As a child born in the early 1960’s the message was simple: abortion is a sin and so is sex outside of marriage. So, I never thought much about abortions or marriage. Then at the age of 12, I remember my teacher asking if there are any circumstances when abortion is acceptable? Not even truly knowing what an abortion was, I answered “no.” Unknown to me, my teacher was a single unwed mother and in the 1970’s this was an unacceptable. Making it very clear to me that it may take two to tango, but the women bear all the consequences of the encounter.

Jumping forward from 1969 when Canada legalized limited abortion (only when the mother’s life is at risk) to the 1980’s. I watched as Dr. Henry Morgentaler opened illegal abortion clinics across Canada on the premise that women have the right to reproductive freedom. I watched the news reports as the Morgentaler abortion clinics were being bombed, harassed by protestors and the medical staff’s lives threated. Then in 1988, the supreme court of Canada in R. V. Morgentaler finds that Canada’s abortion law was unconstitutional, the law violated section 7 of the charter of rights and freedoms because it infringed upon a woman’s rights to “life, liberty & security of person.” (national abortion federation, nafcanada.org). Abortion was now treated like any other medical procedure and was governed by provincial/territorial and medical regulations (nafcanada.org) Sounds awesome, right? However, it takes years before all provinces remove the barriers to women’s access to an abortion.

As a nursing student at age 27, I started to understand the significance of Canada’s abortion legislation,that guards a woman’s reproductive freedoms including cases of ectopic pregnancy. Pregnancy can be a natural process until it goes horribly wrong. I have had friends face the terror & pain of this life-threatening experience. The ectopic pregnancy is non viable as the fetus cannot survive outside the uterus and it is life threatening to the woman. Emergency surgery is necessary to save the woman’s life.

During my maternity rotation, I saw the health risk factors of pregnancy play out. One was the lack of prenatal care which would have screened the woman for fetal defects, genetic defects, diabetes, substance abuse and in this case high blood pressure. The elevated bp can lead to preeclampsia putting the mom at risk for life threatening seizures and infant death. Other maternal risks are incomplete spontaneous, or medical abortions putting the woman at risk of a fatal infection. Where swift medical interventions are necessary to safe the woman’s life.

I have held the hands of both pregnant young teenagers and older women (In North and South America). Some still children themselves and the others already overwhelmed with the children they had at home. I fear for any teen pregnancy because their physical immaturity makes them a high-risk case and have compassion for the already exhausted mom.

At the age of 29 and newly married I came face to face with my own terror of becoming pregnant. I was one year away from graduating and wanted to develop my nursing career. Due to my own medical condition, I was not a candidate for oral contraceptives. My contraception of choice was condoms and foam. It wasn’t until my endometrial ablation at the age of 38 that my fear of pregnancy left me.

Several years later I became a Nurse Practitioner. My scope of practice includes prescribing oral contraceptive, Plan B, Intrauterine device (IUD) and medication for medical abortions. I remember NP
colleges discussing whether or not they would prescribe Plan B or mifepristone as it would cause an abortion. And if you believe life begins at conception, will you prescribe an IUD to stabilize the endometrial lining and/or pregnancy prevention as the IUD prevents a fertilized egg from embedding in the uterus wall. For some this is an abortion. Now having been a health professional for over 30 years, I reflect on these discussions and come up with the same conclusion I did when I started practicing. It is my job to discuss with clients all their options around their healthcare which includes the risk to benefit ratio. This includes family planning, genetic testing, contraception and access to abortion. It is their decision. Seems simple  enough, right?

However, the decision to abort can be as uncomplicated for some woman as it is complex for others. I have screened moms for fetal birth defects and counselled them on their options (referral to genetic specialist, or termination). I would never underestimate the burden and the heartache the woman suffers having to choose to birth or abort a fetus with potential birth defects. Also, I have held the hands of women when they miscarried the baby they have always wanted and have seen the relief on the faces of women after their abortions.

As a NP I have been granted a unique insight into the joys and suffering of woman during their child bearing years. I believe Chief Justice Brian Dickson summed it up nicely when it comes to ensuring women have access to abortion. He wrote: ”forcing a woman, by threat of criminal sanctions to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspiration, is a profound interference with a woman’s body and thus a violation of her security of the person.”

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