In the United States, the recent revocation of the judgment Roe v. wade caused a shock wave far beyond the borders. As reproductive health specialists and committed professionals, we are challenged by this decision, which limits or even prevents access to abortion in several American states. We believe it is important that abortion be easily and quickly accessible to all women in the United States and here. This is why we welcome the action taken by the College of Physicians which aims to make the abortion pill more accessible.
In Quebec, women can have recourse to two types of abortion: medical abortion up to 63 days of pregnancy, with the abortion pill, and surgical abortion. While delays vary by region, surgical abortion services remain widely accessible. Before the approval of the abortion pill, a pregnant woman had to undergo a surgical procedure involving many inconveniences (travel, meetings with a professional, examinations, blood tests and ultrasound) and potential complications which, although rare, can be serious ( perforation, laceration, etc.).
However, medical abortion, which is as effective and safe as surgical abortion, limits these inconveniences and must be facilitated. Do not restrict, on the contrary… In Western countries, medical abortion constitutes between 24%, in Italy, and 98%, in Finland, of all abortions. In the United States, this proportion is 54%, while it is only 10% in Quebec.
Faced with this observation, we can only applaud the changes announced to the requirements that were previously imposed by the College of Physicians of Quebec with regard to medical abortion, and which had the effect of reducing access to it. We can now imagine that medical abortions will be more frequently chosen by women in Quebec. Most of the time, this method of abortion requires no travel since the assessment, prescription and follow-up can be done securely online or by phone.
In addition, medical abortion could be associated with lower costs for abortion services in the province, in addition to granting more time to professionals, allowing them to offer other reproductive health services (contraception , screening for cervical cancer and STBBIs and other gynecological problems). We propose the establishment of a centralized telephone service for the prescription of the abortion pill with the establishment of efficient service corridors for people who would choose surgical abortion, or who would require an in-person assessment.
Finally, we must remain vigilant against the rise of extremist groups in our American neighbour. Experience has taught us that these militant movements easily cross borders. These groups want to force pregnant people to continue a pregnancy even if it is unwanted, and their actions could even lead to restricting access to contraceptive methods. We should also be concerned about the proliferation of “pregnancy crisis centers” supported by anti-abortion groups, which give false information, particularly to vulnerable people.
As for us, as health professionals and trainers of future generations, we must help normalize the discussion around reproductive health issues. It is high time to support free choice in abortion and to facilitate full access to health care without restrictions.