Policy Barriers to Reproductive Health Access in New Brunswick

About

Policy Barriers to Reproductive Health Access in New Brunswick

By Jessi Taylor, Marina Kwak, Mandi Parsons, and Kalum Ng

Poster Presentation

“Value Judgements: Focusing on Patients’ Health and Health Care Outcomes” – UBC Center for Health Services and Policy Research Annual Conference

March 9-10, 2023 | Vancouver, BC

Our data shows that there are barriers to accessing abortion care that are related to stigma. Our data provides context for why people pay out of pocket for Medicare covered services. An important contribution of this data is the integration of historical data and lived experience to contextualise the statistical data and explain access barriers.

See the poster!

Background

Government officials in New Brunswick (NB) are operating with an incomplete picture of the need for, and provisioning of, procedural abortions in the province. Access to a more complete data set is urgently needed. This data gap stems from three persistent issues:
1) Political barriers to a fulsome understanding of abortion need and to ensuring that New Brunswickers (NBers) have access to safe, necessary and constitutionally mandated care;
2) An absence of community health needs assessments on abortion despite provincial Health Authorities routinely using that methodology for other services; and
3) The Medical Services Payment Act (MSPA) restricts Medicare coverage for abortion services to those performed in a hospital setting. These restrictions force NBers to access clinic-based procedural abortions on a fee-for-service basis. The government only collects data on funded abortions, therefore, the data guiding the policy decisions in this area, is incomplete.

Methods

This was an ambitious mixed methods and interdisciplinary project. Methods included:

1) Archival research;

2) Secondary review of data and statistics from abortion providers in NB;

3) Quantitative survey for people who have accessed abortion services in NB from 2015-present;

4) Focus groups with people with a personal stake in access to abortion in NB, (including involvement in sexual and reproductive health sector, and activists);

5) Interviews with abortion related care providers in NB;

6) Interviews with people who have accessed an abortion in NB.

Both qualitative and quantitative methods were used to come to the evidence-based results.

Archival research was conducted by reviewing archival documents over the time period of 1988 and 2023 to better understand the context of access to abortion in the past and its potential impact to present.
Anonymized data on abortion over the past 7-years from healthcare providers in New Brunswick were collected.
The anonymized data are analysed to produce descriptive statistics.
Survey on access to abortion services in New Brunswick over the past 8-years was conducted.
Focus group interviews with people who have a personal stake in access to abortion in New Brunswick, including involvement in sexual and reproductive health sector, activists, ect were conducted. (2 Focus groups totalling 10 people)
Interviews with abortion and abortion related healthcare providers in New Brunswick were conducted. (6 Key Informants, 12 Semi-structured interviews)
Interviews with people who had abortion in New Brunswick were conducted. (4 Abortion havers)

Results

The data shows that there are barriers to accessing abortion care which may be related to stigma and. Our corroborated data explain why some people may pay out-of-pocket for Medicare covered services.

Conclusion

The incomplete data available to policy makers has resulted in decisions which have limited much needed access to abortion in NB, increased difficulties, and downloaded the cost onto individual New Brunswickers when they cannot access Medicare funded services. Policy adjustments such as the repeal of key sections of the MSPA and community-based access points of care could alleviate the discrepancies in abortion access.