Abortion Resources for Family Physicians

We are following the U.S. Supreme Court abortion ruling with interest and concern for the consequences of limiting access to abortion on the health of women, their families, and the population, as well as any potential negative impact on access to safe abortion care in Canada. Abortion care is part of healthcare in Canada. The CFPC stands by its statement regarding abortion issued in in 2016 and revised in 2022.

The following resources are available to family physicians.

Approximately one in three pregnant patients in Canada has an abortion in their lifetime, according to a 2012 report.¹ Family physicians play a crucial role in supporting patients who need abortion care. Currently many Canadian communities, particularly in rural or remote regions, lack abortion services, which forces patients to travel long distances for care. With the availability of mifepristone, a drug used in combination with misoprostol under the brand name Mifegymiso to induce an abortion, family physicians have an opportunity to extend their practices to incorporate this care and improve access to this service for their patients and communities. The College of Family Physicians of Canada (CFPC) provides the following links to resources for family physicians who want to provide or refer their patients for abortion care.

Resources for physicians

• Health Canada approves updates to Mifegymiso prescribing information: Ultrasound no longer mandatory.
  Health Canada has informed Canadians that the prescribing and patient information for Mifegymiso has been updated to reflect that an ultrasound is no longer required before the drug is prescribed. Mifegymiso is a combination product containing two drugs (mifepristone and misoprostol) that are taken in sequence for the medical termination of a pregnancy.
  
  Please click on the link below regarding Mifegymiso prescribing from Health Canada for more information.
  http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2019/69620a-eng.php
• Canadian Abortion Providers Support:
  This online community of practice provides a broad range of information for providers and is supported by the CFPC. The site includes Protocols, Ask an Expert, Academic Resources, Tools, Frequently Asked Questions, Locate a Pharmacy, etc. Users must register to access the site, but membership is free: www.caps-cpca.ubc.ca/index.php/Main_Page
• Society of Obstetricians and Gynaecologists of Canada:
  • Mainpro+^® certified course in English and French on medical abortion (six modules) developed jointly by the CFPC, the Canadian Pharmacists Association, and the Society of Obstetricians and Gynaecologists of Canada (cost: $50.00): www.sogc.org/en/rise/Events/event-display.aspx?EventKey=MATP
  • Medical abortion guideline (payable access to full guideline): www.jogc.com/article/S1701-2163(16)00043-8/abstract
  • Surgical abortion guideline (payable access to full guideline): www.jogc.com/article/S1701-2163(17)31309-9/abstract
• National Abortion Federation (NAF) Canada:
  • NAF Canada Home - National Abortion Federation Canada. National Abortion Federation (NAF) Canada promotes, enhances, and ensures access to quality abortion care. About NAF Canada NAF Canada promotes reproductive health among Canadians by ensuring that abortion care is accessible and carried out to the highest standards. We support physicians, nurses, counsellors, and administrators in providing safe, high-quality abortion care.
  • Medication Abortion Virtual Course - National Abortion Federation Canada. Medication abortion with mifepristone and misoprostol is a safe and effective way for primary care providers to offer abortion care. Sold under the brand name Mifegymiso^®, the medications are covered by provincial health insurance and are approved for use up to 9 weeks of pregnancy.

Resources for patients

• Abortion Rights Coalition of Canada:
  • General website: www.arcc-cdac.ca/home.html
  • List of abortion clinics in Canada: www.arcc-cdac.ca/list-abortion-clinics-canada.pdf
• Action Canada for Sexual Health and Rights:
  • Positive pregnancy test: www.srhweek.ca/caring-for-yourself/pregnancy/positive-test-pregnancy-options
  • Abortion pill/Mifegymiso: www.srhweek.ca/caring-for-yourself/pregnancy/positive-test-pregnancy-options/mifegymiso
  • Find a provider: www.actioncanadashr.org/find-service-provider
• Fédération du Québec pour le planning des naissances (in French only):
  • Grossesse non planifiée : www.fqpn.qc.ca/public/informez-vous/grossesse-non-planifiee
  • Avortement : www.fqpn.qc.ca/public/informez-vous/grossesse-non-planifiee/avortement
  • Les points de service d’avortement au Québec (télécharger la brochure) : www.fqpn.qc.ca/?attachment_id=3468
• SOS Grossesse (Pro-choice) (in French only) : https://sosgrossesse.ca/fr

Reference
1. Norman WV. Induced abortion in Canada 1974-2005: Trends over the first generation with legal access. Contraception. 2012;85(2):185-91. doi: 10.1016/j.contraception.2011.06.009. Accessed 2018 Dec 11.