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Copyright of Canadian Journal of Economics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Governance Review / Revue Gouvernance is the property of University of Ottawa, Center on Governance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In January 2017, the 'abortion pill' was finally used legally in Canada. This paper provides a sociotechnical analysis of the controversy surrounding RU486 in Canada, focusing on its entry into public discourse, 1990-1995. The case study draws primarily on statements made about the pill, both in Canadian media and in various actors' print communications. Using approaches from science and technology studies, the analysis identifies the multiple human and nonhuman actors, their discursive mobilizations of RU486 and each other, and their contingent alliances, illustrating how RU486 mediates and shapes the communication that attempts to define it. Unpacking the network's complexity illuminates how these sense-making practices established the early setting of the technology's path, a first step in understanding why Canada has been a laggard in making the pill available. The discussion illustrates the tensions, instabilities, and reversals in the network that have hindered RU486's movement from development to diffusion. Finally, the paper suggests a framework for future sociological research on controversial reproductive technologies in their shift from discursive to material diffusion, one that recognises the integral role of women as users. [ABSTRACT FROM AUTHOR]

People incarcerated in facilities for women and girls face barriers to accessing abortion, including unclear legislation, operational procedures, and distance. While medication abortion could mitigate distance barriers, prison is not a hospitable environment for medication abortion. Considering this limitation, this paper aimed to identify the distance from institutions of incarceration designated for women and girls to procedural abortion facilities in Canada. This study builds on an inventory of the 67 institutions of incarceration designated for women and girls across 13 provinces and territories in Canada, previously created by the authors. Procedural abortion facilities were identified using publicly available directories. Distances were calculated using Google Maps. The closest procedural abortion facility was identified for each institution, as well as the gestational age limit of each facility. Of the 67 institutions, 23 (34%) were located 0 to 10 km from a procedural abortion facility. Fourteen (21%) were located 10.1 to 20 km away. Ten (15%) were located 20.1 to 100 km away. Eleven were located 100.1 to 300 km away (16%). The remaining 9 (13%) were located between 300.1 and 738 km away. Distances ranged from 0.1 to 738 km. The greatest distances were among institutions in northern Canada. This paper identified a large range of distances between institutions of incarceration and procedural abortion facilities in Canada. Physical distance is only one measure of accessibility of abortion services. For incarcerated people, contextual factors including carceral policies and procedures present barriers to care, with significant impact on health equity. Distance between carceral institutions and procedural abortion facilities reduces equitable access to reproductive health services for incarcerated populations. Pregnant people should be protected from imprisonment to ensure reproductive autonomy. [ABSTRACT FROM AUTHOR]

Though abortion is legal in Canada, policies currently in place at various levels of the health care system, and the individual actions of medical professionals, can inhibit access to abortion. This paper examines the various extra-legal barriers to abortion access that exist in Canada, and argues that these barriers are unjust because there are no good reasons for the restrictions on autonomy that they present. The paper then outlines the various policy measures that could be taken to improve access. [ABSTRACT FROM AUTHOR]

This paper reports on findings from our exploratory qualitative study that aims to advance knowledge around access to and experiences with abortion services among Indigenous Peoples in Canada. We applied an Indigenous methodology to engage with 15 Indigenous Peoples across Canada utilizing a conversational interview method. Our study was informed by an Indigenous Advisory Committee consisting of front-line service providers working in the area of abortion service access and/ or support across Canada. We conducted conversations from September and November 2021. Participants identified with Métis, Cree, Dene, Inuit, Haudenosaunee, Anishinaabe, and Mi'kmaq nations, across nine provinces and territories. Participants spoke to six themes encompassing challenges and potential solutions around abortion access experiences among Indigenous Peoples in Canada. These included (1) logistical barriers, (2) poor treatment, (3) stigma, (4) impacts of colonialism on attitudes towards abortion, (5) traditional knowledge, and (6) follow-up care and support. Our study demonstrates that Indigenous Peoples experience abortion access barriers that are different than non-Indigenous Canadians, and that these barriers are closely linked to colonialism. Indigenous knowledges and practices that honor reproductive choice that pre-dates settler colonialism, must be brought forward into today to enhance the quality of abortion care. [ABSTRACT FROM AUTHOR]

Aims: To explore nurse practitioners' experiences of medication abortion implementation in Canada and to identify ways to further support the implementation of medication abortion by nurse practitioners in Canada. Design: A qualitative approach informed by feminist theory and integrated knowledge translation. Methods: Qualitative interviews with stakeholders and nurse practitioners between January 2020 and May 2021. Data were analysed using critical feminist theory. Results: Participants included 20 stakeholders, 16 nurse practitioner abortion providers, and seven nurse practitioners who did not provide abortions. We found that nurse practitioners conduct educational, communication and networking activities in the implementation of medication abortion in their communities. Nurse practitioners navigated resistance to abortion care in the health system from employers, colleagues and funders. Participants valued making abortion care more accessible to their patients and indicated that normalizing medication abortion in primary care was important to them. Conclusion: When trained in abortion care and supported by employers, nurse practitioners are leaders of abortion care in their communities and want to provide accessible, inclusive services to their patients. We recommend nursing curricula integrate abortion services in education, and that policymakers and health administrators partner with nurses, physicians, midwives, social workers and pharmacists, for comprehensive provincial/territorial sexual and reproductive health strategies for primary care. Impact The findings from this study may inform future policy, health administration and curriculum decisions related to reproductive health, and raise awareness about the crucial role of nurse practitioners in abortion care and contributions to reproductive health equity. Patient or Public Contribution: This study focused on provider experiences. In‐kind support was provided by Action Canada for Sexual Health & Rights, an organization that provides direct support and resources to the public and is committed to advocating on behalf of patients and the public seeking sexual and reproductive health services. [ABSTRACT FROM AUTHOR]

In this study we explored nurse practitioner-provided medication abortion in Canada and identified barriers and enablers to uptake and implementation. Between 2020–2021, we conducted 43 semi-structured interviews with 20 healthcare stakeholders and 23 nurse practitioners who both provided and did not provide medication abortion. Data were analyzed using interpretive description. We identified five overarching themes: 1) Access and use of ultrasound for gestational dating; 2) Advertising and anonymity of services; 3) Abortion as specialized or primary care; 4) Location and proximity to services; and 5) Education, mentorship, and peer support. Under certain conditions, ultrasound is not required for medication abortion, supporting nurse practitioner provision in the absence of access to this technology. Nurse practitioners felt a conflict between wanting to advertise their abortion services while also protecting their anonymity and that of their patients. Some nurse practitioners perceived medication abortion to be a low-resource, easy-to-provide service, while some not providing medication abortion continued to refer patients to specialized clinics. Some participants in rural areas felt unable to provide this service because they were too far from emergency services in the event of complications. Most nurse practitioners did not have any training in abortion care during their education and desired the support of a mentor experienced in abortion provision. Addressing factors that influence nurse practitioner provision of medication abortion will help to broaden access. Nurse practitioners are well-suited to provide medication abortion care but face multiple ongoing barriers to provision. We recommend the integration of medication abortion training into nurse practitioner education. Further, widespread communication from nursing organizations could inform nurse practitioners that medication abortion is within their scope of practice and facilitate public outreach campaigns to inform the public that this service exists and can be provided by nurse practitioners. [ABSTRACT FROM AUTHOR]

Mifepristone medication abortion was first approved in China and France more than 30 years ago and is now used in more than 60 countries worldwide. It is a highly safe and effective method that has the potential to increase population access to abortion in early pregnancy, closer to home. In both Canada and the United States, the initial regulations for distribution, prescribing, and dispensing of mifepristone were highly restricted. However, in Canada, where mifepristone was made available in 2017, most restrictions on the medication were removed in the first year of its availability. The Canadian regulation of mifepristone as a normal prescription makes access possible in community primary care through a physician or nurse practitioner prescription, which any pharmacist can dispense. In this approach, people decide when and where to take their medication. We explore how policy-maker-engaged research advanced reproductive health policy and facilitated this rapid change in Canada. We discuss the implications of these policy advances for self-management of abortion and demonstrate how in Canada patients "self-manage" components of the abortion process within a supportive health care system. [ABSTRACT FROM AUTHOR]

Dr. Garson Romalis (1937-2014) was an obstetrician, gynaecologist and abortion provider in Vancouver, British Columbia. Like other abortion providers in North America, Romalis, his family and his clinic were subjected to years of harassment by pro-life activists. In 1994, Romalis was shot in his home by an anti-abortion terrorist and in 2000, he was stabbed by another terrorist outside of his clinic. Yet Romalis continued to provide this legal and essential medical procedure to British Columbian women, and advocated for the education of more abortion providers. This study will discuss the life and contributions of Gary Romalis and outline the motivations of the man to continue this dangerous work. It will compare his experiences with that of the more famous Canadian abortion provider, Dr. Henry Morgentaler, and speculate upon the significance of the Jewish ideal of tikkun olam (to heal the world) in these men’s lifework. Abortion terrorism will be situated within the constellation of pro-life activities, the goal of which is the curtailment of access to abortion in Canada. [ABSTRACT FROM AUTHOR]

Canada has come a long way since Dr. C. Henry Kempe first described battered-child syndrome in 1962. The year 1999 was crucial in Canada's battle against shaken baby syndrome/abusive head trauma (SBS/AHT), when the first national conference on the topic was held in Saskatoon. This was followed by the issuance of a national statement and multidisciplinary guidelines, recently updated in 2020. Incidence of AHT in Canada is similar to that found in population-based studies from Switzerland and New Zealand. The mainstay of prevention of AHT in Canada is education of parents and caregivers with respect to their response to infant crying. Population-based data for global incidence of AHT are lacking, largely because of social and cultural differences contributing to poor understanding of AHT as a medico-legal entity. India faces a distinct challenge in the battle against female feticide and infanticide. [ABSTRACT FROM AUTHOR]

Purpose: Access to family planning health services in Canada has been historically inadequate and inequitable. A potential solution appeared when Health Canada approved mifepristone, the gold standard for medical abortion, in July 2015. We sought to investigate the factors that influence successful initiation and ongoing provision of medical abortion services among Canadian health professionals and how these factors relate to abortion policies, systems, and service access throughout Canada.Methods: We conducted 1-on-1 semistructured interviews with a national sample of abortion-providing and nonproviding physicians and health system stakeholders in Canadian health care settings. Our data collection, thematic analysis, and interpretation were guided by Diffusion of Innovation theory.Results: We conducted interviews with 90 participants including rural practitioners and those with no previous abortion experience. In the course of our study, Health Canada removed mifepristone restrictions. Our results suggest that Health Canada's initial restrictions discouraged physicians from providing mifepristone and were inconsistent with provincial licensing standards, thereby limiting patient access. Once deregulated, remaining factors were primarily related to local and regional implementation processes. Participants held strong perceptions that mifepristone was the new standard of care for medical abortion in Canada and within the scope of primary care practice.Conclusion: Health Canada's removal of mifepristone restrictions facilitated the implementation of abortion care in the primary care setting. Our results are unique because Canada is the first country to facilitate provision of medical abortion in primary care via evidence-based deregulation of mifepristone. [ABSTRACT FROM AUTHOR]

Objective: The present study explores the content of abortion provider stigma. Background: Abortion stigma extends beyond women who have abortions to abortion providers. Previous analyses of anti-abortion bills and rhetoric have revealed stereotypes of abortion providers as dangerous and less trustworthy than other health professionals. Methods: We present a thematic analysis of one-on-one interviews about attitudes toward abortion providers with Canadian individuals (N = 21) holding an anti-abortion stance. Results: We found participants held two kinds of beliefs about abortion providers: (1) providers are agentic and intentional actors and (2) providers are non-agentic victims of a larger system. While the former subtype of provider was viewed with hostility and disgust, the latter was viewed with pity, with participants suggesting that restriction of abortion would be beneficial for provider well-being. Conclusion: We document a new component of abortion provider stigma: the belief that abortion providers are harmed by abortion and that they are to be pitied for this. This ‘abortion harms providers’ attitude parallels recent anti-abortion arguments that abortion harms women. These stigmatising attitudes both construct the provider as untrustworthy and unable to properly care for women. [ABSTRACT FROM AUTHOR]

Reports that Doctor Henry Morgentaler, Canada's outspoken abortion-rights crusader, has filed papers in the New Brunswick Court of Queen's Bench claiming women are being denied full access to abortion. Provisions under the New Brunswick's Medical Services Payment Act; Accusation of Morgentaler against the government; Controversy surrounding the issue of paying for abortions in private clinics.

Copyright of Canadian Journal of Political Science / Revue Canadienne de Science Politique is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Preference for sons over daughters, evident in China's and South Asia's male sex ratios, is commonly rationalized by poverty and the need for old-age support. In this article we study South and East Asian immigrants to Canada, a group for whom the economic imperative to select sons is largely absent. Analyzing the 2001 and 2006 censuses, 20 percent samples, we find clear evidence of extensive sex selection in favor of boys at higher parities among South and East Asian immigrants unless they are Christian or Muslim. The latter finding accords with the explicit prohibition against (female) infanticide-traditionally the main sex-selection method-in these religions. Our findings point to a strong cultural component to both the preference for sons and the willingness to resort to induced abortion based on sex. [ABSTRACT FROM AUTHOR]

Theories of 'life history evolution' suggest that individuals might adjust the timing of marriage and reproduction, as well as their propensity to terminate a marriage or pregnancy and invest in skill development, in response to indicators of the locally prevailing level of life expectancy. In particular, such theories generate the hypothesis that foreshortened time horizons lead to hastened reproduction and marriage whereas lengthier time horizons increase the likelihood of reproductive and marital termination and lead to greater investment in education. Here, I show that the scheduling and occurrence of marital and reproductive behavior (including both initiation and termination), as well as levels of educational attainment and investment, covary with life expectancy, even after controlling for the effects of affluence. In analyses of variation in marital, reproductive, and educational behaviors at two jurisdictional levels in Canada, life expectancy was positively correlated with patterns of age-specific fertility, age at first marriage, divorce, abortion, conferral of high school and higher education degrees (with the exception of the trades) and mean number of years of schooling. The large and highly consistent relationships observed between life expectancy and the behaviors under investigation suggest that these associations may be mediated by individual 'perceptions' of life expectancy, though more research is needed before conclusions can be firmly reached. [ABSTRACT FROM AUTHOR]

This article explores the work of the Calgary Birth Control Association with a particular focus on their referral service to help Albertan women obtain abortions in Seattle. The fact that Canadian women were travelling to the United States for abortions highlights the shortcomings of the Canadian health-care system and the legal changes in the 1969 omnibus bill. Cross-border travel is also compelling evidence for the argument that reproductive rights are an international issue. More particularly, this study demonstrates the tensions that reproductive-rights activists faced in addressing the needs of individual women vs the long-term objective of changing the laws and improving accessibility. [ABSTRACT FROM AUTHOR]

The American religious right is often taken as the paradigmatic illustration of how conservatives responded to contestation over social issues such as same-sex rights and abortion. This article establishes that the response of Canadian conservatives - as expressed by the Progressive Conservative party - was quite different. The Progressive Conservatives held to a norm, grounded in their party's version of conservative ideology, that rendered partisan mobilization on social issues illegitimate. Rather, the party treated such topics as moral issues on which decisions, if they had to be made at all, ought to be made on grounds of personal conscience. The norm helped limit social conservative mobilization in Canada until the early 1990s, when the Reform Party replaced the Progressive Conservatives as Canada's major right-wing party. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Historical Review is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abortion and same-sex marriage are moral issues that remain highly contentious in the political life of the United States compared to other countries. This level of contention is explained through comparison with Canada. Contrasts in culture and institutions shaping issues and the political avenues that allow their enactment account for differences in the tenor of politics in the two countries. [ABSTRACT FROM AUTHOR]

The right to health under the International Covenant on Economic, Social, and Cultural Rights, to which Canada is a signatory, entitles women to available, accessible, and acceptable abortion care, Abortion care in Canada currently fails this standard. Medication abortion (the use of drugs to terminate a pregnancy) could improve abortion care in Canada, but its potential remains unrealized. This is in part attributable to the unavailability of mifepristone, the safest and most effective pharmaceutical for medication abortion. Given that it could improve abortion care, we investigated why mifepristone remains unapproved in Canada, whether its unavailability is attributable to government inaction, and whether Canada is therefore failing to fulfill its obligations under the right to health. (Am J Public Health. 2008;98:1764-1769. doi: 10.2105/AJPH. 2008.134684) [ABSTRACT FROM AUTHOR]

The article examines the American stem cell debate and the related federal law to reveal the close extent to which abortion laws and politics infect the federal law. The author interprets the position of U.S. on embryonic stem cell research (ESCR) as a reflection of pro-life sensibilities concerning the perceived value of early embryo life. Moreover, it cites that the restriction of Canada in the area of ESCR could prompt a shift to a restrictive position in abortion in the years to come.

Presents several comments on various articles published in the 'Canadian Medical Association Journal.' Significance of the concept of informed consent in medical ethics; Factors that may influence abortion decisions; Controversy associated with the health sequelae of abortion; Results of a study that compared the adverse reactions and deaths attributed to Zyban drug in Canada and in Great Britain.

Examines data from inquests of 100 British Columbian women who attempted to induce a miscarriage between 1886 and 1939, to understand the role of women and physicians in the practice of abortion. Criminalization of abortion; Role of the judiciary; Peer pressure as motivation; Use of contraceptives; Abortion centers; Abortion law.

Profiles Garson Romalis, a Vancouver physician shot because he performs abortions. Romalis' views on importance of abortion unchanged; Concern that young physicians are too frightened to perform abortions; Why he performs abortions; Details about shooting; His background; Climate of fear caused by shootings; Stress on sexuality education and contraception; Life since the shooting; Need for society to condemn shootings. INSET: `They don't really understand what used to be.'.

Background: Most abortions occur due to unintended pregnancy. Unintended pregnancies are linked to poor health outcomes. Canada receives immigrants from countries with disparate sexual and reproductive health contexts which may influence abortion rates post-migration. We examined the association between abortion and region of birth and birth order among Canadian immigrants. Methods: We conducted a population-based person-years (PY) cohort study in Ontario, Canada using administrative immigration (1991–2012) and health care data (1991–2013). Associations between induced abortion and an immigrant's region of birth were estimated using poisson regression. Rate ratios were adjusted for age, landing year, education, neighborhood income quintile and refugee status and stratified by birth order within regions. Results: Immigrants born in almost all world regions (N = 846,444) were 2–5 times more likely to have an induced abortion vs. those born in the US/Northern & Western Europe/Australia & New Zealand (0.92 per 100 PY, 95% CI 0.89–0.95). Caribbean (Adjusted Rate Ratio [ARR] = 4.71, 95% CI 4.55–4.87), West/Middle/East African (ARR = 3.38, 95% CI 3.26–3.50) and South American (ARR = 3.20, 95% CI 3.09–3.32) immigrants were most likely to have an abortion. Most immigrants were less likely to have an abortion after vs. prior to their 1st birth, except South Asian immigrants (RR = 1.60, 95% CI 1.54–1.66; RR = 2.23, 95% CI 2.12–2.36 for 2nd and 3rd vs 1st birth, respectively). Secondary analyses included further stratifying regional models by year, age, education, income quintile and refugee status. Conclusions: Induced abortion varies considerably by both region of birth and birth order among immigrants in Ontario. [ABSTRACT FROM AUTHOR]

Background: Direct primary care provision of first-trimester medical abortion could potentially address inequitable abortion access in Canada. However, when Health Canada approved the combination medication Mifegymiso® (mifepristone 200 mg/misoprostol 800 mcg) for medical abortion in July 2015, we hypothesized that the restrictions to distribution, prescribing, and dispensing would impede the uptake of this evidence-based innovation in primary care. We developed and pilot-tested a survey related to policy and practice facilitators and barriers to assess successful initiation and ongoing clinical provision of medical abortion service by physicians undertaking mifepristone training. Additionally, we explored expert, stakeholder, and physician perceptions of the impact of facilitators and barriers on abortion services throughout Canada. Methods: In phase 1, we developed a survey using 2 theoretical frameworks: Greenhalgh's conceptual model for the Diffusion of Innovations in health service organizations (which we operationalized) and Godin's framework to assess the impact of professional development on the uptake of new practices operationalized in Légaré's validated questionnaire. We finalized questions in phase 2 using the modified Delphi methodology. The survey was then tested by an expert panel of 25 nationally representative physician participants and 4 clinical content experts. Qualitative analysis of transcripts enriched and validated the content by identifying these potential barriers: physicians dispensing the medication, mandatory training to become a prescriber, burdens for patients, lack of remuneration for mifepristone provision, and services available in my community. To assess the usability and reliability of the online survey, in phase 3, we pilot-tested the survey for feasibility. Results: We developed and tested a 61-item Mifepristone Implementation Survey suitable to study the facilitators and barriers to implementation of mifepristone first-trimester medical abortion practice by physicians in Canada. Conclusions: Our team operationalized Greenhalgh's theoretical framework for Diffusion of Innovations in health systems to explore factors influencing the implementation of first-trimester medical abortion provision. This process may be useful for those evaluating other health system innovations. Identification of facilitators and barriers to implementation of mifepristone practice in Canada and knowledge translation has the potential to inform regulatory and health system changes to support and scale up facilitators and mitigate barriers to equitable medical abortion provision. [ABSTRACT FROM AUTHOR]

Jansen expresses concern as to the legal implications of both selective reduction of pregnancy and unsuccessful attempts at termination of pregnancy using mifepristone. This commentary examines the legality of both procedures and concludes that Jansen is over-optimistic in his belief that neither procedure is likely to fall foul of the criminal laws on induced abortion. By contrast his anxieties about civil liability arising from the subsequent live birth of a damaged infant are, it is suggested, unnecessarily pessimistic. Such an action is most unlikely to succeed if brought by the infant herself and any claim on the part of the mother will normally be dependent on proof of negligence. The commentary focusses on the law in England with relevant references to other common law jurisdictions. [ABSTRACT FROM AUTHOR]