The Canadian Institute for Health Information (CIHI) released data tables on Jan. 23 indicating there were 85,195 reported abortions in 2018 – down from a reported 94,030 abortions in 2017.
In response, Global News ran an article by Cassandra Szklarski with the headline: “Canadian clinics and hospitals performing fewer abortions, data suggests.” The same article was also published on various other websites – CTV News, Winnipeg Free Press, MSN.com – with similar titles.
However, because abortion statistics continue to be incomplete year after year, it simply cannot be known whether the actual number of abortions in Canada is decreasing, increasing, or remaining the same.
As CIHI states, “Manitoba and Ontario’s clinic data, and Quebec’s hospital and clinic data include only induced abortions covered by their respective provincial health insurance plan.” Students going to school in these provinces who do not permanently reside there might not have their abortions represented in these figures. And those who travel to Ontario or Quebec seeking a late-term abortion – not commonly carried out elsewhere in Canada – might also not be counted in the statistics.
Further, private abortion facilities (even those publicly funded) are not required to report their activity, and so not all do. Fredericton’s Clinic 554, for instance, which has been fiercely lobbying for taxpayer funds from the New Brunswick government, has not provided data to the CIHI since 2013.
The number of reported clinic abortions in 2018 was at 58,697, its lowest since 2010, so it’s uncertain if there has been a real drop in clinic visits or if reporting is merely sparser.
As Szklarski points out as well, the drop in total abortion figures “coincides with the arrival of the abortion pill Mifegymiso which hit the Canadian market in 2017, but CIHI researchers said it was not possible to know how many of the reported cases involved the drug.” Because one of the purposes of making Mifegymiso available was to grow the accessibility of abortion by decentralizing its provision, it seems unlikely that all the uses of the drug would make it into the CIHI document, which is already quite fragmented.
According to a 2019 Globe and Mailarticle on “Abortion-pill obstacles: How doctors’ reluctance and long-distance travel stop many Canadians from getting Mifegymiso,” the drug was prescribed at least 10,092 times outside of Quebec and Ontario in 2018, an explosive increase of 137 per cent from 2017 country-wideMifegymiso figures supplied by Health Canada. In many provinces, the majority of pill-based abortions were procured through clinics, which, again, aren’t required to report their figures. The Globestates that there were 97,000 abortions – both surgical and chemical – in 2018. While it’s not described how they arrived at this figure, nor how accurate this total should be considered, it does provide an indication of how sorely lacking the CIHI report is.
Despite the deficit of CIHI data and the general decline in reported abortions, three provinces (Newfoundland & Labrador, Prince Edward Island, and Alberta) and two territories (Northwest Territories and Nunavut) saw increases in their reported abortion figures. PEI, which reintroduced abortion to the province in late January 2017, saw a 39.5 per cent increase in reported abortions, though its abortion rate remained amongst the lowest in Canada. Newfoundland & Labrador, whose abortion numbers cracked the 1000-mark in 2018, hasn’t seen that many reported abortions since 1992. As was the case in 2017, however, the Northwest Territories, Quebec, and Alberta had the highest abortion rates in 2018 based on the supplied data.
While the ages of women who get abortions are not fully known in all provinces and territories, the reported share of women 35 and older getting abortions increased in seven provinces and from a reported 17.3 per cent across Canada in 2015 to 19.5 per cent in 2018. The share of such abortions in Quebec and Ontario is particularly high, at 20.7 and 22 per cent respectively. In those provinces/territories where there were no reported abortions on women of unknown ages (Alberta, Manitoba, Quebec, the Atlantic provinces, and the Territories), 18-24 year olds remain the plurality of women obtaining abortions, except in Nunavut. Those 17 and under comprise a very small share of abortion-seekers, just an average 4.4 per cent in those aforementioned provinces and territories. In the seven provinces alone, it’s 3.3 per cent.
It is possible that more older women are requesting abortion in response to adverse fetal diagnoses, as the reported share of late-term abortions (21 weeks +) increased to 3.4 per cent from 3.2 per cent in 2017, 2.7 per cent in 2016, and 2.5 per cent in 2015. That said, 2018 data on gestational age (as well as on previous deliveries, previous abortions, method, and complications) is based only on the 19,444 hospital abortions that took place outside Quebec, and there has been a significant percentage of hospital abortions (18.3-19.6 per cent) committed at unknown gestational ages throughout this 2015-2018 period.
This apparent increase in late-term abortions also corresponds to an increase in dilation and evacuation (D&E) abortions, typically carried out from 13 to 24 weeks – from 8.2 per cent of all hospital abortions in 2015, excluding Quebec, to 10.7 per cent in 2018.
For a long time, the plurality of abortions has taken place between 9-12 weeks. However, in 2018, there were more abortions reported to have been committed in non-Quebec hospitals at 8 weeks or less than between 9-12 weeks. Again, whether this is a reflection of an actual shift or not is unclear.
Similar to 2017, in hospitals outside Quebec at least 38.4 per cent of women getting abortions have previously given birth, compared to at least 35.5 per cent who haven’t. At least 25.7 per cent have previously had an abortion. A minimum 9.5 per cent have had at least two.
The complication rate in these hospitals was a reported 2.2 per cent in the 28 days following the abortion, compared to 2.0 per cent in 2017.