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Op-ed: Maggie O’Dea and Chris Vizena

Medical abortion: The time is now to address inequities in rural N.L.

By Maggie O'Dea and Chris Vizena

Each year, Memorial University medical students converge on the Confederation Building in St. John’s for the Provincial Day of Action.

Next week, we will meet with members of the House of Assembly and policy-makers to advocate on behalf of the health of Newfoundlanders and Labradorians.

We are calling upon the Provincial Government of Newfoundland and Labrador to join New Brunswick, Nova Scotia, Quebec, Ontario, Alberta, and British Columbia and commit to the provision of cost coverage for Mifegymiso, the drug used to induce medical abortion.

Lowest access

Persons in remote Newfoundland and Labrador have long faced inequitable barriers to receiving essential abortion services.

As a result, these persons have one of the lowest access to abortion services in all of Canada.

With surgical abortions performed solely in St. John’s, rural persons have been burdened with a journey that can involve thousands of kilometres, hours of travel, hundreds of dollars and time away from both family and work.

“[Mifegymiso] does not require the training and infrastructure of surgical clinics — or the emotional, physical and financial burden of leaving work and family.”

Canada’s approval in 2017 of Mifegymiso — a combination of two orally administered drugs that induce early abortion — provided Canadians an alternative to such surgery.

Although novel to Canada, Mifegymiso is not new.

Hailed as the “gold standard” for medical abortion, it has been used safely by millions of people in more than 57 countries, including France, China, the U.K., the U.S. and Australia for as long as 30 years in some countries.

Since it can be prescribed by local health professionals, it does not require the training and infrastructure of surgical clinics — or the emotional, physical and financial burden of leaving work and family to travel to city centres such as St. John’s.

Moreover, Mifegymiso can be offered earlier in pregnancy than surgical abortions, making it a generally safer procedure.

Surgical abortions cost five times more

Thus, in Newfoundland and Labrador in particular, Mifegymiso presents a potential solution to issues of inequity and accessibility, and holds great potential for those living far beyond the streetlights of the metropolis of St. John’s.

Yet, unlike surgical abortion, Mifegymiso prescriptions are not covered by the Newfoundland and Labrador provincial health plan.

A cost of approximately $350 can be prohibitive, leaving those who are uninsured and unable to afford to pay with no choice but to undergo the more invasive surgical abortion in St. John’s.

“Memorial University’s medical students are using our voices and our platform to call upon our government to commit to cost coverage of Mifegymiso.”

Ironically, it costs government almost five times more to provide a surgical abortion in hospital: upwards of $1,500.

Newfoundland and Labrador’s current medical coverage scheme is inequitable, uneconomical and, most importantly, insufficient in its goal of supporting the health and well-being of persons in our communities.

This is why we, Memorial University’s medical students, are using our voices and our platform to call upon our government to commit to cost coverage of Mifegymiso.

We are speaking out because:

  • Persons in rural Newfoundland and Labrador have one of the lowest rates of accessibility to abortion services in Canada. At present, persons unable to pay for Mifegymiso are forced to travel long distances and face long wait times to obtain services – compounding social and health disparities that pre-exist within our rural communities.
  • Those most affected by lack of cost coverage are those who need it the most: young, uninsured, low-income earners, who live in rural communities. They face poorer sexual health outcomes and are most vulnerable to the compounding effects of the emotional, physical, and economic burdens of travel.
  • Cost coverage of Mifegymiso reduces the demand for surgical abortions, enabling the health-care system to provide surgical abortions earlier, when they are safest for all persons.
  • Cost coverage of Mifegymiso fulfills an unmet responsibility to optimizing the health of persons living in rural Newfoundland and Labrador communities.

Important opportunity

By removing the financial barrier of Mifegymiso, the Newfoundland and Labrador government has a momentous opportunity to support persons and families from across our province, while also reducing health-care spending.

Accessible Mifegymiso will improve reproductive care and reduce risk and harm to our vulnerable persons.

Accessible Mifegymiso has the opportunity to ameliorate some of the many disparities that afflict our rural populations.

Simply put, it just makes sense.

Note: The term “persons” is used here as a categorical term for people with female-assigned reproductive systems, which includes a variety of gender expressions and bodies including women, trans, gender non-binary and gender-nonconforming people.

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