Bill No. 242 - Protecting Access to Reproductive Health Care Act. - 3rd Reading

CLAUDIA CHENDER « » : Mr. Speaker, I am pleased to rise and speak to Bill No. 242, and I hope the House will indulge me with just a few comments.

We've heard a great deal about this bill. We've heard a great deal of support and some opposition.

I move that this bill be read a third time and do pass, and I'd like to make some comments. I'm new at this.

I want to talk a little bit about what's in this bill. Simply put, this bill prevents anyone from besetting, interfering with, attempting to persuade, filming, or photographing anyone attempting to access abortion services in a prescribed access zone, often referred to as a bubble zone, of around 50 metres, around what is defined in this Act as a facility. This could include a hospital, clinic, physician's office, pharmacy, or other premises prescribed by the regulations, which could be the home of a physician, for instance.

This bill brings us in line with several other Canadian provinces and the hope is that it will open an ongoing conversation about other actions that need to be taken to ensure that women have full autonomy over their own bodies, and appropriate and even access to reproductive health care.

I want to be clear, Mr. Speaker. This bill is not a response to real or perceived threat of violence right now. Luckily, we haven't seen any violence related to the provision of abortion services here in Nova Scotia. It is possible to access abortion services around this province, often without interruption or harassment. We, especially in the NDP caucus, often talk about upstream efforts and if you like, this could be seen as one of those. We want to ensure the safety of women accessing reproductive health care and of abortion providers. We want to ensure that people are free of harassment, specifically harassment related to the services they are attempting to access.

The question will be raised, Mr. Speaker, is this really necessary? The genesis of this bill here in Nova Scotia, in addition to coming into line with other provinces, was the experience of Megan Boudreau and others who witnessed women walking past protesters at the Women's Choice Clinic here in Halifax, who empathized with women who may experience harassment when attempting to access reproductive health care, and who decided to act. Similar legislation is in force in five other Canadian provinces - British Columbia, Alberta, Newfoundland and Labrador, Ontario and Quebec.

The first bill of this kind, the Access to Abortion Services Act, was passed in British Columbia in 1995 after years of heavy and aggressive protesting at two B.C. abortion clinics and the shooting of reproductive health care provider Dr. Gary Romalis in November of that year. In each of these jurisdictions the legislation was debated and passed with a majority of legislative support, with the exception of Alberta, where Opposition Parties refused to debate or even vote on the bill, which passed into law regardless.

Against this backdrop, Mr. Speaker, I am particularly pleased that we seem to have the support of the majority of MLAs in this Legislature, as it should be. Beyond that, I am pleased that we are able to debate it together, even those who have issues. That's what this is for.

I respect my colleagues for coming forward with arguments and opinions, whatever they may be. The legislation in all these other provinces has been passed into law but the question has been asked and will continue to be asked: Is it constitutional? According to the courts in British Columbia and the highest court of the land, yes, it is. It is a justifiable infringement on our freedom of expression under Section 1 of the Charter because the restriction is narrow, and the objective of that restriction is to protect the right to safety, dignity, and privacy of patients and providers.

Access to reproductive health care has been a right guaranteed to women for decades but for decades the availability has been uneven, and access has been difficult. Those two issues - availability and access - are linked. Abortion services are ensured in all provinces and territories, however, access to these services varies. Despite this and, although it did not come easily, the good news is that access to reproductive health care in Nova Scotia is better than it has been.

I say this because I know it to be true and important and because I have been asked by clinicians and advocates who want to be sure that the debate and passage of this legislation doesn't mistakenly scare women into thinking that they will encounter difficulty in that access. Women can self-refer in Nova Scotia due to strong advocacy and to action by the Department of Health and Wellness. Mifegymiso, what's known as medical abortion - two pills that can be prescribed by a physician and taken at home - is now widely available. There are 24 prescribers in the Women's Choice Clinic, plus more family doctors not in the network.

But there are gaps. There's currently no access to surgical abortion on Cape Breton Island. That means that for whatever reason - for preference, for medical reasons, for reasons related to trauma or otherwise - a woman on Cape Breton Island seeking an abortion after nine weeks of gestation must travel to Halifax to receive services. Similarly, St. Martha's Hospital in Antigonish has a long-standing policy against providing medical abortion, leaving women in that community at a similar disadvantage.

Access to abortion care is still mostly provided in large, urban centres. Women in smaller communities or in rural areas without doctors who will prescribe Mifegymiso and without hospitals who will perform surgical abortions still have to travel to the major centres that provide care. Women can access these procedures currently at the QEII, the South Shore Regional, the Valley Regional and the Colchester-East Hants Health Centre. Four sites in our whole province. That is uneven access.

Reproductive health care is about more than access to abortion services, and we have farther to go. Here's one example, we know there are women in Nova Scotia who have had more than one surgical abortion. We don't know why, statistically, and to be honest it's none of our business. Here's what we do know. Many of these women request an intrauterine device, or IUD, when they undergo the procedure. Maybe they can't take the birth control pill for medical reasons, maybe their partner won't let them or refuses to wear a condom - there could be many reasons.

The Women's Choice Clinic is often unable to comply with these requests. Why? Because the cost of an IUD is $400 and is not covered by MSI. But here's the kicker: some Nova Scotians without private insurance do have access to IUDs with just a $5 co-pay. Who? Income assistance recipients. Why? We cover abortion services, but we don't cover the birth control that would render it unnecessary in some cases.

I hope the Minister of Health and Wellness will consider providing a remedy for this inconsistency and cover IUDs, just as the decision was made by his department in 2017 to cover Mifegymiso.

We heard so many moving presentations at the Committee on Law Amendments, and I would be remiss if I didn't share some of the reflections we heard in this Chamber. We heard about the volunteers, usually university students who show up where these protests take place and walk women to their appointment safely. Compellingly, we heard from Dr. Melissa Brooks, co-director of the Women's Choice Clinic at the QEII in Halifax, who spoke about working with Dr. Gary Romalis, the B.C. physician I mentioned earlier whose experiences with being violently attacked for his provision of abortion services were the genesis of the first legislation of this kind.

Dr. Brooks spoke of her initial fear of coming forward on this topic and of how this bill would serve the dual purpose of making her feel safer, her patients feel safer and thereby increase the visibility and the availability of reproductive health services for women. In particular, her focus is on convincing clinicians in rural areas to provide medical abortions in their offices.

We heard from three people who spoke in opposition to this bill, Mr. Speaker. Although their language framed the issue in Constitutional terms, mainly freedom of expression, their actual issue appeared to be around abortion as a moral wrong and as a procedure that should not be performed. As discussed earlier, this bill does not limit people's freedom of expression. People are still very free to peacefully protest this service.

We are protecting women's access to reproductive health care free from harassment, and clinicians' ability to provide these services free from fear. We support choice, Mr. Speaker. In the opposition to this bill that I have heard, both in committee and in this Chamber, what I heard expressed was the desire for choice and autonomy, ironically, for people to possess and express their anti-abortion views.

We support that, Mr. Speaker. In fact, we disagree with any position that would have the net effect of reducing women's autonomy around health care decisions impacting them. We respect differing viewpoints and people's right to hold them. In this case, I respectfully disagree with the assertion that there are two sides to the issue of whether or not women should face harassment when attempting to access reproductive health care. If there are, then I have not heard a good argument about why women should be harassed.

There are people who oppose a woman's right to autonomy over her body and health care decisions, but that is not the subject of this bill, Mr. Speaker. To those people, I can only say that we vigorously disagree and that our position is in accord with international law, federal law, provincial law, common law, and Supreme Court of Canada precedent. Women's autonomy over their own bodies is no longer a subject for debate. We have so much further to go than this bill to ensure that this is and remains the case.

Much of the discussion around abortion, Mr. Speaker, focuses on trauma. There is an assumption that abortion is a traumatic event. Certainly being made to experience shame and harassment is traumatic. As the Minister responsible for the Advisory Council on the Status of Women pointed out in her comments at second reading, it is not always the case. It can be a health care decision, a family decision. In the end it is a decision, one that is a woman's to make.

Thank you to the government for moving this bill forward without amendments and to all members in this Chamber who support the passage of this bill. It was very moving to hear so many of my colleagues - the women of this Chamber, in particular - speak in support of this bill and share some of their own stories. So many people have remarked on how unusual the tenor of this room was on that evening, Mr. Speaker. It was because we were speaking about our own experiences and the experiences of our friends, of our mothers, and of our grandmothers. We were speaking truth.

I know there are other opinions held here too, and there is no requirement that we all think alike. The debate changes significantly when we speak from the heart about the issues that impact us directly. While many men do not need to consider access to basic health care, most women do. This Chamber is still predominantly male. We often hear legislation discussed that we have no direct experience of. So often, the legislation that impacts women is discussed in terms of our wives and our daughters, but not this one. As we heard at second reading, this one is about us. You know what? The rest of it is about us too.

With this proposal and with all actions that seek to increase the ability of women to access health care free from harassment, we are keenly aware that harassment and impediment can be experienced differently by different women, especially those who are already vulnerable. Some women seeking access to abortion services may be well versed in their health and in their rights to access it, and some may be scared, may not be properly informed, and may feel shame and fear. It is for those women, who are doubly disadvantaged, that we seek to make these changes.

I have implied with these words that most men do not need to be concerned about access to health care. There is, of course, a qualification: disabled men, trans men, and racialized men certainly have differential access. At the heart of this bill is the idea that we should all, each of us, have autonomy over our own bodies and the ability to access timely medical care free of intimidation and harassment. It seems simple, but for so long, so many of us have not had that autonomy.

Mr. Speaker, I am proud of my colleagues for standing today in support of this bill which takes us one step further. I want to acknowledge that the choice to support this bill may be difficult for some. For some it may take courage. For those whose faith makes it difficult to acknowledge that women have the right to access legal health care, for some who may prefer not to discuss this issue at all, it is not comfortable, not in here and not most places.

As my colleague, the member for Clayton Park West pointed out, it is somewhat astonishing the time we have spent in this Chamber talking about periods and abortions and tampons, but, Mr. Speaker, that is as it should be. I don't need to remind anyone in here that women make up half of the population and that women's issues are all of our issues.

In closing, I'd like to thank my colleagues for their courage in considering, debating and hopefully in passing this bill. In the words of Maya Angelou, "I am convinced that courage is the most important of all virtues. Because without courage, you cannot practice any other virtue consistently."

We make laws in this Chamber; we make them for everyone. Thank you to my colleagues for the courage to consider this issue, and to the government for moving this legislation forward. Thank you most of all to the doctors, nurses, clinicians, activists, feminists, men, women and people who continue to advocate for a woman's right to make decisions over their own health care and to access that health care free from interference. Thank you. (Applause)