Abortion in Canada: how secure is our right?

[00:00:00] Gabriel Miller: This episode will be in French. Welcome to the Big Thinking Podcast where we talk to leading researchers about their work on some of the most important and interesting questions of our time. My name is Gabriel Miller and I am the President and CEO of the Federation for the Humanities and Social Sciences. In the wake of the U.S. Supreme Court's reversal of Roe v. Wade last year and recent bans on abortion procedures south of the border, it's fair to ask what this means for Canada.

[00:00:42] Today, I will leave the floor to my colleague and friend Annie Pilote, Dean of the Faculty of Graduate and Postdoctoral Studies at Université Laval and Chair of the Federation's Board of Directors. Annie is our host for this episode on reproductive justice, in conversation with Marie-Laurence Raby, a doctoral student in history at Université Laval.

[00:01:13] I'm going to turn it over to Annie. 

[00:01:17] Annie Pilote: Hello Marie-Laurence, it's a pleasure to meet you today and to have this discussion with you. I would like to invite you to introduce yourself and tell us a little bit about your background

[00:01:28] Marie-Laurence Raby: Yes, so hello, thank you very much for the invitation, so for my academic background in fact, I did a bachelor's degree in history at the University of Sherbrooke. Then I came to Université Laval to complete a graduate microprogram in gender studies and it's following this microprogram that I started my master's program, so in history with, under the direction of Aline Charles, a professor at Université Laval.

[00:02:00] And I am now a doctoral student, still under the direction of Aline Charles at Université Laval, with a co-direction from Christabelle Sethna at the University of Ottawa. In addition to my academic career, I am currently the coordinator of the violence pole of the Quebec network in feminist studies, which is a research pole that brings together researchers, students and members of the practice community who are interested in issues of violence against women.

[00:02:32] And I'm also the president of the board of directors of the Femmes d'Aujourd'hui center in Quebec City.

[00:02:36] Annie Pilote: So, what made you study feminist activism in Quebec in the sixties, seventies and eighties? What is it that particularly interests you about this topic?

[00:02:47] Marie-Laurence Raby: Yes, so my interest, in fact for the history of feminism in Quebec was born I think from different elements in my academic and activist background and in fact well during my bachelor's degree in history, I noticed quite quickly that women were not well represented in history and in the history of Quebec in particular.

[00:03:07] And so, from this observation, in fact, was born my desire to contribute in a certain way to the history of women in Quebec. At the same time, I have to say that I have also been involved in student movements. And I also developed my feminist activism through, through these different involvements, and that too, I believe that it is something that is at the root of my interest in feminist movements in Quebec, which have not been studied very much until now.

[00:03:44] And so it was the meeting of all these elements of my background that pushed me to want to do more research on feminist movements and particularly on abortion. In fact, there is very little research done on abortion in Quebec and abortion, I think, like for many young women of my generation, is often presented as a right that is acquired.

[00:04:14] And so we don't hear much about the struggles that led to this. And that's kind of what I wanted to do through my master's thesis, to highlight the work of feminist activists in a concern for a memorial issue.

[00:04:32] Annie Pilote: You are now pursuing your studies at the doctoral level, would it be too indiscreet to ask you to give us an overview of the research that is coming up for you?

[00:04:41] Marie-Laurence Raby: Yes, in fact, my doctoral thesis is on the feminist self-help movements in Quebec. Well, in the years roughly for the same period, so sixty, sixty-eight until the early nineties.

[00:04:59] It's the self-care movements, it's a feminist critique of the medical institution and it's these movements, the interest I think, in these movements is emerging. They have been studied more in the United States and there are also a few studies on this movement in Canada.

[00:05:26] But it's as if Quebec was acting as an exception on a North American scale. And so I want to see how there is a feminist self-help organization in Quebec, and I would say yes, and how these groups fit into a North American context, with once again this whole idea of the circulation of ideas and writings,

[00:05:58] There have been several publications, such as the American book "Our Bodies, Ourselves" which comes from Boston. But how did this book also circulate here in Quebec? So, there you have it, that's it, I want to see a little bit of this whole circulation and dissemination of ideas surrounding self-health.

[00:06:24] Annie Pilote: So that's very promising for the future. I'd be interested to hear how you approach research, whether it's methodological, or in your general approach, to articulate this activist stance with scientific research. If you feel comfortable addressing that question, I would be interested in hearing from you.

[00:06:46] Marie-Laurence Raby: I don't think that the scientific approach and the activist approach are necessarily opposed, I think that they complement each other. I think that every researcher has a position at the base that is reflected in one way or another in his or her research. And I think the difference is that I claim it from the beginning and I bring it out in my research.

[00:07:12] If only by the choice, the choice of subjects that I study, obviously, I adopt a feminist posture, so I try to give women a voice as well. And in this sense, this is also why I use the methodology of oral history, so by doing interviews with key women actors of these movements.

[00:07:36] I think that by giving women a voice, it is in itself an approach, a feminist approach. And I also draw a lot from what is being done in sociology, so in an interdisciplinary perspective, for example by mobilizing concepts that will be developed by other researchers in other disciplines like agentivity, empowerment and all that. So there you have it, that's maybe a bit my, my methodological approach. 

[00:08:05] Annie Pilote: So the right to abortion is an issue obviously that we hear more and more about in the news. So maybe we take it for granted, but we're seeing more and more that it's not, it's not necessarily the case, every issue can come back to the news and I'd like to hear from you on how you feel that activism around this abortion right and reproductive justice has changed between the period of history that you studied and the period of today?

[00:08:37] Marie-Laurence Raby: Yes. In fact, the period I studied begins in 1969 with the federal government's reform of the Omnibus Bill, which allows therapeutic abortion, when the pregnancy endangers the health of the mother.

[00:08:55] And that concludes, my thesis concludes in eighty-eight with the decriminalization of abortion. So this is a period when abortion on demand is still illegal in Canada. So there's really this distinction there that's quite important between therapeutic abortions and abortions on demand, which we call on demand.

[00:09:18] Therapeutic abortions in fact will, for between sixty-nine and eighty-eight, will be judged by therapeutic abortion committees which are composed of three to five doctors who will judge in fact on a case by case basis which pregnancies are actually harmful to the health of the mother.

[00:09:37] And so [...] it allows relatively few women to obtain abortions. So in this context, in fact, feminist groups will take charge of the abortion services they demand, so for the period, for the seventies in Quebec, feminist groups will organize referral services for abortion

[00:09:05] where in fact they will refer women to private clinics of doctors who agree to perform abortions on demand. One of their most famous collaborators is Dr. Henry Morgentaler who was responsible for the Morgentaler v. Queen decision decriminalizing abortion in eighty-eight.

[00:10:25] So these services, in fact, will allow feminist activists to disseminate a feminist analysis of this issue, will also allow them to mobilize women and still offer this service, which is quite difficult to obtain, and in safe conditions as well, because it is also in opposition to the more clandestine abortions, the butcher's abortions that are sometimes done in really deplorable conditions.

[00:11:00] So there you have it, so we went from a struggle for the decriminalization of abortion to a struggle for the accessibility of services and this struggle for the accessibility of services I think it's a continuity, it actually started in the eighties.

[00:11:16] But today, I think that we are really in this issue of accessibility of abortion. This is perhaps the great transformation that has taken place between these two, between yesterday and today. Perhaps in the elements that also persist for feminist mobilizations, for abortion, well it must be said that abortion is a gesture that is still stigmatized today.

[00:11:42] And so I think the feminist movement still has to defend the right of women to actually choose whether or not to continue a pregnancy. So there is still work to bring abortion out of the margins that is, that has been going on continuously since the seventies.

[00:11:59] Annie Pilote: So you've studied the history of women's reproductive health struggles. So what are the lessons learned from those struggles that we shouldn't repeat today?

[00:12:09] Marie-Laurence Raby: That's a very good question that could be the subject of a master's thesis in itself. But in fact, I think that there are several issues of accessibility to abortion that still exist today and that directly echo the problems that were raised by the feminist movements of the seventies and eighties. And in fact, these issues were not entirely resolved by the decriminalization of abortion.

[00:12:36] Among other things, well, according to data from the Quebec Federation for Planned Parenthood, there is a fairly uneven distribution of abortion resources in the province. There are currently four administrative regions in Quebec that have a single point of service for abortion, including the National Capital Region.

[00:12:53] Having only one abortion resource can result in longer delays and greater distances to travel, which are often accompanied by additional costs for women. Of course, there are also additional difficulties for women who find themselves at the intersection of several oppressions, including Aboriginal women, who will tend not to go to services that are in the community, if there is one, to avoid being stigmatized.

[00:13:22] So as with any health care as well, it has to be said that aboriginal women, racialized women, are going to run into a lot of systemic racism that is present. It must also be said that abortion resources do not operate in a uniform manner either. There are certain resources that will create barriers, that complicate access to abortion, for example the need to travel four times to obtain an abortion, so sometimes in contexts where there are long distances to travel, it is four times more costs and travel incurred.

[00:13:51] And all of this for me, echoes the historical period that I studied because well, historically, abortion resources were first concentrated in the Montreal area, in fact up until seventy-six, 97% of the abortions that are done in Quebec are done in the metropolis in Montreal.

[00:14:13] In the 1980s, there were still difficulties in certain regions, for example, the Outaouais region had only one resource for abortion and that was the Outaouais women's health center, so it was a feminist resource. We also know that during this same period, in the 1980s, the women's health center in Quebec City welcomed women from all over eastern Quebec, particularly women from the lower St. Lawrence.

[00:14:37] So it's not just yesterday that Quebec women had to travel and often great distances within the province to obtain an abortion. And then, in fact, when I hear things like the need to return four times to a resource to obtain an abortion, it reminds me of certain barriers that were put in place in hospitals in the seventies and eighties, even if to a lesser degree, as I explained earlier, from sixty-nine onwards, these therapeutic abortion committees which are the bodies that decide whether or not women can have a legal abortion in hospital.

[00:15:16] And it's not uncommon for these committees to directly obstruct the practice of abortion. So either they can actually establish selection criteria that are restrictive, for example based on the age of the women, or only allowing abortions for pregnancies that pose a physiological risk to the health of the mother or these committees can also extend the time frame that leads to the termination of the pregnancy in order to actually have the woman exceed a certain number of weeks that often will set as a limit to do an abortion.

[00:15:55] For example, if the hospital decides that they practice abortions up to twelve weeks and the woman makes a request at ten weeks, they can stretch the time frame so that when the request goes before the therapeutic abortion committee, it's completely, it's already denied outright.

[00:16:13] We can see that this way of obstructing access to abortion is really, is really a continuity in history. And then I'll perhaps finish by talking about access to late-term abortions, which is difficult in Quebec, then as now. In fact, since the 1980s, there has been a marked decrease in the number of abortions of more than sixteen weeks of pregnancy that are performed just about everywhere, particularly in Montreal.

[00:16:46] And then, in the eighties, in fact, only the hospitals of Sherbrooke and Rouyn-Noranda offered abortions of more than sixteen weeks, and from the second half of the eighties, late-term abortions became even more rare.

[00:17:02] This is a phenomenon that we still see today. Before the pandemic, it should be noted that Quebec women had to go to the United States to obtain an abortion of more than twenty weeks. The health measures have forced the reopening of certain services, in Sherbrooke and Quebec City.

[00:17:21] But on the island of Montreal, there are still difficulties that persist and so, in short, I think we have to underline the progress that has been made since the seventies and eighties. But we can see that many of the issues that were highlighted by feminist groups in the seventies and eighties are still present today in one form or another.

[00:17:43] Annie Pilote: So your research focused on the situation of abortion rights in the Quebec context. But this issue obviously crosses borders. We were riveted on the public debates in the United States around the right and access to abortion in that country. What would be the implications in your opinion for Quebec and Canada as a whole of what is happening south of the border?

[00:18:10] Marie-Laurence Raby: We really see that the border between Canada and the United States is permeable when it comes to abortion. And in fact, there is a great circulation of ideas, people and practices. For example, a whole part of my study showed, was in fact interested in the travel for abortion of Quebec women in the seventies.

[00:18:30] So there was a period when abortion on demand was much more repressed, had a form of repression in Quebec. And in this context, feminist groups organized trips, notably to New York, to allow Quebec women to continue to obtain abortions despite the repression.

[00:18:52] And so this circulation of people is quite telling for me in terms of thinking about this idea of the permeability of the Canada-US border. It must be said that the reversal of the Roe versus Wade decision that we saw last June in the United States galvanized the American anti-choice movement, but also, I believe, the Canadian one, since there are quite direct links with the Canadian and American anti-choice movement. For example, there are anti-choice centers that receive funding from groups, often religious, that come from the United States.

[00:19:39] Maybe that's something we need to pay attention to. On the other hand, you pointed it out in the question as well, but one positive thing that needs to be pointed out is that there's a lot more talk about abortion since everything that's happening in the United States than there was before.

[00:20:00] In fact, I think that this will raise or renew interest in this issue, both on the part of feminist groups and on the part of the Quebec government, the Quebec and Canadian governments. It's a positive point to underline anyway.

[00:20:17] Annie Pilote: What can you tell us about the transnational organization of abortion services? 

[00:20:21] Marie-Laurence Raby: Yes. So in fact, what we see in historical research is that, just about everywhere and at several times, there was a transnational organization of abortion services by different feminist groups.

[00:20:41] There are researchers who have studied it for the American West Coast, so feminist groups that set up referral services between San Francisco, Los Angeles and Mexico at a time when abortion was not allowed in the United States. This has also been studied elsewhere in Canada, there is a researcher who has shown the links between the Calgary Birth Control Association and the city of Seattle, abortion clinics in Seattle.

[00:21:12] In Europe, this is also a phenomenon that has been widely highlighted, between, for example, France and Spain. And we know that even Canadian women have traveled to, to Europe, especially to the United Kingdom. In fact, in the early sixties to get abortions.

[00:21:32] There were also trips that were organized as far away as Japan. So it's a phenomenon that is quite, that is quite present. When abortion is prohibited in one place, well women will play on the legislative frameworks of different countries to successfully obtain this service. Then, it's a practice that's still going on today.

[00:22:01] It's also important to note that there are several feminist organizations that still do this kind of transnational abortion. Well, for example, Women on Waves who do abortions in international waters. There are several feminist groups that have organized in the United States.

[00:22:28] But this was also seen in Poland with the abortion ban, to actually send medical abortions to, to places where women, where abortion is prohibited. There's a long, long, history and this practice is still present today and I think what it shows is absolutely the determination of women to abort when they find themselves in, in a situation where they're experiencing an unwanted pregnancy.

[00:22:58] Annie Pilote: What do you see as possible avenues of research for, no matter what discipline in the social sciences and humanities, that could shed light on this phenomenon of abortion rights, either from a historical perspective or from a much more contemporary perspective. Do you see certain questions that would benefit from being researched at this time?

[00:23:18] Marie-Laurence Raby: It's true that as far as abortion is concerned, it's not been dealt with very much, so I would say that everything needs to be done. I think that from a historical point of view, one aspect that I find really worth exploring would be a more intersectional perspective on the issue of abortion and feminist mobilizations for abortion.

[00:23:49] What has been done more on the American side, there are several studies that show, that are interested in the mobilizations of African American women on reproductive justice issues. And in Quebec, finally, we don't talk about it much. There are several things that explain this, among other things, the difficulties of having sources, in history, we work a lot with archives.

[00:24:14] For my dissertation, I did an oral survey, so I met with activists. But I think that there are several difficulties that mean that these questions have not yet been addressed. But I think that it would be a very interesting and promising avenue to see how, how these mobilizations are articulated in fact.

[00:24:44] I think I could perhaps conclude on the forms of recommendations that could be made, on the question of abortion in Quebec and in Canada. I mean, I'm building on the demands of, among others, the Quebec federation for Planned Parenthood. But I think that, at this time, it is important to consolidate the existing points of service and to improve the offer in regions where there is only one point of service, which in fact requires a reinvestment in the health system.

[00:25:22] I also think that there is a lot of work to be done on the side of pro-choice centers that provide support to women such as SOS Pregnancies, which should be more visible and better financed, especially since there are only three of them in Quebec, and that requires mission-based financing rather than project-based financing.

[00:25:43] I think well, it could be interesting to develop a pro-choice certification because we've seen a lot in the news recently that there are a lot of centers that say they want to help women who are experiencing unwanted pregnancies and that in the end they are anti-choice centers and so some form of pro-choice certification could help guide women to good resources.

[00:26:11] And I also think that, in fact, as the Fédération du Québec pour la planification des naissances points out, we need to think about the situation of people who are not covered by the Régie de l'assurance maladie du Québec in order to make abortion truly accessible to all, since the costs incurred by these people can sometimes reach truly staggering amounts.

[00:26:34] So that's what I think are the issues that maybe need some attention from governments today.

[00:26:48] Gabriel Miller: Thank you for listening to the Big Thinking Podcast, to our guest Marie-Laurence Raby, a doctoral student in history at Laval University, and to our host Annie, Dean of the faculty of graduate and post-doctoral studies at Université Laval and president of the board of the Federation.

[00:27:11] I would also like to thank our friends at the Social Sciences and Humanities Research Council whose support makes this podcast possible. Finally, I'd like to thank CitedMedia for their support in producing the Big Thinking Podcast. Follow us for new episodes on Spotify, Apple Podcast and Google Podcast. À la prochaine!