It was Feb. 20, 2014, and the medical director of Prince Edward Island's largest hospital was preparing to present a business case for abortion services to an independent medical advisory body for PEI, the only province in Canada where women still cannot get a surgical abortion.
Then, Rosemary Henderson's phone rang: a call from Health PEI CEO Richard Wedge, telling her the health authority had been "explicitly told to cease work on the abortion project," Dr. Henderson wrote in an e-mail less than two weeks later. "I ignored that and took it to PMAC [the Provincial Medical Advisory Committee] anyway and have finished off my part of it and sent it up the chain.… So it may die there."
Dr. Henderson's prediction proved correct. The Liberal government of former premier Robert Ghiz killed the plan that she and a Health PEI-led working group had crafted for a twice-monthly abortion clinic at the Queen Elizabeth Hospital in Charlottetown, according to documents obtained under Freedom of Information laws.
Now, as Islanders prepare to go to the polls May 4, the man who replaced Mr. Ghiz as Liberal leader is saying he has no appetite to revive an abortion plan that would have saved the province an estimated $37,000 a year; neither does his chief challenger, the Progressive Conservative Leader.
Despite all that has changed since PEI's last election – including the shelved clinic proposal, a standing offer from a Nova Scotia obstetrician to travel to the island to perform abortions, and a poll published in January that found a majority of islanders believe women should be free to end their pregnancies in the first trimester – permitting abortion on the island remains an issue too hazardous for the province's two leading political parties to touch. (The NDP and Green parties have promised to open a full-service women's health clinic that would provide abortions, but neither has any real shot at forming government.)
"It's a very deeply held moral issue for many people," said PC Leader Rob Lantz, who has promised to maintain the status quo of sending women to a Halifax hospital to terminate their pregnancies. "It's often the one and only issue that's raised when I'm campaigning.… They don't care about anything else, in some instances."
Even federal Liberal Leader Justin Trudeau, who has demanded all his MPs and candidates be prepared to cast pro-choice votes in the House, sidestepped the issue of on-island abortions while campaigning with his PEI counterpart Wade MacLauchlan last week. Mr. MacLauchlan declined an interview request, his spokesman citing the leader's busy schedule.
For Holly Pierlot, keeping PEI free of surgical abortions is certainly paramount. But as the president of PEI Right to Life, she would like to see the next premier go even further and stop the province's current practice of sending women to Halifax for publicly funded abortions, as it did in 85 cases last year, 94 in 2013 and 84 in 2012.
"PEI Right to Life considers the status quo a political compromise aimed at keeping opposite sides happy by each getting a little bit," Ms. Pierlot said. "We say that island children deserve to be protected on the island and west of the bridge as well."
But the status quo is hardly keeping women such as Sarah, 26, happy. The Charlottetown mother of a young child, who asked that her real name not be used for fear it would hurt her job prospects, has had two abortions, neither of which were easy to obtain.
"I find it hard to not be outspoken about this stuff because I think it's just such an injustice to women here," she said. "[But] because it's such a topic of dissent here it makes me nervous to completely identify myself because, especially as a parent, I need to work."
Sarah was 19 when she sought her first abortion. She took time off work, borrowed money from her parents and travelled to the Morgentaler clinic in Fredericton for the procedure.
The second time, just last year, her straits were more dire. Already struggling to raise one child and preparing to apply to graduate school, Sarah managed through her connections in the island's pro-choice community to find a doctor willing to administer a medical abortion, which involved an injection at the physician's office followed by pills she took at home.
Medical abortions are available on PEI, but it takes detective work to find out which family doctors offer them.
Colleen MacQuarrie, the chair of the psychology department at the University of PEI and a prominent abortion-access researcher, said she acted as a "conduit" for several years, connecting desperate women with a willing medical abortion provider on the island until the doctor quit taking referrals out of concern he or she would incur the wrath of island pro-lifers.
"I've turned about 20 women away so far, who were looking for medical abortions," Prof. MacQuarrie said. "So, again, we're back to, Who do you know? How resourceful can you be to find out how you would get this? It's very similar and clandestine to the way it was before."
Prof. MacQuarrie was hopeful that all of this would change when an Amherst, N.S., obstetrician offered to travel to the island to provide abortions. Robyn MacQuarrie (no relation to Colleen) first approached Dr. Henderson, then the medical director at Queen Elizabeth Hospital, about performing abortions on the island in 2013, according to the documents, which were first reported on by CBC PEI last fall.
Dr. Henderson assembled a working group that sought advice from the National Abortion Federation, the organization that represents abortion providers in the United States and Canada, and prepared the business case that was ultimately approved by the Provincial Medical Advisory Committee on Feb. 20, 2014. The minutes for that meeting note that Dr. Wedge asked Dr. Henderson to handle the abortion item "in-camera," during a portion of the meeting closed to the public.
Dr. Henderson refused. "It was decided to leave [the abortion proposal] as an out-of-camera item to show that PMAC supported this work and if it is rejected at some point, the record will show PMAC's stand," the minutes say.
A few months later, when it became clear the plan had stalled, the National Abortion Federation called a news conference to reveal the existence of the proposal and denounce the government for shelving it. When a release announcing the event went out May 23, a reporter from The Guardian in Charlottetown asked a Health PEI spokeswoman for an interview with the health minister or Dr. Wedge.
Before replying, she sent an internal e-mail to her communications colleagues, copied to the Premier's press secretary and Dr. Wedge. "FYI, I just spoke to Dr. Wedge who got direction from [Health] Minister [Doug] Currie and Deputy to send the following statement … Health PEI is following Government direction to maintain status quo in terms of abortion services in PEI."
A spokeswoman for the PEI Department of Health and Wellness said staff, including Dr. Wedge, cannot comment during the campaign period. Messages left at Dr. Wedge's home in Summerside went unreturned.
For Dr. MacQuarrie, the obstetrician who wanted to provide abortions on the island, the rejection of her offer has been "disenchanting."
"I was so much of the belief that things happen because they ought to and I didn't really think in this day and age that politics had a place in women's health care," she said. "But I'm seeing more and more that it does."