(Katarina Martins/ The McGill Policy Association)

Abortion is a topic in political discourse that most would agree is touchy at the best of times, and downright volatile at the worst. While much of the debate surrounding the issue concerns access to the procedure itself, some organizations such as the Canadian Pediatric Society have sought to address the issue by researching what preventative factors lead to unwanted pregnancies in the first place. Their conclusion was that one of the factors that could be addressed through policy was the level of access to contraceptive options. This led to their proposal in May of 2019 advocating the inclusion of all contraceptive options under provincial health care programs for all Canadians under the age of 25. This, they argue, would lower the total number of unwanted pregnancies and therefore the total number of abortions, possibly representing a new and less polarizing approach for both pro-choice and pro-life advocates.

The Canadian Pediatric Society (CPS) estimates that in 2014, the under-25 age demographic accounted for approximately 95,000 pregnancies. Of this number, 60,000 are estimated to be unintentional, and 30,000 ended in abortion. For those who believe abortions are morally wrong, there are obvious incentives to minimize the number of unwanted pregnancies, as it stands to reason that doing so would minimize the number of abortion procedures carried out. There are also good reasons for those who do not view abortions as morally wrong to support these same policies.

Firstly, undergoing an abortion has some serious health risks compared to other methods of contraception despite being largely considered a safe procedure by surgical standards, with the potential risk of infection of the womb (approximately 1/10 procedures), excessive bleeding (1/1000), and damage to the womb (1/250-1/1000). Contraceptives, on the other hand, are far safer, less invasive, and cheaper. Medically, there is no reason that abortion should be relied upon in lieu of modern contraception as a first line of prevention.

Despite this, contraceptive coverage in Canada is not universal and varies from province to province. This is in contrast to the fact that abortions, which have been decriminalized in Canada since 1988, are funded by all provincial healthcare plans. However, it should be noted that only abortions occurring up until a certain stage of the pregnancy are covered, and provinces are free to set this limit themselves, creating some discrepancies in access. While some would argue that implementing universal contraceptive coverage would represent a significant increase in government expenditure, this is simply not the case. According to the CPS, universal contraception coverage for all Canadians would actually result in reduced expenditure to the tune of 163 million dollars annually. The CPS claims this is the case due to the offset of direct medical costs, including abortions, that are associated with unwanted pregnancies.

Cost remains the primary obstacle in getting the contraception of choice for the under-25 age demographic. It has been demonstrated that adolescents are much more likely to use condoms if they are provided for free, and two-thirds of adolescents report that they would choose an IUD as their contraceptive method of choice assuming no cost. This is not without good reason; IUDs are essentially uterine implants that prevent pregnancies for up to 12 years. They are highly effective, and unlike other forms of birth control, they are not user-dependent. They are, however, the most expensive mainstream contraceptive option. Most individuals within this demographic tend to have less disposable income compared to older cohorts - adolescents are in most cases entirely financially dependent on their parents or legal guardians, who may not have the means or even be willing to pay for contraception for their child.

Despite this, data indicates that a majority of Canadians are sexually active by age 17. This is unlikely to change, and the evidence clearly suggests that many in the under-25 age demographic will risk pregnancy rather than use existing user-dependent alternatives. This is illustrated by the fact that 25% of sexually active young women who do not wish to become pregnant do not use contraception consistently or at all.

As described in a separate CPS study on the effective usage of contraception for youths, the more user-dependent the contraception, the less effective it is. This is the main reason that the CPS has argued that IUDs, which are already the gold standard in contraception, should become the standard for Canadian youth. If abortions are covered through medicare, it logically follows that cheaper and safer alternatives should be as well, especially for the under-25 demographic. Unwanted pregnancies are a legitimate medical concern, and healthcare policy should include more proactive measures to optimize both costs and care. The CPS’ ideas and suggestions are a good place for the government to start.

A Win for Pro-Life and Pro-Choice Supporters?