The history of abortion access on Prince Edward Island

The U.S. Supreme Court last week voted 6-3 to overturn the Roe v. Wade interpretation of the constitution, finding it does not protect abortion rights and opening the way for states to restrict or outright ban the medical procedure.

Prince Edward Island was long considered Canada's most pro-life province, and the Island's abortion politics have a long and fraught history.

Here's a look back at the evolution of abortion rights on P.E.I.

Decriminalization

Abortion in Canada was formally banned in 1869 and remained illegal until 1969, when the Criminal Law Amendment Act decriminalizedtherapeutic abortions, as long as a committee of doctors certified that the pregnancy endangered the pregnant person's life or health.

On P.E.I., the last legal abortion was performed in 1982 when the Protestant and Catholic hospitals merged, shortly before the opening of the Queen Elizabeth Hospital in Charlottetown.

In 1988, the Supreme Court of Canada's historic Morgentaler decision struck down Canada's abortion laws as unconstitutional, ruling that laws against abortion violated Section 7 of the Charter of Rights and Freedoms because theyinfringed against the right to "life, liberty and security of a person."

The decriminalization of abortion granted access to the procedures across the country, allowingabortions to be treated like any other medical procedure, governed by provincial and medical regulations.

Following the decision, almost all of the provinces began funding abortion under their health legislation.P.E.I. and New Brunswick were the only provinces to restrict payment for abortions, refusing to pay for procedures performed in private clinics.

The P.E.I. government of the time responded to the Morgentaler decision by introducing an anti-abortion resolution a policy that prohibitedabortions from being induced on the Island.

This meant pregnant people had to travel to Nova Scotia or New Brunswick to obtain an abortion. Approval for a publicly-fundedprocedure required a referral from two doctors, and doctors could refuse to write a referral based on ethical and religious grounds. Abortion access was therefore effectively out of reach for many Islanders.

Abortions performed in a hospital were paid for by the province, but manyinstead opted to pay the $800 out of pocket for abortions at private clinics, like the Morgentaler Clinic in Fredericton.

A 2014 paper Trials and Trails of Accessing Abortion on P.E.I., by Colleen MacQuarrie, Jo-Ann MacDonald and Cathrine Chambers lays out the stories of dozens of people who were essentially barred from accessing abortions as a result of the regulations.

"The access to abortion was described as a maze of multiple paths leading to dead ends, barriers, and delayed access, but participants in the project somehow found a way to end the pregnancy," the paper reads.

"Some were forced to leave the province, others tried to self induce by their own hand or with the help of boyfriends and others used medical abortion; however without local surgical termination, this choice in at least one case resulted in maltreatment in the local emergency room. Some women were forced to continue the pregnancy, give birth, and parent against their will. All participants documented various harms to health in the maze of trying to access abortion services in P.E.I."

A Rallying Cry

In the 1990s. Dr. Henry Morgentaler went to court to challenge the provincial government's policy of not paying for abortions at private clinics.

He initially succeeded in having the regulation thrown out, but the decision was overturned on appeal and the regulations were reinstated.

Ottawa also called on P.E.I to change its abortion funding policy in 2001, arguing it violated the Canada Health Act that deemed abortion a "medically necessary service" in terms of public funding.

The provincial government at the time, facing intense pressure from both the pro-choice and anti-abortion camps, maintained the status quo with the procedure being available only off-Island.

In 2011, the pro-choice P.E.I. Reproductive Rights Organization held its first public rally, demanding access to abortionon the Island. The anti-abortion Campaign Life Coalition held a counter rally at the same time and place. This set the stage for a series of head-to-head protests and heated debates in the coming years.

Pro-choice advocates won a series of small victories, including the 2012 launch of a Health P.E.I. website providing basic information on abortion services.

Another pro-choice group, Abortion Access Now P.E.I., emerged in 2014 with the stated goal of lobbying for full access tosurgical and medical abortion services on the Island. The organization also wanted diagnostic and follow-up care provided and paid for in P.E.I.

That same year, the Morgentaler Clinic in Fredericton closed. At the time, the clinic was providingabortions and care for 70 to 80 Islanders each year.

The Charter of Rights and Freedoms

In 2015, the province struck a deal with the Moncton Hospital in New Brunswick to provide access to abortion services for Island women. For the first time, patients from the Island could make an appointment for a procedure themselves without a doctor's referral.

That same year, the abortion drug RU-486, also known as Mifegymiso, was greenlighted by Health Canada to let people privately terminate pregnancies under seven weeks. Unlike other provinces, Prince Edward Island refused to cover the cost of the drug, until 2017.

In 2016, Abortion Access Now announced plans to sue the province to force the provincial government to provide full access to publicly-funded abortion services on the Island. The group filed a notice of application in the Supreme Court of P.E.I., leaving the province with 90 days to respond.

Then-premier Wade MacLauchlan, who has a background in constitutional law, reviewed the court filing and responded swiftly. Within days, his Liberal government announced it wouldn't fight the legal challenge and would provide abortions within the province by the end of the year.

At the time, MacLauchlan said the province likely wouldn't have been able to successfully defend itself against the suit. He also said a provincial abortion rights policy like the one P.E.I. had was contrary to the Canadian Charter of Rights and Freedoms.

The province tasked Health P.E.I. with planning a new women's reproductive health centre that would offer a number of services, including medical and surgical abortions, paving the way for the first abortions to be performed on the Island in 30 years.

Anti-abortion groups vehemently opposed the plans. Protests continued and advocates urged the province to reconsider, maintaining that abortion was not a constitutional right.

In January 2017, abortion services were offered for the first time at the Prince County Hospital in Summerside under the new Women's Wellness Program and Sexual Health Services.