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The struggle to get Canadian women a good non-surgical option for abortion received little attention for years

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Before 2017, nearly all Canadian women seeking abortions had to undergo surgery, while women elsewhere could choose medication to induce a miscarriage.

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For decades, Canada didnt have the gold standard abortion pill, mifepristone (also known as RU-486, or Mifegymiso). After being used in France for 30 years and the United States for 15, the abortion pill was finally approved in Canada in 2015 under Stephen Harpers Conservatives, becoming available to the public in 2017. Among progressive politicians, only Thomas Mulcairs New Democratic Party had pressed the issue. The Liberals did nothing. On the last major front for Canadian abortion rights, progressive politicians were largely silent.

Many are now professing commitments to abortion rights now that the U.S. Supreme Court has overruled Roe v. Wade and with it, federally protected abortion rights. The Dobbs v. Jacksondecision means individual states can now decide whether to permit or ban abortions.

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Beware the fairweather activism. The struggle to get Canadian women a good non-surgical option for abortion received less news coverage and parliamentary attention in 20 years than Roe v. Wade did in the past two months.

Beware the fairweather activism

While surgery was used for nearly all abortions in Canada before mifepristone was easily available, thats now down to about two-thirds as a result of usage of the medication. About 100,000 abortions are performed per year in Canada. If the abortion pill had been approved at the same time as it was in the U.S., it would have prevented roughly 510,000 surgeries (30,000 per year for 17 years). Notably, access to abortion medication doesnt increase the overall abortion rate it simply reduces the proportion of surgeries.

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In France, women could use the abortion pill starting in the late 1980s. When the United States approved mifepristone in 2000, there was hope it might soon come to Canada the manufacturer said it wouldnt try until approval was secured in the U.S. to prevent any black markets. A 2001 article in the Canadian Medical Journal of Health said Health Canada would fast-track approval when a submission was made. Physicians were urged in 2006 to ask Health Canada to consider the drug.

Nearly a decade went by and nothing happened. The NDP began to publicly push for mifepristone in November 2013, when then-MP Libby Davies asked the deputy minister of health, George Da Pont, why the drug wasnt available in Canada. He said he hadnt received an application. This was wrong an application was first submitted to Health Canada in December 2011, and was resubmitted in 2012.

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In early 2014, the Canadian Medical Journal of Health published a scathing editorial outlining literally, with a map how Canada was an outlier in the developed world. Delays in mifepristones approval were reported by CBC, which cited longtime activists and the NDPs health critic Davies. Nicki Ashton, another NDP MP, questioned the government once more about the delays. A Conservative MP in mid-2014 presented a petition asking the then minister of health, Rona Ambrose, to reject mifepristone. The next day, the NDP pressed Ambrose about whether political intervention was holding up the drugs approval. She said it was all in Health Canadas hands. Mulcair, leading the NDP, warned against political interference; Liberal Leader Justin Trudeau simply said he trusted the scientists to go through the proper procedures.

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Ambrose, in fact, had statutory powers under the Food and Drugs Act that could have expedited or added hurdles to the process. Both the NDP and the Liberals could have asked more about this they just didnt. In December 2014, Health Canada said it would decide whether to approve the drug by mid-January 2015; when that rolled around, it was delayed without explanation. Approval was finally stamped in July 2015 permitting use starting in July 2016. Conservative cabinet ministers and even big-tent progressives like Michelle Rempel Garner declined to comment; a pro-life MP voiced disappointment. The drugs market debut was pushed back to January 2017. Rollout at the provincial level was slow.

Heavy restrictions limited use to the first seven weeks of pregnancy following an ultrasound, and required a doctor to dispense it (not a pharmacist, which doctors thought was pointless). By mid-2017, regulatory bodies for physicians and pharmacists advised members to ignore certain strict requirements. Facing a mutiny, in late 2017 Health Canada bumped the use cap to nine weeks and permitted pharmacists to dispense it. Mandatory ultrasounds were dropped in 2019.

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Mifepristone took years to approve

A column by the Globe and Mails Andr Picard called the medications long road to approval shameful. It was a fair assessment. Mifepristone took years to approve, while the norm was 300 days.

Libertarian, socially-progressive Conservatives had little to say about this the least they could have done was ask for a progress report. Liberals were equally silent in the House of Commons. Only the NDP can say they pressed for access to abortion medication on the public record, and they only did this 13 years after the U.S. approval.

Its hard to tell if the problem was a lack of answers, because there was a profound lack of questions in the first place. Regardless, the cone of political silence on mifepristone imposed 510,000 unnecessary surgeries on women who would have chosen otherwise.

Keep those women in mind when opportunistic politicians ride the media wave of Roe v. Wade.

National Post

Email: sarkonakj@protonmail.com | Twitter: Twitter.com/sarkonakj

Jamie Sarkonak is an Edmonton writer.

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Jamie Sarkonak: Progressives failed Canadian women on the abortion pill - National Post