This article is based on the Imagining the Next Chapter for Abortion Care in Canada: Pathways to Access and Equity panel hosted by missINFORMED on May 2, 2024. We invited five leaders in reproductive health and abortion to provide their insights on the present and future of abortion care in Canada.
This is part 2 of our 3-part webinar recap. Click here to read the previous article
Abortion care is healthcare for anyone who is or can become pregnant. While there are many barriers that are common for all who seek abortion, additional barriers exist for some folks as a result of the identities they hold. For this reason, intersectionality is really important when talking about access to abortion care.
Intersectionality is a term first coined by Professor Kimberlé Crenshaw (1). It refers to the ways in which forms of inequality or oppression intersect and create unique barriers that are difficult to understand when only looking at one part of someone’s identity. As an example, a Black trans-man will face unique barriers when accessing abortion as compared to a Black cis-woman or a white trans-man. When thinking about moving towards reproductive care that is equitable, intersectionality must be at the forefront.
Many of our panelists serve communities in their day-to-day work that face systemic barriers to accessing safe abortion care. We asked our panelists to share the unique challenges faced by these groups and/or what aspects of care need to be changed.
People facing criminalization: Natasha highlighted the work of Wellness Within, an organization that advocates for prison abolition and serves people who face criminalization. Folks who are criminalized have to deal with intersecting barriers and systems of oppression when trying to access abortion care, including racial discrimination, gender segregation, poor mental health, lack of social support and more. Choice in abortion care is often denied for people who are incarcerated. Medication abortion is often not an option because of barriers imposed by the prison system. For example, a person receiving a medication abortion must take 2 pills 24-48 hours apart and the structured schedule of a prison makes the timely administration of these medications difficult (2). There may also be limited access to menstrual supplies and restrictions on over-the-counter pain relief medications, both of which may be needed to help someone manage bleeding and cramping associated with receiving a medication abortion (2). Due to the violence and discrimination inherent in prison systems, people facing criminalization have negative experiences accessing healthcare. They may be shackled during their appointments and have their right to confidentiality breached by having prison guards in the room during their appointments. Mistrust in the healthcare system grows with each negative experience which can mean that people avoid getting care when they need it, leading to delays and denial of care. Natasha points to this as an area where providers can advocate for their patients and set in place policies that protect the patient’s right to safe and dignified care.
Indigenous communities: Willow talked about the historical experiences of Indigenous Peoples accessing reproductive care within colonial healthcare systems. These experiences include forced and coerced abortions, sterilization, and contraception. Historical legacies of harm within Indigenous communities and the various identities an Indigenous person may hold (e.g., gender, education, income, disability) together influence how an Indigenous person views the healthcare system and how healthcare providers view them. As a result of colonialism and ongoing prejudice against Indigenous Peoples, Indigenous folks often have their needs dismissed within healthcare systems. Trusted traditional knowledge is often ignored within healthcare spaces that are based in Eurocentric ways of knowing. Willow shared that the erasure and rejection of Indigenous knowledge makes it difficult for Indigenous folks to advocate for themselves and receive culturally safe care.
Disabled people: Clark highlighted that there are groups missing from policy discussions around abortion care. One example is the unique experiences of folks who are disabled. Clark shared his experience as a queer person with a disability accessing a hysterectomy: “No one pushed me on whether or not I was needing my uterus to have children because it wasn’t even a thought. The idea of someone who is first of all trans getting pregnant is not really something that folks think about, but also there is such a history of stigma and infantilization and the historical trauma of sterilization of disabled people as well”. Clark’s story highlights the importance of intersectionality; their experiences were unique as a queer and disabled person accessing reproductive healthcare. Clark encouraged everyone to look for those who are missing from reproductive health policy-making spaces. These are the voices that need to be considered and amplified in conversations around abortion care.
By now we know that abortion care is healthcare for anyone who is or can become pregnant, and should be safely accessible regardless of one’s identity. Still, our identities (gender, race, income, education, disability) produce advantages and disadvantages that impact how easy it is for us to navigate the healthcare system and access abortion care. As we heard from our panelists, certain communities face overwhelming barriers when accessing abortion care. A more equitable landscape for abortion and reproductive care requires individual, community-level and systems-level solutions. As we dream of our reproductive futures, we must include and uplift diverse voices to ensure change is truly equitable.
Want to learn more about what our panelists have to say? Watch the full panel webinar.
Acknowledgement:
We at missINFORMED are incredibly grateful to all of our panelists for their dedication to reproductive justice and their willingness to participate in our panel discussion. Thank you to our panelists and to all who have engaged with our panel discussion.
References:
Only information that was not mentioned during the panel discussion is cited.
Crenshaw K. Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum. 1989: 139–67, p. 149. Available from: https://philpapers.org/archive/CREDTI.pdf?ncid=txtlnkusaolp00000603
Paynter MJ, Norman WV. The Intersection of Abortion and Criminalization: Abortion Access for People in Prisons. In Seminars in reproductive medicine. 2022: Vol. 40, No. 05/06, p. 264-267. Available from: https://researchonline.lshtm.ac.uk/id/eprint/4668415/7/Paynter_Norman_2022_The-intersection-of-abortion-and.pdf
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