By: Tatiana Furtado
New Brunswick is the only province in Canada to restrict abortion care to a hospital setting and Dr. Adrain Edgar, owner and director of Clinic 554 is concerns about the future of reproductive rights and care in the province.
Clinic 554 opened its doors to New Brunswick in 2015. The leap of faith was taken by medical director, Dr. Adrian Edgar in hopes of beating all odds and starting a new chapter in history when it came to abortion care in the province. Although, New Brunswick is known for taking a conservative view on abortion care, and while other Canadian provinces were progressing, they stayed behind with their own agenda in mind.
“We’re the only province that restricts abortion care to a hospital setting. That’s not the standard of care for abortion provision anywhere around the world,” Clinic 554 Medical Director, Dr. Adrian Edgar said.
In 1988, Canadian physician and pioneer of abortion advocacy, Dr. Henry Morgentaler led the appeal to the Supreme Court of Canada regarding the current abortion law which violated section seven of the Canadian Charter Rights and Freedoms. Once the Supreme Court of Canada found it unconstitutional, no other law was put in place and any future abortion laws were now determined under provincial jurisdiction. This meant that each province and territory was free to establish their own laws and regulations regarding access to abortion. Prior to the ruling in 1985, the New Brunswick government passed Bill 92 which declared it illegal to perform abortions outside of accredited hospitals; coincidentally happening after Morgentaler sent a letter to premier Richard Hatfield asking for assistance to open a free-standing clinic in the province. These significant moments have now shaped and influenced the provinces handlings of abortion care.
Hospital Care vs. Free-Standing Clinic
Access to free surgical abortion is available in New Brunswick's three hospitals, Chaleur Regional Hospital, Dumont University Hospital Centre and Moncton Hospital with anyone with a valid New Brunswick Medicare card up until the 13 weeks and six days. Abortion past this gestational period can be accessed at Clinic 554 up to 16 weeks and six days with additional costs.
On the government of New Brunswick’s website there is no information linking to surgical abortion, only a medical abortion program which covers the cost of abortion pills, mifepristone and misoprostol.
Without adequate information regarding access to surgical abortions, people requiring care may think they have no other option but to perform a medical abortion. Yes, medicated abortions have solved part of the accessibility issue, Dr. Adrian Edgar says the government of New Brunswick needs to acknowledge it still might not be the right option in certain cases.
“This government is really pushing a narrative and I find this happening all over Canada, the face that if someone can have a medication abortion, that they don’t need to have access to a procedural abortion. Just think about a person who lives with a violent partner, for them to go home and take the pills and have an abortion where the persons going to see them bleeding for weeks on end. It’s going to raise suspicion that could put their life at risk as opposed to if they come to the clinic and have the procedure done that day,” Dr. Adrian Edgar said.
If you search surgical abortion care in New Brunswick on Google, the first website that appears is by Vitalité Health Network breaking down the options of unplanned pregnancy in New Brunswick. The website writes that surgical abortions are free for women with a valid New Brunswick Medicare card. What’s alarming about this is abortion care does not just apply to women, it applies to all genders and sexual orientations seeking care. Abortion information, especially on a credited health network website, needs to be inclusive and representative of all its residents and if not, it shows their out-dated, non-inclusive views.
Bringing Modern Views to Rural Canadian Provinces
Dr. Adrian Edgar provides abortion and sexual reproductive care at Clinic 554 and he says it’s a place where patients can feel comfortable obtaining care that’s not necessarily offered at local hospitals.
“I had trained in Vancouver in an inner city family medicine program so I brought a lot of those urban skills to New Brunswick. So I provide abortion care, LGBT inclusive care and trans health, HIV care and prep which is preventing HIV transmission. I think those are all the things that were a little bit difference about my practise,” Dr. Adrian Edgar said.
Since Clinic 554 is a free-standing clinic, they receive no provincial funding and Dr. Adrian Edgar is forced to pay out of pocket. The clinic relies on community fundraising and non-profits like high school bake sales, drag queen fundraising, campaigns and donations. The clinic works closely with Action Canada for Sexual Health and Rights and the National Abortion Federation of Canada to support their patients.
Canada Federal Health Transfer
Schedule 2 of Regulation 84-20, under the Medical Service Payment Act in New Brunswick limits medicare funding for abortion to a hospital setting, classifying Clinic 554 out of medicare funding. Without this funding Dr. Adrian Edgar says they are constantly struggling to make ends meet.
“If we’re going to talk about the Canada Health Act and New Brunswick is in violation of that. It’s really like sex selective discrimination in New Brunswick and healthcare because if you are a person who has a uterus, you don’t have the same access to healthcare as someone who doesn’t. We do provide publicly funded vasectomy’s in freestanding clinic but we don’t provide abortion. It goes against the charter of rights and freedoms in terms of a person's right to bodily autonomy,” Dr. Adrain Edgar said.
Each year, the federal government releases four Federal Health Transfer to all provinces and territories to support policy areas of health care, post-secondary education, social assistance and social services, early childhood development and child care.
In 2021, the federal government reduced the Canada Health Transfer to New Brunswick, cutting back approximately $140,000 because of the provinces failure to fund out-of-hospital abortions. Since the cut, the New Brunswick government has shown no efforts to change their public health policies.
Joyce Arthur, executive director for Abortion Rights Coalition of Canada says, “it’s really important to have hospitals involved because it helps integrate abortion care into the whole healthcare system and make it kind of a normalized part of healthcare.”
But this issue is deeper than just healthcare and it weighs on the decisions of powerful government officials in the province.
Anti-abortion provincial leaders
New Brunswick premier Blaine Higgs has made his anti-abortion views very clear and during a campaign stop in 2020, he mentioned supporting private clinics is not something we do in Canada, meanwhile New Brunswick the only province not doing so.
“I think New Brunswick is unique because you know, our current health minister and premier are both individuals who are on camera speaking against abortion as a practise, so it’s very difficult to hope for change when the health minister doesn’t think abortion is healthcare,” Dr. Adrain Edgar said.
During a legislature debate in 2014 Higgs said, “I would suggest that the unborn child is, indeed, one of the most vulnerable members, if not the most vulnerable member, of our society.”
There are many religious stigma around abortion in New Brunswick, meaning more pro-life views and fewer pro-choice. But, Dr. Adrian Edgar says for a better future, it’s critical from the province to separate religious views from legislation.
Potential Change in the Coming Months
The Canadian Civil Liberties Association, a non-profit national human rights organization committed to defending the freedom of all people in Canada won its first round of abortion lawsuit against New Brunswick this past June.
The formal lawsuit was against the New Brunswick government and its Regulation 84-20 which limited the access to abortion to a hospital setting. The next stages of the lawsuit are expected to continue in the coming months.