title: Abortion health services in Canada: Results of a 2012 national survey.
abstract: OBJECTIVE
  To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers.
  
  
  METHODS
  An international survey was adapted for Canadian relevance. Public sources and professional networks were used to identify facilities. The bilingual survey was distributed by mail and e-mail from July to November 2013.
  
  
  METHODS
  Canada.
  
  
  METHODS
  A total of 94 abortion facilities were identified.
  
  
  METHODS
  The number and location of services were compared with the distribution of reproductive-age women by location of residence.
  
  
  RESULTS
  We identified 94 Canadian facilities providing abortion in 2012, with 48.9% in Quebec. The response rate was 83.0% (78 of 94). Facilities in every jurisdiction with services responded. In Quebec and British Columbia abortion services are nearly equally present in large urban centres and rural locations throughout the provinces; in other Canadian provinces services are chiefly located in large urban areas. No abortion services were identified in Prince Edward Island. Respondents reported provision of 75 650 abortions in 2012 (including 4.0% by medical abortion). Canadian facilities reported minimal or no harassment, in stark contrast to American facilities that responded to the same survey.
  
  
  CONCLUSIONS
  Access to abortion services varies by region across Canada. Services are not equitably distributed in relation to the regions where reproductive-age women reside. British Columbia and Quebec have demonstrated effective strategies to address disparities. Health policy and service improvements have the potential to address current abortion access inequity in Canada. These measures include improved access to mifepristone for medical abortion; provincial policies to support abortion services; routine abortion training within family medicine residency programs; and increasing the scope of practice for nurses and midwives to include abortion provision.
authors.affiliation: Assistant Professor and Canadian Institutes of Health Research Chair of Family Planning Public Health Research in the Department of Family Practice at the University of British Columbia in Vancouver. wendy.norman@ubc.ca.
authors.forename: Wendy V
authors.initials: WV
authors.lastname: Norman
authors.affiliation: Senior Medical Advisor in the Institut national de santé publique du Québec in Quebec city.
authors.forename: Edith R
authors.initials: ER
authors.lastname: Guilbert
authors.affiliation: Research assistant in the Department of Family Practice at the University of British Columbia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Okpaleke
authors.affiliation: Resident in the School of Population and Public Health at the University of British Columbia.
authors.forename: Althea S
authors.initials: AS
authors.lastname: Hayden
authors.affiliation: Professor of Clinical Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine in Chicago, Ill.
authors.forename: E
authors.initials: E
authors.lastname: Steven Lichtenberg
authors.affiliation: Professor in the Beth Israel Deaconess Medical Center at Harvard Medical School in Boston, Mass.
authors.forename: Maureen
authors.initials: M
authors.lastname: Paul
authors.affiliation: Associate Professor at the Baystate Medical Center at Tufts University School of Medicine in Springfield, Mass.
authors.forename: Katharine O'Connell
authors.initials: KO
authors.lastname: White
authors.affiliation: Assistant Professor in the School of Public Health in Hunter College at the City University of New York in New York, NY.
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Jones
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D010821:Physicians, Family; D011247:Pregnancy; D012424:Rural Population; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult