Country Profile: Canada

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

There are no legal restrictions on abortion, including no gestational limit. Abortion services form part of medically required health services provision and are regulated as such. The Canada Health Act outlines coverage for abortion services. Access however in practice varies depending on the availability of public facilities, and gestational limits vary at province level. As the Ministry of Health states in its Annual Report on the Health Act for2014-2015 (Source 7, see Chapter 2, page 13): “During 2014–2015, Health Canada continued to monitor the following ongoing compliance and interpretation issues: Abortion services are insured in all provinces and territories; however, access to these insured services varies within and between jurisdictions across the country. In Prince Edward Island and New Brunswick, the services are only covered if performed in a hospital (for example, private clinic procedures are not covered). In addition, Prince Edward Island lacks abortion services on the island and residents must travel off the island to access them. In New Brunswick, access has improved because certification of medical necessity by two physicians, and performance of the service by a specialist in gynecology or obstetrics in a hospital are no longer required. Prince Edward Island service has improved because the province has eliminated the need for a referral from an Island doctor and now allows women to self-refer to a Moncton, New Brunswick, hospital. However, accessibility and comprehensiveness concerns remain because neither province covers private clinic abortions under their respective provincial health insurance plans.”

The Induced Abortion Guidelines (2006) of the Society of Obstetricians and Gynaecologists of Canada state: “If a minor presents for abortion accompanied by a parent, it is important to ensure the youth was not coerced and the decision is voluntary. In Canadian common law and in some provinces “age of consent” follows the “mature minor” rule: the legal right to make health care decisions depends on decision-making ability rather than age; in other provinces the age of consent is consistent with the age of majority.6

The key element is the minor’s competence and capacity to understand the consequences of the procedure and the potential for complications, not her chronological age. In provinces that have not adopted the mature minor rule, health care providers can treat minors when appropriate without parental involvement, as common law invariably overrides local legislation. However, there should be documentation that the health care provider discussed the importance of involving parents in health decisions, and there must also be a reasonable impression that the intervention is in the best interests of the minor. It is imperative that health care providers be aware of the laws of the province in which they work.”

The Guidelines can be accessed at http://sogc.org/guidelines/induced-abortion-guidelines/

In British Columbia, for instance, there is no minimum age of consent to medical treatment. If specific conditions are met, it is not necessary to obtain consent from the infant’s parent or guardian. The conditions are that the health care provider providing the health care: a) Has explained to the infant and has been satisfied that the infant understands the nature and consequences and the reasonably foreseeable benefits and risks of the health care; and, b) Has made reasonable efforts to determine and has concluded that the health care is in the infant’s best interests.

In British Columbia, contraceptive counselling is part of broader counselling in the context of abortion care.

In Ontario, mifepristone/misoprostol is publicly funded.

For example, in British Columbia, the abortion care guidelines permit individual health care providers to choose whether or not to participate in the provision of abortion services relating on grounds of their personal values. They recognize the obligation of health care providers to provide appropriate care in emergency situations and to facilitate a woman’s access to information about abortion and services as requested.

Medical associations at province level may provide guidance on the issue of objection and the obligation to refer. See, for instance, a factsheet on effective referral issues by the College of Physicians and Surgeons of Ontario, accessible at: http://www.cpso.on.ca/CPSO/media/documents/Policies/Policy-Items/PAD-Effective-Referral-FactSheet.pdf”

For example, in British Columbia, the abortion care guidelines permit individual health care providers to choose whether or not to participate in the provision of abortion services relating on grounds of their personal values. They recognize the obligation of health care providers to provide appropriate care in emergency situations and to facilitate a woman’s access to information about abortion and services as requested.

Medical associations at province level may provide guidance on the issue of objection and the obligation to refer. See, for instance, a factsheet on effective referral issues by the College of Physicians and Surgeons of Ontario, accessible at: http://www.cpso.on.ca/CPSO/media/documents/Policies/Policy-Items/PAD-Effective-Referral-FactSheet.pdf”

For example, in British Columbia, the abortion care guidelines permit individual health care providers to choose whether or not to participate in the provision of abortion services relating on grounds of their personal values. They recognize the obligation of health care providers to provide appropriate care in emergency situations and to facilitate a woman’s access to information about abortion and services as requested.

Medical associations at province level may provide guidance on the issue of objection and the obligation to refer. See, for instance, a factsheet on effective referral issues by the College of Physicians and Surgeons of Ontario, accessible at: http://www.cpso.on.ca/CPSO/media/documents/Policies/Policy-Items/PAD-Effective-Referral-FactSheet.pdf”

For example, in British Columbia, the abortion care guidelines permit individual health care providers to choose whether or not to participate in the provision of abortion services relating on grounds of their personal values. They recognize the obligation of health care providers to provide appropriate care in emergency situations and to facilitate a woman’s access to information about abortion and services as requested.

Medical associations at province level may provide guidance on the issue of objection and the obligation to refer. See, for instance, a factsheet on effective referral issues by the College of Physicians and Surgeons of Ontario, accessible at: http://www.cpso.on.ca/CPSO/media/documents/Policies/Policy-Items/PAD-Effective-Referral-FactSheet.pdf”