Seeking support for abortion care from national hotlines in Canada: Caller characteristics and call outcomes, 2019-2021.

OBJECTIVES: Both the National Abortion Federation Canada and Action Canada for Sexual Health and Rights operate national toll-free hotlines that provide information, financial support, and travel assistance to abortion seekers. We aimed to characterize callers to both hotlines before and after the onset of the COVID-19 pandemic. METHODS: Hotline personnel routinely document information about callers and type(s) of assistance needed and received. We received call logs from both organizations for a two-year period (April 1, 2019 through March 31, 2021). We exported these data to Microsoft Excel® and analyzed them using descriptive statistics. We analyzed case notes for content and themes. RESULTS: Over the study period, the two hotlines worked with 270 unique callers. Nearly two-thirds of callers (n = 174) were seeking support to obtain abortion care for pregnancies after 14 weeks gestation, including 69 callers (26%) who were at or beyond 24 weeks gestation. Most callers were seeking support to obtain abortion care outside of their province of residence because services at their gestational age were not available. Caller needs were similar before and after the onset of the pandemic, but fewer traveled to the United States for abortion care in the COVID-19 era. DISCUSSION: Assistance hotlines play an important role in helping some abortion seekers navigate the Canadian health system to obtain needed abortion care. The needs of those seeking care after the 14 weeks gestation points to gaps in current service availability. Identifying ways to expand later abortion care in Canada, particularly after 24 weeks, appears warranted.

Incidents of violence and disruption reported by the National Abortion Federation's Canadian members in 2017.

OBJECTIVE: To explore violence and disruption events reported by Canadian facilities providing abortion care in 2017, when only 3 provinces had passed safe access zone legislation. METHODS: We reviewed self-reported data from 16 of 38 Canadian members of the National Abortion Federation. RESULTS: Twelve facilities in 7 provinces reported 571 instances of picketing (97%), trespassing (1%), threats of harm (0.2%), and harassing calls/mail/emails (2%); 4 facilities reported no incidents. Freestanding clinics reported more picketing than hospital-based facilities. DISCUSSION: Abortion providing facilities in Canada experienced picketing and other kinds of violence and disruption in 2017. These data serve as a baseline for future studies.

Trends in medication abortion provision before and after the introduction of mifepristone: A study of the National Abortion Federation's Canadian member services.

OBJECTIVE: We analyzed trends in medication abortion provision before and after the 2017 introduction of mifepristone in Canada. METHODS: We reviewed 2016-2018 abortion services data from Canadian members of the National Abortion Federation (NAF) to determine the overall proportion of medication abortions in each calendar year as well as temporal and geographic trends in provision. RESULTS: In 2016, NAF's Canadian members reported on 33,857 abortions of which 2,844 (8.4%) were with medications and used a methotrexate/misoprostol regimen. In 2018, 8,534 (25.6%) of the 33,320 reported abortions were with mifepristone/misoprostol. DISCUSSION: Mifepristone/misoprostol has been rapidly incorporated into abortion services in Canada.