When there are no abortion laws: A case study of Canada

Canada decriminalized abortion, uniquely in the world, 30 years ago. We present the timeline of relevant Canadian legal, political, and policy events before and since decriminalization. We assess implications for clinical care, health service and systems decisions, health policy, and the epidemiolog...

Full description

Saved in:
Bibliographic Details
Published in:Best practice & research. Clinical obstetrics & gynaecology 2020-01, Vol.62, p.49-62
Main Authors: Shaw, Dorothy, Norman, Wendy V.
Format: Article
Language:English
Subjects:
Abortion
Abortion, Criminal
Abortion, Induced
Abortion, Legal
Canada
Decriminalization
Female
Health law
Health policy
Health Policy - legislation & jurisprudence
Humans
Induced
Legislation as Topic
Pregnancy
Pregnancy Trimester, Second
Women's Rights - legislation & jurisprudence
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Canada decriminalized abortion, uniquely in the world, 30 years ago. We present the timeline of relevant Canadian legal, political, and policy events before and since decriminalization. We assess implications for clinical care, health service and systems decisions, health policy, and the epidemiology of abortion in the absence of criminal legislation. As the criminal abortion law was struck down, dozens of similar private member's bills, and one government bill, have been proposed, but none were passed. Key findings include that initially Canadian provinces attempted to provide restrictive regulations and legislation, all of which have been revoked and largely replaced with supportive policies that improve equitable, accessible, state-provided abortion service. Abortion rates have been stable over 30 years since decriminalization, and a falling proportion of abortions occur late in the second trimester. Canada demonstrates that abortion care can safely and effectively be regulated as a normal component of usual medical care. •Canada's 30-year experience may guide others considering decriminalizing abortion.•Regulating abortion as a healthcare service has not led to higher abortion rates.•Canada's geography and population density create specific access challenges.•Average gestational age at abortion is decreasing as access to services increases.•As medical abortion increases, training and access for second trimester abortion are concerning.
ISSN:1521-6934
1532-1932
DOI:10.1016/j.bpobgyn.2019.05.010