New Brunswick

Holt government repeals ban on funding abortions outside hospitals

New Brunswick’s new Liberal government has eliminated the legal restriction on public funding for procedural abortions outside hospitals.

Liberal premier says next step is working on how doctors can offer the service in new locations around N.B.

A group of people stand behind a microphone. One of them is holding up a document.
Health Minister Dr. John Dornan and Premier Susan Holt seen at Thursday's announcement for changes to Regulation 84-20. Holt holds the cabinet order, signed by the lieutenant-governor, officially repealing the ban on Medicare funding for procedural abortions performed outside hospitals. (Jacques Poitras/ CBC)

New Brunswick's new Liberal government has eliminated the legal restriction on public funding for procedural abortions outside hospitals.

The cabinet order swept away the decades-old rule — a single sentence in the provincial Regulation 84-20, first put in place to block a Fredericton clinic from offering the service.

Premier Susan Holt was applauded by members of her cabinet and caucus, and dozens of women who fought the restriction for years, as she brandished a copy of the order.

"Our team is proud to take this one small step," she said.

"We believe that abortion is health care and that everyone deserves access to the care that they need, when and where they need it." 

Holt acknowledged the crowd of activists invited to her office "who have done the work over the last 40 years, pushing for this constantly, making sure it didn't get forgotten [and] it was always on the radar.

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Abortions will be funded outside hospitals, Holt announces

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Premier Susan Holt announced Thursday that her government has approved changes to Regulation 84-20, which will allow Medicare to cover the cost of surgical abortions performed outside of hospitals.

Among them was Judy Burwell, a former manager of the Morgentaler clinic in Fredericton — the facility that led a previous government to adopt the restriction.

"It's a good day for everybody, not just for us, but for all the young people who've been working for abortion services, and working very hard," Burwell said.

Holt said health officials will now work with the New Brunswick Medical Society and the province's two health authorities to work out how physicians to offer the service more widely across the province.

That could include having it in some of the community health clinics the Liberal leader promised in this fall's election.

A one-storey building on a street corner with a sidewall painted in rainbow colours. A sign says Clinic 554.
Surgical abortions were performed at the Morgentaler clinic in Fredericton for years. After it shut down about a decade ago, it was taken over by Clinic 554 and Dr. Adrian Edgar. Edgar closed the clinic in February. (Jon Collicott/CBC)

Holt and Dornan said procedural abortions will be reclassified as minor, not major, surgery, and the government will sort out what fee doctors will be paid for it and what other support they will need. 

"That will be starting tomorrow. What we've done today is allow that to happen," said Health Minister Dr. John Dornan.

He said several doctors have already expressed an interest.

Holt said the government aims to have those issues sorted out by March 31 next year.

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Premier Susan Holt removed New Brunswick's last restriction on public funding for abortions, making it possible for clinics outside of hospitals to receive Medicare funding for those performed surgically.

Dr. Lise Babin, the president of the New Brunswick Medical Society, said she expects the process will be straightforward.

"I think it's going to take a little bit of planning," she said. "We have to make sure that it's done properly." 

Currently, Medicare only funds procedural abortions in hospitals, and only three hospitals — two in Moncton and one in Bathurst — offer it.

Two white-haired women smiling broadly.
Simone Leibovitch and Judy Burwell are former managers of the Morgentaler clinic. (Jacques Poitras/CBC)

Former premier Blaine Higgs argued in 2020 that the province's two health authorities were offering enough access to the service and would have told him if more was needed.

But Dornan — a former CEO of the Horizon health authority — acknowledged Thursday that "we probably missed people that should have had access" because of the travel distances to Moncton and Bathurst.

"I'm not sure that was entirely accurate. The community has told us: 'We want this outside hospitals.'"

The regulatory restriction that was eliminated Thursday was adopted by one of Holt's Liberal predecessors as premier, Frank McKenna, in his attempts to block Dr. Henry Morgentaler from offering the service at a downtown clinic he opened in 1994.

"He's going to get the fight of his life," McKenna vowed at the time.

Former clinic manager Simone Leibovitch said Thursday she didn't believe she'd ever see the regulation changed to eliminate the restriction.

"When you fight and fight and fight, you just get worn out," said Leibovitch, who oversaw the shutdown of the clinic in 2014.

"It's a great day," she said. "My question is: where do we go from here? Let's get it going."

A smiling man in a crowd of people outside
The regulatory restriction was adopted by former Liberal premier Frank McKenna. (CBC)

The Morgentaler clinic later reopened as Clinic 554 in 2015, when Dr. Adrian Edgar took it over.

But he closed the clinic in February, saying it was no longer sustainable financially without Medicare funding the abortions he provided there.

Jula Hughes, a former University of New Brunswick law professor who co-authored a federal report on abortion access in New Brunswick, said many other issues remain to be resolved but Thursday's change was momentous.

"It's not everything that needs to happen, but everything that needs to happen needed this to happen first." 

A woman with glasses in a brown sweater stands in a crowded room talking to a reporter.
Jula Hughes, a former University of New Brunswick law professor who now teaches at Lakehead University in Ontario, attended Thursday's announcement. (Ed Hunter/CBC)

Edgar said Thursday that the change to the regulation allows him to look at providing the service again, though he said it may not happen in the same building.

"I would definitely become a provider again. … It really opens doors up," Edgar said.

"This is a sensible move. We are really just catching up with the rest of the country."

A person in a light blue suit wearing a surgical mask stands in a crowded room.
At Thursday's announcement by Premier Holt, Dr. Adrian Edgar said he might consider reopening Clinic 554. (Ed Hunter/CBC)

Martha Paynter, a reproductive health expert who teaches nursing at the University of New Brunswick, said she expects the service will more likely be offered at community health centres providing other forms of care, rather than in dedicated clinics.

She said that's because a growing share of abortions in the province — more than 70 per cent currently — are now done via mifepristone, a prescribed medication, meaning a shrinking demand for procedural abortions.

"The numbers are so low it would be extremely difficult to support a dedicated clinic," she said.

a woman with a bright yellow blazer and red eyeglasses stands in a crowded room speaking into a microphone.
Martha Paynter, a reproductive health expert who teaches nursing at the University of New Brunswick, says a large share of abortions in New Brunswick are now handled with medication. (Mikael Mayer/Radio-Canada)

But Paynter hailed the regulatory change as a watershed moment for the province nonetheless.

"We simply won't feel like such outsiders," she said.

"There has been this special and disparaging treatment towards New Brunswick abortion-care providers from the province, so this is very important from a symbolic perspective."

A woman speaking into a mic
Harini Sivalingam of the Canadian Civil Liberties Association, which is suing the province over the regulation, was at Holt’s news conference and told reporters the organization will likely withdraw the lawsuit soon. (Jacques Poitras/CBC)

Harini Sivalingam of the Canadian Civil Liberties Association, which is suing the province over the regulation, was at Holt's news conference and told reporters the organization will likely withdraw the lawsuit soon.

"We expect that this announcement will render our legal action moot," she said.

ABOUT THE AUTHOR

Jacques Poitras

Provincial Affairs reporter

Jacques Poitras has been CBC's provincial affairs reporter in New Brunswick since 2000. He grew up in Moncton and covered Parliament in Ottawa for the New Brunswick Telegraph-Journal. He has reported on every New Brunswick election since 1995 and won awards from the Radio Television Digital News Association, the National Newspaper Awards and Amnesty International. He is also the author of five non-fiction books about New Brunswick politics and history.