward her fetus because it would interfere with the exercise of her autonomy rights during pregnancy and faced difficulty in defining a standard of care in pregnancy. Only a legislature can do this. In Winnipeg Child & Family Services v. G. , courts determined that a pregnant woman addicted to solvents could not be civilly committed for treatment.

Access throughout Canada

Abortions in Canada are provided on request and funded by Medicare, to Canadian citizens and permanent residents in hospitals across the country. Abortion funding for hospitals comes from the various provincial governments. One-third of hospitals perform abortions, and these perform two-thirds of abortions in the country. The remaining abortions are performed by public and private-for-profit clinics.
Medical abortion is available in Canada on a limited basis using methotrexate, misoprostol, and mifepristone. Clinical trials were done in 2000 in various Canadian cities comparing methotrexate to mifepristone, after approbation by the federal government. While both drugs had overall similar results, mifepristone was found to act faster. After years of trials and debates, RU-486 was approved for use in Canada when prescribed by doctors on July 29, 2015.

Access by province

In 2004, Dr. Henry Morgentaler launched a judicial battle against the New Brunswick government, seeking to have abortion recognized as a constitutional right under the Canadian Charter. In a review of Regulation 84-20 in 2014, the government eliminated the requirement for two physicians to certify the medical necessity of a procedure effective 1 January 2015. The amended regulation requires all abortions be performed in a hospital.
Until 2004, Manitoba did not fund private abortion clinics. However, in July 2004 the province's only private abortion clinic was purchased by a non-profit organization, which then successfully sued the provincial government to pay for abortion procedures there. In December 2004, a Manitoba Justice ruled that the province must pay for all therapeutic abortions. This was overruled in 2005 by the Manitoba Court of Appeal because the trial Justice should not have made a decision based on written documents only. Leave to appeal to the Supreme Court of Canada was denied. The same plaintiffs have launched a new court challenge to the government practice of not paying for therapeutic abortions outside hospitals.
Quebec used to fund only in part abortions done in private facilities. A 2006 judgment concluded that this practice did not conform to the Act respecting the Régie de l'assurance maladie du Québec; it was initially decided that abortion in private facilities would only be fully paid for if a woman could show that she attempted to obtain an abortion in the public system and could not obtain one. In January 2008, the government decided to fund all abortions without any limitations.
Access in British Columbia is governed by the Access to Abortion Services Act, which limits political demonstrations outside abortion-providing facilities, doctor's offices, and doctor's homes to set distances. Similarly, demonstrations are prohibited in certain "buffer zones" in Ontario under the Safe Access to Abortion Services Act.

Politics

Of the main federal parties, the Bloc Québécois, the New Democratic Party, the Liberal Party of Canada, and the Green Party of Canada are all staunchly in favour of abortion rights. While the Conservative Party of Canada has both members who favour abortion rights and members who oppose them, traditionally, more Conservative members are against abortion.
The Conservative Party has had to wrestle with combining the conflicting social policies of its two predecessor parties, the moderate Progressive Conservative Party and the more right-wing Canadian Alliance, which merged in 2003. Many socially conservative Alliance supporters were angered at the prospect of Belinda Stronach, who favoured abortion rights, winning the leadership election in early 2004, while some Conservatives objected during the 2004 federal election to the new party's perceived openness to legislation that would restrict abortion rights. In the March 2005 policy convention, in a narrow vote, the party voted to not introduce legislation on the subject of abortion.
The Liberal Party, on the other hand, has a few anti-abortion members, but any potential new Liberal MPs have been told by their current leader that they will have to vote according to the party's abortion-rights policy, rather than according to their own conscience, when it comes to matters of abortion. Liberal MP Paul Steckle introduced in June 2006 a bill that if passed, would make abortion after 20 weeks gestation a criminal act. The bill has not been acted on since its introduction.
Although the issue of abortion rights has popped up from time to time in Federal elections as a wedge issue, the issue is consistently rated as a low priority for most Canadians. The Christian Heritage Party of Canada claims to be Canada's only stated pro-life federal political party, but has never had a member elected to parliament.
Motion 312 was introduced by Conservative MP Stephen Woodworth in 2012, calling for a House of Commons committee to determine when human life begins, but was defeated 203–91.
On October 19, 2012, anti-abortion protester Patricia Maloney expressed concern over 491 cases of live-birth abortions between 2000 and 2009. The finding reported to Statistics Canada did not include detailed information on how long each fetus survived after removal or how many would have been possible to save. Further complicating the issue is the fact that Canada, unlike the United States, does not have a law confirming or denying the legal rights of a baby who survives abortion. On January 23, 2013, Conservative MPs Wladyslaw Lizon, Leon Benoit, and Maurice Vellacott wrote a letter requesting that the RCMP investigate how many of the 491 live-birth abortions meet the definition of homicide set forth in the Criminal Code. When CBC and The Canadian Press used the phrase "investigate all abortions performed after 19 weeks gestation", Vellacott accused the media outlets of false reporting and acknowledged that abortion in Canada is fully legal. The CBC / Canadian Press story was subsequently corrected. The move drew approval from Dr. Eike-Henner Kluge, former director of ethics and legal affairs for the Canadian Medical Association, who said that doctors should "do the best can for what is now a person in the eyes of the law". However, Dr. Douglas Black, president of the Society of Obstetricians and Gynaecologists, said that the situation is not one of homicide, but rather allowing fetuses "to pass away, depending on what the circumstances are, sometimes in their mom's arms".

Opinion polls

The abortion rights movement in Canada focuses on establishing abortion as a component of provincial health care plans, to ensure it is available in all regions, especially for those who couldn't afford it otherwise.
Dr. Henry Morgentaler was widely seen as the one individual personifying the Canadian abortion rights movement, but organizations such as the Canadian Abortion Rights Action League, Canadians for Choice, and the Pro-Choice Action Network also contributed significantly to advancing the abortion rights movement in Canada. CARAL folded, and has been replaced by the Abortion Rights Coalition of Canada, whose focus is on the objectives mentioned above. Feminist or pro-feminism organizations also contribute to promote the abortion rights approach.
The Canadian affiliate of Planned Parenthood, now known as the Canadian Federation for Sexual Health, is also in favor of abortion rights, and while it does refer pregnant women to abortion providers, it does not have a history of engaging in widespread litigation in favour of legalized abortion.

Anti-abortion movement

The anti-abortion movement disapproves of the lack of legal restrictions on abortion in Canada, and of abortions being funded by provincial health care programs, even if the abortion is not for therapeutic reasons. A medical reason for obtaining an abortion is no longer required in Canada since the 1988 removal of abortion from the Criminal Code.
The pro life movement in Canada is represented by the Catholic Church, The Wilberforce Project, Campaign Life Coalition, REAL Women of Canada, We Need A Law, Abortion in Canada, Action Life, Inc., among other organizations.

Attacks on doctors who perform abortions