The Politics of Abortion in Canada After Morgentaler: Women’s Rights as Citizenship Rights by Rachael Elizabeth Grace Johnstone A thesis submitted to the Graduate Program in the Department of Political Studies in conformity with the requirements for the Degree of Doctor of Philosophy Queen’s University Kingston, Ontario, Canada November, 2012 Copyright © Rachael Elizabeth Grace Johnstone, 2012 Abstract This dissertation explores the regulation of abortion in Canada following the landmark R v Morgentaler decision (1988), which struck down Canada’s existing abortion law, causing the procedure’s subsequent reclassification as a healthcare issue. The resulting fragility of abortion rights is still evident in the varying provincial regulations governing the nature of access to the procedure. While access has been accepted as the new terrain of abortion rights, research into this area to date has taken a largely national focus, surveying provincial barriers and compiling lists of potential motivations for differences in service. This dissertation builds on this work through the use of specific case studies of provinces representative of a spectrum of access in Canada – New Brunswick, Ontario, and Quebec. Through the use of original interview data, these cases are compared and contrasted on previously enumerated grounds believed to have an influence on the treatment of abortion. By isolating the impact of specific processes responsible for the regulation of abortion, through research into its treatment in politics, law, medicine, and public discourse, this study endeavours to offer a more nuanced explanation for varying levels of provincial access to abortion services. Ultimately it finds that a province’s social climate, characterized by attitudes towards the ongoing rights versus morality debate championed by pro- and anti-choice social movements, has had the greatest impact in shaping public perceptions of the procedure. These attitudes in turn have a profound effect on the nature of provincial access. Using a citizenship framework grounded in social reproduction, which understands anti- abortion politics as elements of backlash against progressive advances in women’s citizenship, this dissertation argues for the need to understand abortion as a right of women’s citizenship to address the precarious treatment of abortion services. Recognition of women’s unique reproductive abilities through a citizenship paradigm is necessary before women can hope to ii achieve equality. Only when abortion is entrenched as a right of citizenship and this understanding of the procedure is embedded in social perceptions, can women not only be treated as equal citizens, but also understand themselves to be equal citizens. iii Acknowledgements First and foremost, I would like to acknowledge my supervisor Dr. Abigail Bakan for her support and guidance during my time at Queen’s. I have always found our discussions enlightening and am grateful for her constant encouragement. I must also thank the faculty and staff of the Political Studies Department, whose advice, assistance, and welcoming attitudes helped me through this process. I would like to specifically thank Margaret Little, Elizabeth Goodyear-Grant, Janet Hiebert, and Jonathan Rose. Additionally, I want to acknowledge Barb Murphy, Frances Shepherd, Dianne Flint, Jennifer Falle, Jeananne Vickery, Amelia Pont-Viveiros, Micheline Boomhour, and Karen Vandermey. I would also like to thank the purveyors of the Graduate Dean’s Travel Grant for Doctoral Field Research for supporting me in my research. Life in the Department would not have been the same without my friends and colleagues, with whom I shared countless entertaining conversations. I would like to acknowledge Megan Gaucher, Lucia Salazar, Erin Tolley, Aaron Ettinger, Andrea Collins, Beesan Sarrouh, Erin Clow, Jessie Lindley, Victoria Tait, Emmett MacFarlane, Anna Drake, Charan Rainford, Adrienne Koning, Iain Reeve, and Sara Pavan for providing an invaluable support network. I would also like to thank my longtime friend and officemate Chris Samuel. I would be remiss if I did not thank Angela Pietrobon for her wonderful work editing my thesis. I am also grateful to Joanne Wright, whose guidance and encouragement helped convince me to pursue my doctorate in the first place. I cannot forget to thank the Chevriers, my second family, for their lifelong love and encouragement, especially Sara Dunton, for her comradery throughout this degree. I would like to thank my parents, Lowell and Raylene Johnstone, and my brother, Robert iv Johnstone, for their endless love and support. They endured many late nights and plenty of stress on my behalf in helping me to get here, for which I am eternally grateful. Finally, I must thank my partner, Christopher Bennett, not only for his love and support, but for making the final leg of this experience a truly happy one. v Dedication For my parents, Lowell and Raylene Johnstone, who, when I said I was going to study feminism instead of medicine, said “Great!” And, when Gender and Politics led me to the study of abortion access, said “Wonderful!” Thank you for talking about my work with pride no matter how awkward dinner party conversations became. I love you both more than I could ever express. vi Table of Contents Abstract ........................................................................................................................................... ii   Acknowledgements ........................................................................................................................ iv   Dedication ...................................................................................................................................... vi   Glossary of Acronyms .................................................................................................................... x   Chapter 1. Introduction ................................................................................................................... 1   Abortion as a Right of Citizenship ............................................................................................. 4   Methodology ............................................................................................................................. 10   Case Studies .............................................................................................................................. 11   Mixed-Method Approach: Documents and Interviews ............................................................ 14   Difficulties Accessing Information ........................................................................................... 20   Chapter Outlines ....................................................................................................................... 20   Chapter 2. Rights, Morality, and Abortion Access in Canada ...................................................... 26   The Moral and Rights Frames .................................................................................................. 26   Necessary Essentialism: Addressing Issues of Intersectionality in Body Politics .................... 33   Abortion Access in Canada: The Literature ............................................................................. 36   Original Contributions .............................................................................................................. 39   Chapter 3. “Fragile, Incomplete, and Contradictory”: Abortion in Canadian Federal Politics and the Courts ...................................................................................................................................... 42   Law and Politics: Abortion Regulation Before 1988 ................................................................ 46   Dr. Henry Morgentaler ............................................................................................................. 50   Expanding Westward ............................................................................................................ 56   R v Morgentaler (1988) ......................................................................................................... 57   The Mulroney Administration .................................................................................................. 60   Testing the Limits of the Morgentaler Decision (1988) ........................................................... 62   Borowski ................................................................................................................................... 65   Bill C-43 ................................................................................................................................... 67   Pro-Choice Caucus ................................................................................................................... 70   The Harper Administration ....................................................................................................... 73   Conclusion ................................................................................................................................ 78   vii Chapter 4. Political and Legal Responses to R v Morgentaler (1988) in the Provinces: Along a Spectrum of Citizenship ................................................................................................................ 80   New Brunswick: Falling off the Spectrum ............................................................................... 83   Ontario: Citizenship Rights on Precarious Ground .................................................................. 97   Quebec: Women as Equal Citizens ......................................................................................... 102   Conclusion .............................................................................................................................. 110   Chapter 5. The Courts in Context: the Case of Abortion Rights in Canada ............................... 113   Feminist Legal Scholarship .................................................................................................... 115   Abortion in the Courts Before the Charter .............................................................................. 119   R v Morgentaler (1988) .......................................................................................................... 121   Testing the Limits of the Morgentaler Decision: Maternal, Paternal, and Fetal Rights ......... 124   Provincial Access .................................................................................................................... 128   Conclusion .............................................................................................................................. 134   Chapter 6. It’s Pro-Choice or No-Choice: Social Movement Activism in a Policy Vacuum ..... 137   Social Consensus and Social Movements: Views on Abortion in Canada ............................. 140   Silence in New Brunswick ...................................................................................................... 143   Ambivalence in Ontario .......................................................................................................... 150   Pro-Choice Quebec ................................................................................................................. 155   Conclusion .............................................................................................................................. 159   Chapter 7. Abortion in Medicine ................................................................................................ 162   The Procedure ......................................................................................................................... 166   The Organization of Physicians and Health Insurance in Canada .......................................... 168   Case Studies: Provincial Overlap in Service Provision .......................................................... 175   Facilities .............................................................................................................................. 175   Clinics ............................................................................................................................. 176   Crisis Pregnancy Centres ................................................................................................ 182   Hospitals ......................................................................................................................... 184   Training Future Providers ................................................................................................... 188   New Brunswick: Medically Unnecessary ............................................................................... 190   Ontario: High Levels of Service ............................................................................................. 195   Quebec: Pro-choice Practice ................................................................................................... 197   viii Aboriginal Women and Access to Abortion Services ............................................................ 199   Conclusion .............................................................................................................................. 201   Chapter 8. Never Going Back: Women’s Experiences of Citizenship in Canada After Morgentaler (1988) ..................................................................................................................... 204   Women’s Experiences of Citizenship ..................................................................................... 206   New Brunswick ................................................................................................................... 206   Ontario ................................................................................................................................ 207   Quebec ................................................................................................................................ 208   Moving Forward ..................................................................................................................... 209   Future Research ...................................................................................................................... 217   Conclusion .............................................................................................................................. 219   References ................................................................................................................................... 221   Original Research ................................................................................................................... 231   Appendix A. GREB Letter .......................................................................................................... 234   Appendix B. Letter of Information for Interviewees .................................................................. 235   Appendix C. Consent Form for Interviewees ............................................................................. 236   Appendix D. Recruitment Email Template ................................................................................ 237   Appendix E. Prevalence of Abortion by Province and Facility .................................................. 238   Appendix F. Interviewee Descriptions ....................................................................................... 243   Appendix G. Anti-Choice Private Member Bills and Motions Introduced in Canada Since 1987 ..................................................................................................................................................... 247   Appendix H. Legislative Timelines ............................................................................................ 253   ix Glossary of Acronyms ARCC. Abortion Rights Coalition of Canada. CARAL. Canadian Abortion Rights Action League. CFC. Canadians for Choice. CIHI. Canadian Institute for Health Information. CLSC. Des Centres Locaux des Services Communautaries (Local Community Service Centres). CMA. Canadian Medical Association. CMQ. Collège des médecins du Québec (College of Physicians of Quebec). CPSNB. College of Physicians and Surgeons of New Brunswick. CPSO. College of Physicians and Surgeons of Ontario. FQPN. Fédération du Québec pour le Planning des Naissances (Quebec Federation for Planned Pregnancy). MPP. Member of Provincial Parliament. MLA. Member of the Legislative Assembly. NAF. National Abortion Federation. NDP. New Democratic Party. PM. Prime Minister. TAC. Therapeutic Abortion Committee. SOGC. Society of Obstetricians and Gynecologists of Canada. x