THE OTHER OPTIONS INVOLVED IN REPRODUCTIVE CHOICE 

June 3, 2019

by Laura Lewis MD, CCFP

Reproductive choice is not simply access to abortion. Choice must also entail fully informed consent, alternatives to abortion, and respect for the validity of not choosing abortion. If we as a nation seek to uphold a woman’s right to reproductive choice, then we must make room to support these other options as well.

Every year pregnancy care centres across Canada respond to thousands of clients who seek out support. This support may be a visit to talk through pregnancy options and the challenges that often accompany an unintended pregnancy. It may be to participate in parenting programs or to receive material supplies for those who choose to parent. Or others may seek a safe place to work through self-identified negative emotions after an abortion. Pregnancy care centres provide a place for all these forms of support, and in doing so, are an important and needed part of the safety net in many communities.

As a physician, I understand the need for regulated care, clarity of service provision, and the importance of standards. I can also see through the crafted attempts by abortion lobbyists to invalidate pregnancy care centres. After working as a family doctor for 22 years, I have witnessed and know the important role local pregnancy care centres have in helping to empower women to make their own well-informed reproductive choice.

I now serve as the Executive Director of CAPSS, the Canadian Association of Pregnancy Support Services. We are a registered, Christian charity serving as a national best-practice affiliation of pregnancy care centres, providing support to 70+ centres across Canada. We continue to look for ways to assist our affiliated centres to do their work with excellence. This includes training and education, and standards which uphold our belief that women have the right to make their own well-informed pregnancy decision. The primary pregnancy options tool that is recommended for use by centres has been reviewed by 45 healthcare professionals. It covers abortion, adoption, and parenting. Our affiliated pregnancy care centres that provide healthcare services are also regulated by their provincial medical and nursing colleges. We care that our information is medically accurate. CAPSS continues to look at new ways to standardize the care provided and to develop tools to facilitate this care.

While we are discussing regulations, I have concerns about what regulations are in place for the provision of abortion. Research underscores the importance of a well-informed pregnancy decision to help mitigate negative emotional outcomes. Women who enter an abortion decision with uncertainty or coercion have a greater risk of experiencing negative emotions after their abortion. A point which is cited in the National Abortion Federation textbook for abortion providers.1

In an article posted in theJournal of American Physicians and Surgeons entitled, Women Who Suffered Emotionally from Abortion: A Qualitative Synthesis of Their Experiences.2 The authors surveyed 987 women who contacted crisis pregnancy centers for post-abortion care. Some of the findings are noted below:

  • 58.3% of the women reported aborting to make others happy
  • 73.8% experienced some form of pressure from others to abort
  • 28.4% aborted out of fear of losing their partner
  • 66% said they knew in their hearts that they were making a mistake when they underwent the abortion
  • 67.5% revealed that the abortion decision was one of the hardest decisions of their lives

This is important information and it should make us pause.

What safeguards or regulations are in place to ensure that no woman is pressured into an unwanted abortion? I am sure some physicians and abortionists do this well, but sadly we know of many women who have said they were pressured, were not listened to, or were not given other options – whether by their partner, by their parents, or even by their physician.

What about informed consent? An excerpt from the Canadian medical protective association (CMPA) cites this regarding consent:

“…[consent] must meet certain requirements. It must have been voluntary, the patient must have had the capacity to consent and the patient must have been properly informed. Patients must always be free to consent to or refuse treatment and be free of any suggestion of duress or coercion.”

And what about consent when the young woman is a minor? What is the minimum age of consent for a medical procedure?

“The legal age of majority has become largely irrelevant in determining when a young person may consent to his or her medical treatment. The concept of maturity has replaced chronological age, except in Québec, where the age of consent is 14 years and older.” CMPA

At the present time, the only requirement for medical consent to an abortion, is that in the opinion of the physician the patient understands the procedure and what she is consenting to. If the physician believes a 13 year old girl is mature enough to grasp the scope of her decision and the life-impacting nature of her choice, that is good enough.

There are no other requirements or regulations. There is no mandatory education or counselling, and no waiting period. And yet, even the Society of Obstetricians and Gynecologists of Canada (SOCG) states that no woman should be given the abortion pill if she is uncertain or having mixed feelings about her decision. In medical terms this is considered an absolute contraindication and requires that the medical care provided include assistance other than abortion.

We must remember that at the centre of these discussions are people – real people who often feel trapped, overwhelmed, confused, and hurt. We live in a democratic nation which upholds diversity as a national value. I appreciate this, and I ask that this national attribute be afforded to the highly politicized and often toxic abortion debate. As we make room for diverse worldviews, let us include diversity in the reproductive options provided to women.

1Paul M, Lichtenberg S, Borgatta L, et al. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Surrey, UK: Wiley- Blackwell; 2009.

2Priscilla K. Coleman, Ph.D.Kaitlyn Boswell, B.S.Katrina Etzkorn, B.S.Rachel Turnwald, B.S.

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