Angelica Vecchiato:

Beginning on July 4, physician training and ultrasounds prior to prescribing Mifepristone were no longer required in Quebec.  

More than 300 pro-abortion doctors from across the province signed an open letter calling for these changes. The doctors condemned the requirements for the Mifepristone abortion pill as “unjustified” because, they argue, the barriers impede access and increase patient delays for chemically induced abortions. 

Mifepristone, formerly known as RU-486, followed by Misoprostol in a regimen known as Mifegymiso, are pills prescribed by doctors to induce abortions for women up to nine weeks (63 days) gestation. The pills are taken within 24-48 hours of each other. Mifepristone blocks the hormone progesterone, destroying the interior of the uterus, which then gives way for Misoprostol to induce contractions to expel the tiny preborn child.

According to the doctors calling for the changes, since the Mifegymiso pills can only be taken up to nine weeks gestation, the ultrasound requirement proved a time constraint on the abortion pill. 

The training for medical abortions must be done in-person, which according to Dr. Geneviève Bois, a family doctor who practices in Montreal, Gatineau, and Nunavik in northern Quebec, creates further barriers to access. She says that “physicians have to provide a lot of different care,” which makes it difficult for them to “take many days off to go do this training just in case they need to provide medical abortions.”

Georges Buscemi, president of Campagne Quebec-Vie, told The Interim he is “disappointed that they would act in such a predictable manner,” believing that “this is virtue-signaling to jump on the Roe v. Wade bandwagon.” He says that, “western governments have concerted with each other to see how to react to show their disapproval of the decision.”

Campagne Quebec-Vie opposes the relaxation of abortion pill measures “on principle.”  “With or without ultrasound, it is another form of killing the baby,” said Buscemi. “They wanted to make the pills easier to prescribe for further liberalization. However, the lifting of ultrasound constraint is irresponsible from a medical perspective because it was a means of indicating that the child was sufficiently small so as not to hurt the women.” 

The measure will continue to be challenged by Campagne Quebec-Vie, which Buscemi hopes will materialize with the provincial election this fall. “The election is soon and that’s when the rubber hits the road, especially when it comes to medical legislation.”

Buscemi said, “We encourage our supporters to vote pro-life. Some pro-life MPs could get elected this fall, which would send a message to the current ruling party.” 

While pro-life groups remain disappointed, pro-abortion groups, such as Action Canada for Sexual Health and Rights, are celebrating the recent headlines, claiming on Twitter that this is “excellent news” because in dropping the ultrasound requirement “Quebec joins the rest of Canada in removing an unnecessary barrier to the abortion pill.” 

In July 2015, Mifepristone was approved for use in the country by Health Canada with stipulations developed in accordance with the drug-maker, Linepharma International Limited, that physicians must fulfill certain terms and conditions prior to the prescription of Mifegymiso, which is distributed in Canada by Celopharma Inc.

Those conditions required the physician to counsel each patient on the risks of the drug; obtain the patient’s written informed consent to take the drug; exclude ectopic pregnancy and confirm gestational age by ultrasound; and to complete the mandatory Mifegymiso training, prior to prescription. After the distribution of Mifepristone, Health Canada decreed that patients have access to emergency medical care for up to 14 days and that physicians schedule a follow-up to confirm complete pregnancy termination.

The pro-abortion lobby in Canada sought to remove these measures and in seven years have managed to completely dismantle the supposed safeguards Health Canada imposed when they approved the abortion pill.

Health Canada first made adjustments to their previous Mifegymiso dispensing and prescribing policies in 2017, relaxing some of the rules. The abortion-inducing drug can now be dispensed directly to patients by a pharmacist or a prescribing health professional. Health professionals are no longer required to complete an education program, the requirement for written patient consent is no longer necessary and health professionals will no longer be required to register with Celopharma in order to prescribe or dispense Mifegymiso.

In 2019, Health Canada moved to drop the ultrasound measure, citing that it was responding to concerns that “some patients may have been facing unnecessary  barriers or delays in accessing” Mifegymiso. The ultrasound was intended to determine gestational age of the child and rule out ectopic pregnancy because the abortion pill’s manufacturer says it is dangerous to use after nine weeks gestation or in cases of ectopic pregnancy. Without it, both questions have been surrendered to the judgement of the medical professional inducing the chemical abortion.

Quebec was the last to follow suit with Health Canada’s relaxation of regulations since the provincial College of Physicians (CMQ), not the federal government determines the rules and regulations with regards to abortion pills. Across Canada, this is the only professional, provincial confederation with the ability to do so.

Since Mifepristone’s development in 1980, France was the first European country to approve it for use in 1988, followed by the United Kingdom in 1991 and Sweden in 1992. In these countries, ultrasound use is up to the discretion of the physician dispensing the abortifacient.