What’s behind Ontario’s ‘relatively stable’ abortion rate as other U.S., European areas see spikes?

While access to abortion services in Ontario has been expanding, the abortion rate in the province has held steady, according to research from the University of British Columbia.This compares to a “substantial” increase in abortions in other Western jurisdictions, including in the U.S. where abortion bans in certain states limit access to the service.The disparity can partly be attributed to ideological influences on how and to what extent abortion services are made available, according to Laura Schummers, a researcher and professor of pharmaceutical sciences at UBC.“When people are supported by the health system to make choices that best fit their needs and reproductive goals, we tend to see gradual declines in abortion rates,” Schummers said in a UBC News article.“There will always be pregnancies that need abortion services, but we will see a tempering of the abortion rate when services are provided in a way that is not encumbered by ideology.”Schummers noted that in Canada, mifepristone, an abortion medication, is easily accessible: the pills can be prescribed by any licensed prescriber, dispensed by any pharmacist, and self-administered in the patient’s own home.“Many settings have restrictions on mifepristone use that are not based in science, but come from an ideological position about who should have abortions and why. We [in Canada] don’t have that,” Schummers said.In the 14 U.S. states that have banned abortion with few exceptions, medical providers cannot prescribe or dispense mifepristone, as explained in an article published by CBC News. After mifepristone was made available in Canada in 2017, abortion rates in Ontario gradually increased; there were an additional “1.5 abortions per 1,000 females by the first quarter of 2020 compared with pre-mifepristone trends,” according to a study led by Schummers.In 2020 and 2021, there was a “pandemic-related decrease” in abortion rates in Ontario followed by a return to pre-pandemic trends.Meanwhile, between 2020 and 2023, “substantial increases” in abortion rates were reported in the U.S., the U.K. and Europe, according to the study. In Scotland, for example, rates “rose abruptly” to 16.1. abortions per 1,000 females in 2022 and 17.6 in 2023, compared with 13.0 and 13.5 abortions in 2018 and 2021, respectively. In England and Wales, rates increased to 20.6 in 2022 from 18.2 in 2020. And in the U.S., rates increased to 15.9 in 2023 from 11.2 in 2020.The sharper increases in abortion rates in these jurisdictions are in part tied to the quality of primary care and contraception services, in addition to the regulatory environments, according to Schummers.“You can’t really separate the frequency of abortions from provision of contraception services. The pandemic created a real struggle to consistently provide excellent primary care services, where contraception is usually provided,” she told UBC News.There has also been an increase in mis/disinformation through social media about contraception being unsafe, leading to lower use, Schummers added.She also acknowledged that abortion access is still uneven across Canada, despite the expansion of abortion services in Ontario. “We still struggle to provide services for our geographically distributed population, and we have persistently poor access in some jurisdictions,” she said.

What’s behind Ontario’s ‘relatively stable’ abortion rate as other U.S., European areas see spikes?

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