A groundbreaking study has revealed an astonishing rise in abortion access in Ontario over the past five years, following the approval of the abortion pill, Mifegymiso. While access skyrocketed from a mere 37% in 2017 to a staggering 91% in 2022, surgical abortion services faced a troubling decline that demands urgent attention.

Published in the Canadian Medical Association Journal, the research highlights how the approval of Mifegymiso—a combination of mifepristone and misoprostol by Health Canada in 2017—dramatically transformed the landscape of abortion services across Ontario. The study, which analyzes health administrative data from 2017 to 2022, found that the medication accounted for a remarkable 56% of all abortion procedures in 2022, markedly up from just 8% in 2017.

Lead author Laura Schummers, an assistant professor at the University of British Columbia's faculty of pharmaceutical sciences, emphasizes the significance of these findings: "This is really the first evidence we have in Canada of how access to abortion services have changed since the introduction of mifepristone."

In a striking example of this shift, pharmacist Anushya Vijayaraghevan opened her Toronto pharmacy in 2022 specifically to meet the urgent need for Mifegymiso. She shares her experience of patients seeking help from remote areas like Timmins, Ont., often facing barriers of privacy that make visiting local pharmacies uncomfortable. Her initiative fills a vital gap in service delivery, with OHIP coverage ensuring that patients receive their medications swiftly and discreetly.

However, Ontario's progress is not mirrored nationwide. In Alberta, a report in The Lancet warns of only minimal improvements in access over the past decade, and Quebec sees only 17% of abortions involving the pill. Conversely, New Brunswick reported a striking 68% uptake of medical abortions.

While the introduction of Mifegymiso has broadened access to abortion services, the decline in surgical options is alarming. The study indicates that local access to surgical abortions fell from 22% in 2017 to 18% by 2022. Schummers highlights the need for this balance, stating, "While access to medical abortion has improved, we must not neglect the preservation of surgical options."

Health Canada guidelines allow Mifegymiso to be prescribed for patients up to nine weeks pregnant, a timeframe that can be restrictive. TK Pritchard, Executive Director of Abortion Care Canada, points out that many individuals often do not realize they are pregnant until around the seven-week mark. Furthermore, there are cases where patients require surgical abortions due to health conditions, intimate partner violence, or other personal circumstances, where discretion becomes a fundamental concern.

The study points to a disturbing trend of clinic closures; for instance, Vancouver's Elizabeth Bagshaw Clinic recently shut its doors after 35 years. Abortion Access Canada has been forced to cut its direct client support by 75%, and New Brunswick’s only non-hospital surgical abortion clinic will cease operations in 2024.

Despite the increasing access to medical abortions, there remains a critical need for enhanced support and resources for surgical procedures. Pritchard argues, "We must keep the spotlight on both medical and surgical abortions, as each is essential to comprehensive reproductive healthcare."

As Ontario celebrates its progress, the nation as a whole faces a pivotal moment: will it step up to ensure that all forms of abortion access remain robust and equitable? The clock is ticking, and the stakes couldn't be higher.