Save Clinic 554 and provide abortion access for all

Abortion clinic in New Brunswick faces potential closure as the government refuses to invest in clinical abortion services

In March 2020, roughly $140,000 was deducted from New Brunswick’s annual health transfer payments by the Canadian federal government. Yet in April, the temporary reimbursement of the same amount was provided to the province due to the COVID-19 pandemic.

The initial decision to deduct money was a result of the province not subsidizing out-of-hospital abortions. The province has been criticized for not providing adequate abortion access.

Medicare from the province for abortions currently only covers three hospitals, two in Moncton and one in Bathurst. While Moncton is the most populated city of New Brunswick, all three hospitals are located at least 150 km away from Fredericton and Saint John, the two other most populated cities of the province.

New Brunswick Premier Blaine Higgs has stood by his decision and refused to subsidize abortion costs for the province’s only private clinic offering abortion services, Clinic 554. However, Clinic 554 is a family medical practice and all other costs apart from abortion are covered by the province.

The federal government and other activists arguing against the province’s decision stated that New Brunswick is violating the Canada Health Act, Canada’s federal legislation for publicly funded health care insurance.

The Canada Health Act notes that provinces and territories should fulfill five criteria and two conditions. Of these criteria and conditions, accessibility is one of the criteria.

The act also states that provinces and territories should ensure there is no extra billing and user charges for insured health services. Violation of the act removes their entitlement to the full Canada Health Transfer.

In 2017, people from New Brunswick spent $140,216 out-of-pocket at a clinic when they were supposed to be covered by Medicare.

In 2017, people from New Brunswick spent $140,216 out-of-pocket at a clinic when they were supposed to be covered by Medicare.

Dr. Adrian Edgar runs Clinic 554, the only clinic that currently offers abortion services in New Brunswick and specializes in 2SLGBTQIA+ health care. Unlike the three hospitals, Clinic 554 is located in the city of Fredericton.

Edgar said that for those who do not have Medicare yet, such as international students or migrant workers, abortions at hospitals can cost roughly $2,400 to $2,700.

At Clinic 554, there is a $700 to $800 fee for each abortion service administered, but Edgar has been performing the service for free to those who can not afford the fee.

In September, Edgar said that the clinic itself subsidizes abortions for patients. However, the cost is no longer viable and therefore Edgar is forced to consider closing the clinic.

As of November, Clinic 554 is still open and continues to provide abortion services for patients. Edgar noted that the clinic has had to drastically reduce its services in the last year due to the lack of funds. The clinic no longer provides services relating to transgender health, routine family-practice care or addiction care.

A national civil liberties group known as the Canadian Civil Liberties Association has now filed a legal notice in the first stage of a suit against the News Brunswick government.

“We gave the government the chance to do the right thing but sadly they have given us no other option,” said Michael Bryant, CCLA’s executive director and general counsel.

“We gave the government the chance to do the right thing but sadly they have given us no other option,” said Michael Bryant, CCLA’s executive director and general counsel.

Higgs had previously expressed that he is concerned that funding abortion services at Clinic 554 would set a precedent for further funding of other private clinics. Higgs suggested that if there is a lack of access, the solution should be to consider whether another hospital should offer abortion services.

The Student Health Education Centre, run by the McMaster Students Union, expressed their concern for this issue and wrote a letter to Higgs and New Brunswick’s Minister of Health, Dorothy Shepard.

“This limitation notably restricts access to safe, legal, sex-positive, trauma-informed and gender-celebratory abortion care from a group of qualified licensed medical professionals,” the letter stated.

The letter stated that although the lack of accessible abortion services is occuring in a different province than that of the university, there are many students from New Brunswick attending McMaster. This included Edgar, who was a 2010 McMaster graduate.

Responding to Higgs’ rationale that further accessibility should mean more hospitals rather than clinics offering abortion services, Sydney Cummings, coordinator of SHEC, said that she disagrees with this reasoning as clinics are often a preferred option for those seeking abortion services.

“I truthfully do not think that [investing more in abortion services in hospitals] would be very helpful to many of the folks that want or need this care . . . I don’t think that’s the answer personally,” Cummings said.

“I truthfully do not think that [investing more in abortion services in hospitals] would be very helpful to many of the folks that want or need this care . . . I don’t think that’s the answer personally,” Cummings said.

Cummings added that statistics show abortion clinics are necessary and have been providing a service that people use. In fact, statistics show that in recent years, the number of abortions done in clinics outnumbers those done in hospitals.

In 2018, statistics compiled by the Canadian Institute for Health Information showed that across Canada, 26,498 abortions were done in hospitals while 58,697 abortions were done in clinics.

Aside from a lack of abortion services in general, making hospitals the only option for abortions has been a concern especially amidst the COVID-19 pandemic.

Speaking to Global News, Edgar said that he believes funding private abortion clinics is important now more than ever to help limit travel and patient exposure to bacteria.

Edgar also said that reports have been filled out by many patients of his clinic, complaining about the lack of access to services during the pandemic. Edgar said that the clinic is sending these complaints to the ministry of health.

The urgency of the matter during a pandemic was also noted in SHEC’s letter.

“[I]t is unethical to send people to a hospital in the midst of a global pandemic when these procedures could easily be done safely in a lower-risk environment. Especially given the immunocompromised state of most pregnant persons,” the service wrote.

Cummings expressed that the need for abortion clinics lies in its ability to provide person-centred care. Hospitals across Canada are often overburdened and healthcare staff may not get the appropriate care-focused training that they need to provide abortion services.

Clinics can help ensure a greater level of care and understanding from the staff towards sensitive healthcare needs, such as abortions.

The decision for SHEC to reach out to the New Brunswick government and focus on this issue was largely because they heard of the important work that Clinic 554 does, said Cummings. The clinic is providing services for marginalized communities such as sex workers and members of the 2SLGTBQIA+ community.

Hearing that such an important resource is facing closure propelled the team to take further action.

“Forcing individuals from these [marginalized or oppressed] communities to seek out support from healthcare workers who don’t respect their identities is an act of indirect violence,” the service wrote in their letter.

Resources for abortion care: 
→ https://www.actioncanadashr.org/campaigns/call-access-line-1-888-642-2725 
→ https://choiceconnect.ca/
→ https://exhaleprovoice.org/after-abortion-talkline/