Foster Angel M, LaRoche Kathryn J, El-Haddad Julie, DeGroot Lauren, El-Mowafi Ieman M
Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada; Institute of Population Health, University of Ottawa, Ottawa, ON, Canada.
Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
Contraception. 2017 May;95(5):477-484. doi: 10.1016/j.contraception.2017.02.016. Epub 2017 Feb 21.
New Brunswick (NB)'s Regulation 84-20 has historically restricted funded abortion care to procedures deemed medically necessary by two physicians and performed in a hospital by an obstetrician-gynecologist. However, on January 1, 2015, the provincial government amended the regulation and abolished the "two physician rule."
We aimed to document women's experiences obtaining abortion care in NB before and after the Regulation 84-20 amendment; identify the economic and personal costs associated with obtaining abortion care; and examine the ways in which geography, age and language-minority status condition access to care.
We conducted 33 semistructured telephone interviews with NB residents who had abortions between 2009 and 2014 (n=27) and after January 1, 2015 (n=6), in English and French. We audiorecorded and transcribed all interviews and conducted content and thematic analyses using ATLAS.ti software to manage our data.
The cost of travel is significant for NB residents trying to access abortion services. Women reported significant wait times which impacted the disclosure of their pregnancy and the gestational age at the time of the abortion. Further, many women reported that physicians refused to provide referrals for abortion care. Even after the amendment to 84-20, all participants reported that they were required to have two physicians approve their procedure.
The funding restrictions for abortion care in NB represent a profound inequity. Amending Regulation 84-20 was an important step but failed to address the fundamental issue that clinic-based abortion care is not funded and significant barriers to access persist.
NB's policies create unnecessary barriers to accessing timely and affordable abortion care and produce a significant health inequity for women in the province. Further policy reforms are required to ensure that women are able to get the abortion care to which they are entitled.
新不伦瑞克省（NB）的第84 - 20号法规历来将获得资助的堕胎护理限制在两名医生认定为医学必需的程序，并由妇产科医生在医院进行。然而，2015年1月1日，省政府修订了该法规，废除了“两名医生规定”。
我们旨在记录在第84 - 20号法规修订前后，新不伦瑞克省女性获得堕胎护理的经历；确定获得堕胎护理相关的经济和个人成本；并研究地理、年龄和语言少数群体身份对获得护理的影响方式。
我们对2009年至2014年期间（n = 27）以及2015年1月1日之后（n = 6）在新不伦瑞克省进行堕胎的居民进行了33次半结构化电话访谈，访谈语言为英语和法语。我们对所有访谈进行了录音和转录，并使用ATLAS.ti软件进行内容和主题分析以管理数据。
对于试图获得堕胎服务的新不伦瑞克省居民来说，交通成本很高。女性报告了很长的等待时间，这影响了她们怀孕情况的披露以及堕胎时的孕周。此外，许多女性报告说医生拒绝提供堕胎护理的转诊。即使在第84 - 20号法规修订之后，所有参与者都报告说他们仍被要求有两名医生批准他们的手术。
新不伦瑞克省对堕胎护理资金的限制存在严重的不公平。修订第84 - 20号法规是重要的一步，但未能解决基于诊所的堕胎护理未获资助这一根本问题，且获取护理的重大障碍依然存在。
新不伦瑞克省的政策为及时获得负担得起的堕胎护理制造了不必要的障碍，并给该省女性带来了严重的健康不公平。需要进一步的政策改革以确保女性能够获得她们应得的堕胎护理。
