DETROIT — Canada might become the closest place for Metro Detroit residents to get a legal abortion if the Roe v. Wade decision legalizing abortion is overturned and anti-abortion forces win their legal battle to let a 1931 Michigan law banning abortion take effect.
Canadian Social Development and Families Minister Karina Gould told CBC Canada that Americans would be allowed to seek reproductive care, including abortions, across the border. Gould made the offer last month, soon after a leaked draft opinion from the U.S. Supreme Court indicated a conservative majority of justices was poised to overturn Roe.
The offer represented a role reversal for the two countries. After the 1973 Supreme Court decision in Roe, the United States became a destination for Canadian women seeking abortions since the medical practice was still outlawed in Canada.
For now, Michigan residents could still seek abortions in the state if Roe is overruled by the nation's highest court, which is expected to release its decision within the next two weeks. A state judge issued a preliminary injunction barring Michigan's now-dormant 1931 law from going into effect after a lawsuit by Planned Parenthood of Michigan. Gov. Gretchen Whitmer filed a similar lawsuit in Oakland County court.
But if the Republican-led Legislature and anti-abortion groups win their legal challenge to the judge's injunction, abortions would be banned in Michigan under the 1931 law. Ohio and Indiana would have similarly restrictive laws against abortion, making Illinois the next closest abortion haven for many Michigan residents in the United States.
Canada — located across the Detroit River in Metro Detroit and the St. Mary's River near Sault Ste. Marie in the Upper Peninsula — would offer the closest place for legal abortion for Metro Detroiters.
Planned Parenthood of Michigan is confident the preliminary injunction by Michigan Court of Claims Judge Elizabeth Gleicher will hold, spokeswoman Ashlea Phenicie said. The group is expecting a surge of patients in Michigan if Roe is struck down rather than needing to send Michigan residents out of state, she said.
"In the unlikely event that Michigan's 1931 criminal abortion ban is allowed to take effect, Planned Parenthood of Michigan would serve as a connector, helping patients find care in other states like New York and Illinois," Phenicie said. "Some Michiganders may turn to Canada for care, but traveling internationally involves additional barriers. They would need a passport, enhanced driver's license, NEXUS card or another qualifying form of identification."
Right to Life of Michigan hopes women in Michigan won't travel to Canada in the event that Roe v. Wade is overturned, spokeswoman Anna Visser said, noting Michigan has more than 150 pregnancy resource centers and adoption agencies.
"The 1931 law was put into place to protect all human rights, not deprive women health care, which abortion is not," Visser said. "We know that there may be some who travel to get abortions but hopefully, the majority of families and women in Michigan feel empowered and supported."
Canadian rules for abortion
Abortion is legal in Canada up to 24 weeks of gestation and medical abortions are available up to nine weeks of gestation. Twenty-three hospitals and clinics in the province of Ontario provide abortion care, according to the Abortion Rights Coalition of Canada.
The main barrier non-Canadians face when accessing any kind of health care services there is affordability, said Access Line Manager for Action Canada for Sexual Health and Rights Jessa Millar.
"You can call up an abortion clinic or whatever the provider is ... you can make an appointment and say, 'I don't have Canadian health care coverage. I'm going to be paying out of pocket,' and you're allowed to do that. It's just that you won't be covered and it could be quite expensive," Millar said.
While Ontario residents are guaranteed coverage of reproductive health care under the Canadian health system, the cost of medical abortion pills for non-residents or those without provincial coverage is between $300 and $370 while surgical abortions at free-standing clinics range from $400 to $2,300 depending on gestational age, according to Planned Parenthood Toronto.
Another potential barrier is the number of abortion providers. Two providers offer abortion care in the Windsor area — the Windsor Regional Hospital and the Windsor Essex Community Health Center.
Hospital representative Steve Erwin said the hospital would not comment on the accessibility of abortion care for non-Canadians until a decision was made regarding Roe v. Wade. Windsor Essex Community Health Center currently does not offer abortion care to non-Canadian citizens, according to a center employee who wouldn't identify herself.
"In the Windsor area, the hospital does provide abortions and it seems to be able to meet the need for most people in that area," said Carolyn Egan, a spokeswoman for the Ontario Coalition for Abortion Clinics based in Toronto. "We have not seen many women coming from that part of Ontario to the clinics that exist here in Toronto."
Although wait times for other medical health procedures in Canada can be longer, most patients don't have to wait more than one to two weeks for an abortion appointment since the majority of abortions happen in the first trimester, Millar said.
"If somebody's ending a pregnancy later on in their pregnancy, like the second trimester, third trimester, there are less medical professionals who have the training and capabilities to provide that care," she said. "That's when you can see wait times of two or three weeks or even four weeks."
Supply and demand
The main barriers Canadian abortion seekers face are a lack of information about where to go and potential travel-related difficulties, Millar said. There are fewer abortion facilities in rural areas and more in urban areas.
Toronto is a major hub of abortion clinics in the province of Ontario, said Egan with the Ontario Coalition of Abortion Clinics, adding that at the moment, they are not at capacity or overstretched.
"If they were to be overstretched, I think you would see clinics either expanding or new facilities being opened," Egan said.
Christabelle Sethna, a professor in the Institute of Feminist and Gender Studies at the University of Ottawa, agreed with that assessment.
"It may be that there are clinics specifically set up for Americans or parts of clinics specifically set up for Americans, depending upon the volume of the traffic of Americans coming north," Sethna said.
But abortions are functionally inaccessible for individuals without transportation, said Katie Nelson, a doula who offers abortion support services in Stratford, a more rural part of Ontario. She said she expects an increase in wait times if Americans flood the Canadian health care system.
"Here, the access, when it comes down to it, is not all it's made out to be at the end of the day," Nelson said. "I think it would increase a lot of wait times. Our health care system, in general, is not doing very well right now."
The COVID-19 pandemic exacerbated problems with the Canadian health care system, resulting in average wait times of 25.6 weeks for medically necessary procedures following referral in 2021, according to the Fraser Institute, a Canadian research group.
Michiganians spring into action
Some Metro Detroiters already have sprung into action, posting on the Auntie Network subreddit, an online support system where "aunties" from around the world offer a place to stay, food and transportation to individuals traveling to get an abortion. One Michigan resident offered a place to sleep and recover after getting an abortion in Windsor in one posting, while a Detroiter posted about providing a room and a ride across the border.
Several states, including Mississippi and Texas, have attempted to pass laws limiting or criminalizing travel for out-of-state abortions and the mailing of abortion medications across state lines. Sethna said Americans seeking abortions in Canada might get questioned at the border upon their return.
In 2019, Canada and the United States entered into a memorandum of understanding that allows for the sharing of biographic data collected upon entry to each country to create exit records.
When asked, the Canada Border Services Agency did not specify what information individuals seeking abortions will have to provide when attempting to cross the border either into or out of Canada.
"In light of the possible overturning of Roe v Wade, we are taking proactive steps to ensure there are appropriate guidelines at the border so that American women seeking access to reproductive health services in Canada are treated respectfully, compassionately and in a manner that is consistent with the Canadian Charter of Rights and Freedoms," Minister of Public Safety Marco Mendicino wrote in an email.
If Roe is overturned, Americans would have to weigh whether it makes more sense to seek an abortion in the United States or Canada, Millar said.
"The abortion providers in America are going to have an influx of patients," said Millar, referring to the states that would still allow abortions. "Wait times are going to go up, and then it's going to be up to the individual seeking abortion care to weigh the pros and cons.
"Do I want to stay in my country and have this longer wait time, or is it worth it for me to maybe travel to Canada, with the expenses that would bring, if it means that I can maybe be seen sooner?"
