The politest form of racism: sexual and reproductive health and rights paradigm in Canada.

The Canadian national identity is often understood as what it is not; American. Inundation with American history, news, and culture around race and racism imbues Canadians with a false impression of egalitarianism, resulting in a lack of critical national reflection. While this is true in instances, the cruel reality of inequity, injustice and racism is rampant within the Canadian sexual and reproductive health and rights realm. Indeed, the inequitable health outcomes for Black, Indigenous and people of color (BIPOC) are rooted in policy, research, health promotion and patient care. Built by colonial settlers, many of the systems currently in place have yet to embark on the necessary process of addressing the colonial, racist, and ableist structures perpetuating inequities in health outcomes. The mere fact that Canada sees itself as better than America in terms of race relations is an excuse to overlook its decades of racial and cultural discrimination against Indigenous and Black people. While this commentary may not be ground-breaking for BIPOC communities who have remained vocal about these issues at a grassroots level for decades, there exists a gap in the Canadian literature in exploring these difficult and often underlying dynamics of racism. In this commentary series, the authors aim to promote strategies addressing systemic racism and incorporating a reproductive justice framework in an attempt to reduce health inequities among Indigenous, Black and racialized communities in Canada.

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.

Training reproductive health professionals in a post-conflict environment: exploring medical, nursing, and midwifery education in Mogadishu, Somalia.

Following two decades of civil war, Somalia recently entered the post-conflict rebuilding phase that has resulted in the rapid proliferation of higher education institutions. Given the high maternal mortality ratio, the federal government has identified the reproductive health education of health service professionals as a priority. Yet little is known about the coverage of contraception, abortion, pregnancy, childbirth, and sexual and gender-based violence (SGBV) in medicine, nursing, or midwifery. In 2016, we conducted a multi-methods study to understand the reproductive health education and training landscape and identify avenues by which development of the next generation of health service professionals could be improved. Our study comprised two components: interviews with 20 key informants and 7 focus group discussions (FGDs) with 48 physicians, nurses, midwives, and medical students. Using the transcripts, memos, and field notes, we employed a multi-phased approach to analyse our data for content and themes. Our findings show that reproductive health education for medical and nursing students is inconsistent and significant content gaps, particularly in abortion and SGBV, exist. Students have few clinical training opportunities and the overarching challenges plaguing higher education in Somalia also impact health professions programmes in Mogadishu. There is currently a window of opportunity to develop creative strategies to improve the breadth and depth of evidence-based education and training, and multi-stakeholder engagement and the promotion of South-South exchanges appear warranted.