There is no plan to extend access to the Mifegymiso abortion pill beyond larger communities, say territorial officials.
Nine women have been prescribed Mifegymiso, commonly known as the abortion pill, in the NWT since it became available last year, stated Northwest Territories Health and Social Services Authority (NTHSSA) spokesperson David Maguire.
The figures do not include Hay River, he added.
The pill is offered in Yellowknife, Inuvik, Fort Smith and Hay River through the Northern Options for Women (NOW) program.
The NTHSSA is monitoring use of the pill in the NWT “to determine whether expansion of use would be both safe and appropriate,” stated Maguire.
To obtain a prescription, an ultrasound is required to ensure the fetus is under 63 days old, and there are financial limitations to offering the service, including the cost of installing ultrasound equipment – between $20,000 and $50,000 – and staff training and hiring, stated Maguire.
The health authority isn't aware of any requests from community groups, organizations or individuals seeking wider access to the drug, and those wanting the pill can go through the NOW program, which offers medical travel to the nearest location where it can be prescribed, according to Maguire. Mifegymiso consists of two different drugs. First, Mifepristone blocks the hormone progesterone, which is required to continue a pregnancy while another drug called misoprostol induces contractions to trigger the shedding of the uterine lining.
In a July 31 interview with News/North, federal Status of Women Minister Maryam Monsef said the government takes this issue seriously.
“Our government will always stand up for a woman's right to choose and ensuring access to reproductive health services and options is a priority for us,” she said. “This particular issue is one that we share jurisdiction with provinces and territories, and to the extent that the federal government has jurisdiction, we have worked to reduce the barriers in access that we are responsible for.”
Health Canada is the lead on working with provinces and territories to improve access to the aborition pill for rural and remote women, and is actively reviewing access to ensure all Canadian women have equitable reproductive health choices, said Monsef.
On July 18, Newfoundland and Labrador was added to the list of provinces and territories offering universal coverage of the abortion pill.
The cost of the series of pills is between $300 and $450, depending on the provider, making it cost-prohibitive for many women, states Action Canada for Sexual Health and Rights on its website.
Eight provinces have universal cost coverage programs that allow clients to access Mifegymiso for free by presenting a health card.
After New Brunswick instituted universal coverage, the number of surgical abortions fell and the number of terminated pregnancies rose, according to the New Brunswick Department of Health.
The NTHSSA is a separate entity from the GNWT Department of Health and Social Services.
Gaps in coverage prompted MLA Julie Green to pose questions to Health and Social Services Minister Glen Abernethy in the legislative assembly in February about when GNWT would extend Mifegymiso coverage to all women in the territory, and if the government would expand access to regional centres with doctors or midwives.
The department is reviewing coverage gaps for the pill to understand how to close the gaps, including considering supporting NOW in other regional centres of the NWT, said Abernethy during that exchange.
The abortion pill could bridge the rural-urban divide in abortion access, as more physicians incorporate medical abortion into their family practice, states the National Abortion Federation on its website.
In November 2017, the federal government eased restrictions on prescribing Mifegymiso, extending the term limit for prescribing the pill to nine weeks of pregnancy from seven weeks, and loosening restrictions for prescribing practices, allowing pharmacists or a prescribing health professional to dispense the pills directly to patients.