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Cost coverage of abortion pill doesn鈥檛 improve rural access

Ultrasound requirement still a barrier for Agassiz, Harrison, Hope
10137838_web1_180109-AHO-M-AgassizPharmacy

The B.C. government鈥檚 recent announcement of universal, no-cost coverage for Mifegymiso 鈥 an oral alternative to surgical abortion 鈥 has been looked to as an answer for improving access to abortion in rural communities across the country.

The combination of Mifepristone and Misoprostol, currently free in five other Canadian provinces, is used to terminate early pregnancies only 鈥搖p to nine weeks or 63 days from the last menstrual period.

Most B.C. pharmacies will provide Mifegymiso once it becomes fully cost-covered Jan.15, and will likely order it on an as-needed basis.

But the zero-cost price tag on the pill may remove just one of many barriers facing rural women with unwanted pregnancies.

To get a prescription, patients are required to have an ultrasound to confirm the gestation stage and ensure that an ectopic pregnancy 鈥 when a pregnancy occurs outside the uterus 鈥 isn鈥檛 taking place.

Most rural doctor clinics don鈥檛 have ultrasound equipment, so patients will need to travel to the closest hospitals or urban centres where ultrasounds are available. Even then, long wait times can cause delays and ultrasounds at private clinics often come with a fee.

Fr茅d茅rique Chabot, director of health promotions for Action Canada for Sexual Health and Rights, says that since the decriminalization of abortion nearly 30 years ago, improving access in rural communities has been one of the biggest struggles.

鈥淎ccess really varies across Canada and the people who are getting the short end of the stick are definitely people in rural and remote areas,鈥 she said. 鈥淭o offer a medical abortion is way more accessible for service providers than to set up the services needed for surgical abortion.

鈥淚n a rural community you don鈥檛 have the same access to a pretty important medical service. And that鈥檚 not what our health care system is about. It鈥檚 supposed to be universal.鈥

While Chabot said cost coverage for Mifegymiso is a huge step towards removing multi-tiered access, Action Canada for Sexual Health and Rights is still advocating to remove the current ultrasound requirement.

鈥淐ost coverage was the first step that we had identified as making the biggest difference,鈥 she said. 鈥淸Before] people would have to pay out of pocket 鈥 something like $400. We had a pretty major victory with most Health Canada restrictions being taken down, but the mandated ultrasound continues to stand in the way for access in some areas.

鈥淲e鈥檙e working with a lot of activists and other organizations to continue to chip away at these barriers.鈥