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The Liberal government deducted $270,000 for abortion services provided at Clinic 554 in Fredericton over three years and was calculated by the amount of money patients paid for abortion out of pocket.Brian Atkinson/The Globe and Mail

The federal government is clawing back money from health transfers in an attempt to force New Brunswick to make publicly funded abortion services more accessible.

New Brunswick is the only province that does not fund abortion in standalone clinics – a policy that health care advocates say is misogynistic and part of a long-standing legacy to limit abortion rights in the province.

The Liberal government deducted $270,000 for abortion services provided at Clinic 554 in Fredericton over three years to penalize the province for its continued refusal to provide the medically necessary service without fees as outlined in the Canada Health Act.

The total was for a three-year period ending in 2020 and calculated by the amount of money patients paid for abortion out of pocket based on evidence provided by Clinic 554 and data published by the Canadian Institute for Health Information.

“We’re not taking money for the sake of taking money,” said Guillaume Bertrand, a spokesperson for the federal Minister of Health Jean-Yves Duclos. “If provinces work with us to address the issue we’ll give them back the money.”

However, so far New Brunswick has refused to co-operate, added Mr. Bertrand, unlike other provinces that were dinged for other medically necessary services such as diagnostic imaging. Last week, the federal government announced it was clawing back $82.5-million in health transfers for 2020-21 to seven provinces, including New Brunswick, which was deducted $1.3-million – $64,850 of which was for abortions in Clinic 554.

The New Brunswick government said in a statement that it’s fully committed to the principles of the Canada Health Act. “We are continuing to assess all the potential implications of this federal decision,” said spokesman Sean Hatchard.

The province only funds abortions in hospitals in Moncton and Bathurst, which Valerya Edelman of Clinic 554 says is a barrier for people coming from other parts of the province.

In its response to The Globe and Mail, the province said Mifegymiso, better known as the abortion pill, has reduced the demand for procedural abortions in New Brunswick. The drug is available by prescription only, and is a combination of two drugs, and can be taken at home with guidance and monitoring from a health care professional during the first nine weeks of pregnancy.

Ms. Edelman, a social worker who runs Clinic 554, said the suggestion that chemical abortions address the accessibility problem in New Brunswick fails to consider that people accessing abortions at the clinic are often the most vulnerable and at-risk. They may not have a safe home or there may be mental-health barriers in the ability to self-manage a chemical abortion, she said.

“They’re often in very dire circumstances and can’t afford the cost,” said Ms. Edelman. The $700 to $850 fees for a procedural abortion are often offset by donations from the National Abortion Federation and subsidized by Clinic 554 for patients that can’t afford to pay, she added.

Ms. Edelman applauded the move to claw back federal transfer funds and said it highlights the need for the province to change its restrictive abortion policy, but said it doesn’t address the urgent need for improved abortion access in New Brunswick. “It’s misogynistic,” she said about the provincial policy. “For decades, New Brunswick has gotten away with really terrible access to abortions and it’s only because of public pressure that it has improved over the years.”

The accessibility of abortion is the subject of a University of New Brunswick-led study funded by the federal government. It will look at the numbers of patients who accessed abortion care at Clinic 554, where they travelled from, and their ability to pay. The report will be made public by next year.

Clinic 554 provides two to three abortions a week and is at capacity, said Ms. Edelman. Numbers provided by the Canadian Institute for Health Information show that about one-sixth of the procedural abortions performed in New Brunswick in 2018 occurred in Clinic 554. The vast majority of all abortions in Canada are done in clinics.

Justin Trudeau’s Liberals pledged during the 2021 election campaign to introduce regulations under the Canada Health Act to ensure abortion services were medically necessary and publicly funded, but after consulting with stakeholders, priorities have shifted, said Mr. Bertrand. The focus is now on helping organizations make sexual and reproductive information and services more available, he said.

“We’re trying to work with the province but at the end of the day, it’s the province’s responsibility to provide health care,” said Mr. Bertrand. “We need to push for abortion services.”

With a report from Carly Weeks

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