Dr. Adrian Edgar feels relieved.
There were points in the last several years when he thought the repeal of 84-20 might never happen. It was legislation that prevented Medicare from paying for out-of-hospital abortions.
The policy forced the closure of Clinic 554, which Edgar operated alongside his team. It was started by Canadian physician and abortion rights activist Dr. Henry Morgentaler in 1994.
“I was fearful, very fearful in the last year or two that we would never see this day come,” he said, in an interview with CHCO-TV.
Several successive governments, both Liberal and Progressive Conservative, have not moved to repeal 84-20 until now.
Six days after being elected Premier Susan Holt alongside her cabinet announced it would allow for out-of-hospital surgical abortions.
“I’ll be relieved if New Brunswick (does) not know how close we came to never repealing this,” he said.
The challenges in New Brunswick
Over the years, getting a surgical abortion in New Brunswick has been difficult and cost-prohibitive.
Edgar and his clinic manager Valerya Edelman have worked tirelessly to help bring collaborative, comprehensive, patient-centered reproductive care to individuals who can become pregnant.
The two have worked together for more than a decade.
But Edelman said limiting surgical abortions to hospitals alone carries many challenges.
“I’ve spoken to over a thousand people who have received or have been interested in getting an abortion in New Brunswick,” she said. “Some really common experiences were not being able to get to the hospital. There were wait times.”
She said oftentimes people are required to travel, which can be unideal, especially in an emergency situation, or wait due to delays out of their control.
Surgical abortions are only available in Moncton and Bathurst, while medication abortions are available in some clinics in Fredericton, Saint John, and Moncton.
“It was kind of scary for them just to experience that on their own,” she said. “We saw people from all walks of life.”
Hospital settings, Edgar and Edelman said, also create unintended consequences. In hospitals, people can run into family, co-workers, and friends – some, they explained, may not agree or support the decision.
“We had hospitals and people were still coming to the clinic,” Edelman said. “People were coming to the clinic.”
The clinic provided a much-needed refuge for people capable of pregnancy to find a safe space to receive the health care they needed, free of judgment – notably written on the sign at the entrance of the clinic.
Medication abortions
While Edgar said the introduction of medication abortions was part of the process, the introduction of it without the additional option of surgical abortion really narrowed people’s choices.
“The government, the previous Liberal government, decided not to allow clinic-based abortions like procedural abortions to be funded,” he said. “Then we started to see the harm of that two-tier access system being legislated and patients having to choose what was available instead of what was appropriate.”
In some cases, he explained, a medication abortion is not the right option. He said studies showed that New Brunswick had the highest rates of medication abortion, which was being celebrated and supported by some within the medical community and outside.
“Our experience on the ground was that (it) wasn’t a reflection of patient choice,” he said. “That was a reflection of the lack of patient choice.”
The future of clinic 554
Edgar said he hopes to be able to provide surgical abortions in the capital region with these new changes, but it likely will not happen at Clinic 544.
“We were bullied because we had an anti-abortion organization that built a building next door to the clinic,” he said.
The clinic and the organization next to are separated by only metres.
“I think it confuses patients,” he said. “We had patients that would go there by accident and then come to us crying afterward and terrified, I would say terrified.”
He said he does feel saddened that the location no longer fits given the history of it, but feels there is a space that will work better.
“I don’t know what’s in store,” he said. “I have met with the New Brunswick Medical Society, and I have met with some of the other abortion providers who currently work in hospital settings and some of the other physicians in the region who would be important players in determining where this service could be provided.”
Both Edgar and Edelman said they are keen to understand how providing reproductive health care could work in the Liberals 30-new collaborative care clinics.
They hope to be invited to the table to share their wealth of knowledge in the field.
“We were able to provide the care so that they had it done safely, (and) deeply respectfully and with that community (and) non-judgmental care,” said Edelman.
Edgar said he feels thankful to the Holt government.
“I think it is important that we have women in leadership,” he said. “I think that we’ve had this regulation for decades, literally decades, and in all that time, we’ve never had a woman Premier.”
“Then six days after we had our first woman as a premier, we saw the advancement of women’s health care rights, and I don’t know if that would have happened if we had another male.”
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