Abortion pill access in Manitoba falls short, medical student group says

A group of medical students is calling on the Manitoba government to make the abortion pill free for everyone — and calling out the health minister for consistently deflecting questions about women's reproductive health.

"The provincial government has sidestepped the issue and brushed it off," said Lucy Karp, a second-year medical student at the University of Manitoba and member of Medical Students for Choice.

"This is fundamentally an access issue," Karp said. "Manitoba is falling short."

Manitoba and Saskatchewan are the only provinces in Canada that do not offer universal free access to the abortion pill.

The drug — called Mifegymiso — is administered orally in two pills to terminate early pregnancies. In Canada, it can be taken up to nine weeks into a pregnancy.

Since Mifegymiso became commercially available in Canada in 2017, most provinces have moved to make it free for everyone through provincial health-care plans.

The abortion pill is available for free in Manitoba, but only at three locations: Health Sciences Centre in Winnipeg, the Women's Health Clinic, also in Winnipeg, or the Brandon Regional Health Centre. All three health centres also offer surgical abortions.

Outside of these locations, patients in Manitoba are required to pay for the pill themselves, at a cost of around $350.

Manitoba Medical Students for Choice members say the province is discriminating against women in communities outside of Winnipeg and Brandon, who stand to gain the most from free access to the abortion pill.

"Mifegymiso has the potential to be a game changer for women who are wanting to access abortion in rural and northern communities. Rather than have to fly down to receive a surgical abortion [in Winnipeg or Brandon], they can have a medical abortion in the comfort of their own communities," Karp said.

The group is planning an event today for Women's Day, hoping to drum up support and get signatures for a petition.

Health minister won't answer questions

Karp said her group has been asking to speak with the health minister about their concerns, but his office consistently sends them to the minister for the status of women instead.

"The response we got from the health minister was, 'This doesn't fall under my domain,' " Karp said. "We think it does. We think this is a health issue."

Manitoba's Health Department is responsible for all funding for reproductive health services, including any changes to abortion access. 

Earlier this week, the Health Minister Cameron Friesen refused to answer reporters' questions about whether abortion pill access would be changed to fall in line with other provinces.

"I will defer to her on this matter," Friesen said, speaking about Status of Women Minister Rochelle Squires.

"The premier has chosen wisely to put Minister Squires in charge of that file. I assure you I've got plenty on my plate," he said.

Free for low income, First Nations

Squires would not say whether the province will make Mifegymiso universally available.

"We're monitoring uptake, and measuring progress as we go, to make sure we're always responding to the needs of women in our province," she said to reporters Thursday.

The abortion pill is free for women who are low income, on social assistance or First Nations, she said.

"We've only had fewer than five per cent of women need to pay for it in some or all of the cost. So we do think that it is very available to many women in the province of Manitoba," she said.

"I work very, very closely with our Health Minister Cameron Friesen," she said. 

Squires said she'll meet with the students soon, but did not provide a date.

Theresa Oswald, CEO of Doctors Manitoba, said she personally supports the push for universal abortion pill access, but her organization doesn't take a position on it.

"They certainly do have the right as a government to make those decisions in terms of which minister they want to put in charge of what," she said.

Oswald, who was health minister when she was an NDP MLA, said having a status of women minister in charge of reproductive health is unusual.

Clinic reports to 2 ministers

The provincial government's decision to roll reproductive rights into the Status of Women Department has made things "tricky" for Winnipeg's Women's Health Clinic, executive director Nadine Sookermany said.

"I don't know of any other jurisdiction that has done this, so it is concerning."

While funding for the Women's Health Clinic comes from the Health Department, her organization reports abortion numbers to the Status of Women Department.

"It isn't anything that we have any control over," she said. "It isn't clear who makes the decision, and that makes it very difficult for us to do any type of work that says, 'This is what our clients need.' "

"When we're asking for increased access to Mifegymiso, or how we can ensure that women in Manitoba receive the care that they need when it comes to medical and or surgical abortions … we don't get the answers from the minister of health."

'Obstacles are multiple'

About one-third of the abortions performed at the Women's Health Clinic are done using Mifegymiso. Since the clinic began offering the drug in November 2017, there have been 690 medical abortions (using the pill) and 2,159 surgical abortions.

Sookermany said 25 per cent of their clients come from outside of Winnipeg, including many from northern communities as far away as Flin Flon, Norway House and The Pas.

They'd like to see free Mifegymiso offered outside southern Manitoba, she said.

The cost of the pill is just one of the barriers that could stop someone from accessing Mifegymiso, Sookermany said.

"The obstacles are multiple, and it does certainly increase the further north you go or the further away from an urban centre you are."

Some doctors don't suggest the abortion pill as an option and some aren't trained to dispense it, she said.

The Women's Health Clinic hopes to expand abortion services to more areas and is working with several physicians to help provide better access.

Sookermany is concerned about the message the province is sending by placing women's sexual and reproductive health in a separate government portfolio, which she says essentially separates a woman's health needs based on body parts.

"We are a whole body," she said.