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Author Topic: Physician, Teach Thyself
Rundler
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Babbler # 2699

posted 09 October 2002 12:44 PM      Profile for Rundler     Send New Private Message      Edit/Delete Post  Reply With Quote 
The legality of abortion may not be at risk in Canada, but the availability of services is. In many cases, Canadian medical schools and hospitals are not offering abortion training for future physicians, making the legal right to abortion meaningless no providers, no choice.

http://www.rabble.ca/news_full_story.shtml?x=15979&url=

This is the fight that just won't go away. Is it time for another collective, nation-wide push for women's reproductive rights?


From: the murky world of books books books | Registered: May 2002  |  IP: Logged
Michelle
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posted 09 October 2002 01:03 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
I was asking Audra about this in email, but I'm curious in general - how can doctors not be trained in how to terminate a pregnancy medically? Don't doctors learn how to do D&C's, or learn how to remove a fetus from the womb if it dies? Seems to me this would be part of basic medical training even if abortion was illegal. And according to a friend who is a retired doctor, and also against abortion, he said that he and his colleagues learned how to do those things, it just wasn't called abortion because the intent wasn't to stop a viable pregnancy, it was to help when something went drastically wrong. Also, they had to know how to treat women who came to them with complications from back-alley abortions.
From: I've got a fever, and the only prescription is more cowbell. | Registered: May 2001  |  IP: Logged
Debra
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posted 09 October 2002 01:05 PM      Profile for Debra   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
This is the fight that just won't go away. Is it time for another collective, nation-wide push for women's reproductive rights?


Yes


From: The only difference between graffiti & philosophy is the word fuck... | Registered: Apr 2001  |  IP: Logged
Michelle
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posted 09 October 2002 01:09 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Agreed. If it's legal then all women should have equal access.
From: I've got a fever, and the only prescription is more cowbell. | Registered: May 2001  |  IP: Logged
janew
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posted 09 October 2002 01:12 PM      Profile for janew     Send New Private Message      Edit/Delete Post  Reply With Quote 
That's a really interesting story, Audra.
It's easy to forget about this problem with abortion rights. No matter how legal it is, if the doctors aren't available or willing, it's still a problem. I've always wondered why midwives couldn't be trained to do them. They often tend to be more pro-women and my understanding is that with modern techniques, they're not very high risk. Do you know if there's any movement towards allowing that?

Mark's photo is fabulous. I sure like working with such interesting and high quality graphics. Is the picture actually of Greenaway?


From: Toronto, Ontario | Registered: Apr 2001  |  IP: Logged
audra trower williams
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posted 09 October 2002 01:29 PM      Profile for audra trower williams   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Yep, that's Kate! I'm going to try to rope her into participating in the discussion. Thanks, all! I'll pass along the nice words to Mark, as well
From: And I'm a look you in the eye for every bar of the chorus | Registered: Apr 2001  |  IP: Logged
Rundler
editor
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posted 09 October 2002 01:49 PM      Profile for Rundler     Send New Private Message      Edit/Delete Post  Reply With Quote 
That's really interesting about midwives -- anyone know the answer about whether they do it or could do it? Do we have any midwife babblers out there?
From: the murky world of books books books | Registered: May 2002  |  IP: Logged
angela N
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posted 09 October 2002 02:02 PM      Profile for angela N   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
As long as there is money to be made I wouldn't be too concerned.
From: The city of Townsville | Registered: May 2002  |  IP: Logged
Lima Bean
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posted 09 October 2002 02:54 PM      Profile for Lima Bean   Author's Homepage        Edit/Delete Post  Reply With Quote 
If I were in need of an abortion, you can bet your life I'd rather have a midwife perform it for me. It might turn out to be somewhat less traumatic if the experience itself weren't so scary and clinical and inhuman. Maybe just a touch...

It's probably really possible. Might already happen some, even...maybe?


From: s | Registered: Aug 2002  |  IP: Logged
Michelle
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posted 09 October 2002 02:58 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
I was told when I was pregnant that if I went with a midwife for child birth, I would have to do it without pain killers since they cannot prescribe them or administer them. Maybe that's not true anymore; however, if it is, I certainly wouldn't want to go through an abortion without pain killers.
From: I've got a fever, and the only prescription is more cowbell. | Registered: May 2001  |  IP: Logged
Debra
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posted 09 October 2002 03:20 PM      Profile for Debra   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
There are many things midwives do which decrease the need for drugs.

However, many midwife assisted deliveries are done in a hospital environment and so epidurals are still available.

After all it is the aenesthitist that provides that treatment not the doctor.


From: The only difference between graffiti & philosophy is the word fuck... | Registered: Apr 2001  |  IP: Logged
Trinitty
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posted 09 October 2002 03:35 PM      Profile for Trinitty     Send New Private Message      Edit/Delete Post  Reply With Quote 
Some midwives do homebirths too, thus no access to meds.

Laws on midwifery are varied. In some provinces they aren't legal, in others they are covered by medicare. Go figure.

http://members.rogers.com/canadianmidwives/

As Earthmom pointed out, midwives do many things that make pain meds less asked for. Sane labour plans with the mothers holistic comfort in mind for one, massage and warm baths for others.

On the abortion issue,

From the midwives I know and the books I've read, I can't see them lining up to perform abortions.

Their focus is always healthy pregnancies, safe and joyous deliveries for both mom and babe and post-birth aftercare. Elective abortion is the antithesis of midwifery from what I know of it. I hope to take the training in Seattle some day.


From: Europa | Registered: Jun 2001  |  IP: Logged
Debra
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posted 09 October 2002 03:39 PM      Profile for Debra   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Why Seattle?
From: The only difference between graffiti & philosophy is the word fuck... | Registered: Apr 2001  |  IP: Logged
'lance
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posted 09 October 2002 03:44 PM      Profile for 'lance     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
As long as there is money to be made I wouldn't be too concerned.

Are you suggesting that simply 'unleashing the profit motive' will take care of any problems with access to abortion?

It might make a difference; but it would likely mean that instead of women in some areas of the country being unable to get abortions, women anywhere who couldn't afford it would be unable to. Hardly an improvement, indeed a step backwards, away from the widely accepted idea that medical care is for everyone, not just those with money.


From: that enchanted place on the top of the Forest | Registered: Jul 2001  |  IP: Logged
Trinitty
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posted 09 October 2002 03:46 PM      Profile for Trinitty     Send New Private Message      Edit/Delete Post  Reply With Quote 
I've talked with a midwife in BC, asking about the program at UBC, and she mentioned Seattle.

http://www.seattlemidwifery.org/sms.htm

They've had many years of experience, I could study online much of the time, they have small, focussed classes, transferrable qualifications, etc. They seem to be right near the top of the list.

I learned about them before the UBC program got off of the ground, I'm keeping an eye on UBC though to see how their program blossoms. I could very well try going there.

It's down the line a ways though, after my own kids, that sorta thing. For now I'll just keep reading birth books.

http://www.midwiferytoday.com/

[ October 09, 2002: Message edited by: Trinitty ]


From: Europa | Registered: Jun 2001  |  IP: Logged
Cate
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posted 09 October 2002 04:19 PM      Profile for Cate     Send New Private Message      Edit/Delete Post  Reply With Quote 
The most recent article I read on the legalities of abortion was one my sister's friend wrote. Her article suggested that doctors have not only a moral obligation to discuss terminating a pregnancy but also a legal obligation. To not do so could expose them to liability for future wrongful life/wrongful death cases and a whole bunch of other things.

The article also cited Medical Students for Choice because apparently although the law has been saying "you have to be able to at least talk about this so your patient can have informed consent", there has been a shift away from training doctors to be able to perform any kind of termination procedure and students have had to fight to get into the class curriculum (or in most cases, students just don't want to know while they're at school and never bother to learn the procedure and nobody complains.) The problem comes later when patients are saying they didn't make informed consent when they made choices about their pregnancy.

The article didn't deal with midwives or nurses or any other profession getting involved as abortion providers. But basically the gist of the article was if the medical community wants to stick its head in the sand now and ignore their moral obligation to provide information/access, the problem will catch up with them later on with a legal obligation.

Not to best reason why doctors should be trained and provide access, but not the worst one either...


From: out in the west | Registered: Aug 2002  |  IP: Logged
swirrlygrrl
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posted 09 October 2002 04:48 PM      Profile for swirrlygrrl     Send New Private Message      Edit/Delete Post  Reply With Quote 
Legally of course midwives couldn't do abortions, but the Jane collective proved that first trimester abortions for women without risk factors (like former ectopic pregnancy, etc.) don't have to be medicalized to be safe.

Jane didn't provide painkillers*, but, like midwives do, made sure a woman was comfortable, and involved in the procedure if she wanted to, and respected the woman, so that for most of the women they served, pain wasn't this issue. I don't think its unusual that women who face protestors outside a clinic, or hospital staff that may not be too pleased with having to be there before or during the procedure are more tense and feel more pain than women whose choice is supported totally by the people providing the service, accounting for some of the difference here.

While I agree that its time for a new push on access to abortion services, since its sick how radically it's split by region, age, race, ability, class, and location in province, and I believe there will always be a place for medical practitioners in abortion provision, I mourn that there isn't (or at least I haven't seen it) that push that there was in the 70s towards demedicalizing the procedure, involving the women in it, and teaching things like menstrual extraction to everyday women.

While the destruction of criminal laws regulating abortion was of course a boon to women, the victory also meant a huge loss of momentum, which has allowed the chipping away at access after the slow build, and which meant that more radical ideas sort of died out. But I guess that's the way of movements that depend on the strength of middle class and essentially conservative voters/activists - few are going to stick around once their rights have been secured, and most will only come back to the fight when their rights are challenged. But maybe I should be posting this on the age of selfishness thread?


* as I recall - its been a while since I immersed myself in this, so I apologize if I'm making this up!


From: the bushes outside your house | Registered: Feb 2002  |  IP: Logged
Michelle
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posted 09 October 2002 05:11 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
What is menstrual extraction?
From: I've got a fever, and the only prescription is more cowbell. | Registered: May 2001  |  IP: Logged
Timebandit
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posted 09 October 2002 05:19 PM      Profile for Timebandit     Send New Private Message      Edit/Delete Post  Reply With Quote 
I can't see midwives or even nurses being qualified to perform abortion procedures, which are classed as a type of surgery. Even a basic D&C procedure is considered surgical.

And even though I've had two births without pain meds (one in hospital with a doctor, the second at home with a midwife), if I was going to choose to abort, I want to be sedated. Heavily.

I find the trend to not provide adequate access to services terrifically disturbing. It puts women living in poverty at even more risk, especially the very young ones.

So who do I call up and yell at?

(An aside on midwives -- in some provinces, midwifery is not legal at all. Here in Saskatchewan, they are acknowledged in the legislation but are not give hospital priveleges, and home birth is still in a legal grey area - not technically legal, but not outright illegal, either. So, while allowed to exist, they are not really allowed to practice. There were only 2 or 3 in the whole province 2 years ago, when I gave birth to my daughter at home. And things are not looking up. )


From: Urban prairie. | Registered: Sep 2001  |  IP: Logged
skadie
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posted 09 October 2002 05:25 PM      Profile for skadie     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
I've always wondered why midwives couldn't be trained to do them. They often tend to be more pro-women and my understanding is that with modern techniques, they're not very high risk. Do you know if there's any movement towards allowing that?

If there was I wouldn't support it. D&C is an internal procedure using tiny instruments and anasthetic injected into the cervix. There is no way I'd allow anyone but a doctor preform it on me. On the other hand, medical abortion is an injection and a few suppository pills. I'm not too familiar with the medical training a midwife gets, but if they can safely administer an injection than they can safely administer a medical abortion.


From: near the ocean | Registered: Jan 2002  |  IP: Logged
bolivar
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posted 09 October 2002 05:45 PM      Profile for bolivar     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
An aside on midwives -- in some provinces, midwifery is not legal at all

This place you mention, Saskatchewan -- is it a multi-cultural area as much of your country is said to be? In my country we formally would give designations to the first wife, second, or last wife -- some people I have heard to be saying the phrase, "the midwife", if they had three. You live in a free country, if only one province makes it illegeal.


From: jordan | Registered: Oct 2002  |  IP: Logged
Timebandit
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posted 09 October 2002 05:59 PM      Profile for Timebandit     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
I'm not too familiar with the medical training a midwife gets, but if they can safely administer an injection than they can safely administer a medical abortion.

Midwifery training varies. Some midwives are nurse-midwives, and in some places are authorized to administer certain medications. Others are practical midwives and are not trained in the use of medications at all.

quote:
This place you mention, Saskatchewan -- is it a multi-cultural area as much of your country is said to be? In my country we formally would give designations to the first wife, second, or last wife -- some people I have heard to be saying the phrase, "the midwife", if they had three. You live in a free country, if only one province makes it illegeal.

Yes, I suppose we are multicultural. Most people here are aboriginal or descended from German, Ukranian, Scandinavian and British settlers. We have many other ethnic groups as well, Phillipino, African, Carribean, other Europeans, Indian, etc, but they are very much a minority.

Polygamy is not legal here, so "midwife" refers specifically to women who deliver babies who are not doctors. It is a more holistic, natural and preventive practice than the more common Western medical way.

I don't think that if only one province makes midwifery illegal means that we are all that free a country. (Besides that there are other provinces where midwifery is not allowed -- I believe Quebec doesn't, either, last I heard). It is as if we are able to decide whether we want to carry a pregnancy to term, but after that we are not smart enough to decide how we will bring that child into the world.

To me, that isn't much freedom. It's a dictatorship of doctors.

Sorry for the drift, all. I'll be good now.


From: Urban prairie. | Registered: Sep 2001  |  IP: Logged
bolivar
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posted 09 October 2002 06:01 PM      Profile for bolivar     Send New Private Message      Edit/Delete Post  Reply With Quote 
thank you ... I am so sorry to have been translating so literally.
From: jordan | Registered: Oct 2002  |  IP: Logged
rosebuds
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posted 09 October 2002 09:47 PM      Profile for rosebuds     Send New Private Message      Edit/Delete Post  Reply With Quote 
Doctors are the most appropriate health professionals to be trained in and provide abortions. Of course, abortion isn't part of the standard medical school curiculum. GPs don't perform them - I think it's actually got to be done by an OB/GYN or a surgeon.

I have always believed that abortions are more available than most of us think. I've never actually heard of someone who needs/wants an abortion not being able to get one. Of course, I am likely wrong, and it's may indeed be my blind faith that allows the disintegration of the service to take place.

Perhaps the more important question lies in the awareness of this service. I wasn't even aware that they were performed at my local hospital and that they were covered by medicare until I needed one. I was fortunate that I didn't have a doctor who presumed I would be overjoyed to be pregnant. There was no need for me to say again and again "I can't have this baby. I can't have this baby". She told me right away what my options were. And she didn't blink an eye when I told her my choice.

It's interesting to have the experience of medical professionals who have issues with abortion, though. Since I had an abortion, the procedure has become part of my chart at the hospital. Therefore, every time I go in (say, for the stomach flu), everyone I deal with knows about it.

For some reason, the stomach flu necessitates some nurse commenting on "that OTHER procedure" I had (nudge nudge, wink wink). Their opinion is obvious, and they find it vital to ensure that I know that THEY know.

It's very awful, and it makes me not want to go to the hospital at all anymore. Yet another price to pay...


From: Meanwhile, on the other side of the world... | Registered: Mar 2002  |  IP: Logged
adlib
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posted 10 October 2002 04:13 AM      Profile for adlib     Send New Private Message      Edit/Delete Post  Reply With Quote 
Having looked into studying midwifery in several provinces, and being generally interested in health issues, I try to keep informed about what's going on.

Zoot- Midwifery is actually fully legalized in Quebec, we also have one of the two midwifery schools in Canada at present. There are very stringent requirements for entry into the program, only 14 students are admitted yearly. The program is very thorough, however I'm not sure whether D&Cs are part of the curriculum. If you really want to know, I can check- I have the course list around here somewhere. At any rate, the midwives are trained in the same OB/GYN courses as the medical students, they just don't take all the same courses.

quote:
Their focus is always healthy pregnancies, safe and joyous deliveries for both mom and babe and post-birth aftercare. Elective abortion is the antithesis of midwifery from what I know of it.

Trinitty- Not at all my understanding of midwifery philosophy. Simply because safe, joyous, and healthy deliveries require prepared, happy moms. Many midwives I know also perform the routine tasks gynecologists do, which includes all aspects of reproductive health- unwanted pregnancies, fertility education, STDs, and pregnancy avoidance. I don't think these are opposite at all- an informed person in charge of their reproductive health is the ideal.

quote:
What is menstrual extraction?

Michelle- I can't vouch for the safety of this procedure, and my knowledge/experience on it is limited. Basically, my understanding is that it is the use of a simple, "gentle" suction instrument to "extract" the contents of the uterus. I think they are sort of hand-pumps, and they are usually sold by the DIY gynecology types.

About what kinds of things a midwife can do for an unwanted pregnancy...
I've assisted friends in the use of herbs, and vitamins, and other means, to bring on their periods or have an abortion.

There are various herbs which can be used because of their different properties as emmenegogues (bring on your period- earlier in the term and gentler) or abortificients (later in the term, more powerful therefore more care must be taken). If anyone wants to know what they are or how to take them, I can be more specific. I don't want to just name them because there's lots of information a user would need to know for them to be safe and effective.

Basically, though, aside from menstrual extraction, the do-it-yourself "abortion" process has to be at least started within the first few weeks to be really effective. Most of my friends who have used those methods have made appointments with a clinic just in case, and then cancelled them when/if they weren't needed.

I think reproductive rights are always in jeopardy, as long as people are denied access to basic information about their own reproductivity, and as long as people in general are taught a medical-model way of viewing their own bodies. More limitations on access is always worse, so are uninformed doctor "experts".


From: Turtle Island ;) | Registered: Jul 2002  |  IP: Logged
swirrlygrrl
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posted 10 October 2002 11:21 AM      Profile for swirrlygrrl     Send New Private Message      Edit/Delete Post  Reply With Quote 
Rosebuds - while in some areas abortions are readily accessible, though not publicized, its really quite frightening to look at the areas of the country that don't have an abortion provider. For example, Alberta lost their abortion provider in Fort McMurray 5 or 6 years ago, the only one north of Edmonton (about the centre of the province), so any woman north of Edmonton had to travel. Southern AB was slightly better but not much - outside Calgary, there was one hospital willing to provide abortion.

The situation is similar in many provinces, and abortion services are almost always clustered in urban areas. Generally speaking, abortion is more accessible the father west and/or south you go in Canada.

And, of course, access is limited by so many other factors outside geography, including class most specifically (love those provinces that don't pay for clinic abortions! and of course there is the cost of getting to a hospital/clinic if it isn't offered in your community) and age is also a big factor, because of lack of information, lack of money, and lack of ability to travel (gee, mom and dad, I have to go to EDmonton for a few days to have an abortion - that goes over real big in a lot of families).

And there have been women in Canada who have been outright denied abortions. Women whose physicians have lied to them, telling them its not legal, or they have to be a certain age (sometimes true), etc. Or they may be mislead by anti-choice pregnancy counselling centres like Birthright.

In most cases of women denied abortions, it isn't a matter of women oublicly being told they can't have an abortion when they demand the option, its the private counselling or misinformation they are given that makes them think it isn't an option, or they resign themselves to the pregnancy because they don't have the money, can't think of a way to get to the hospital/clinic, etc, or by the time they can get all of that together, they are past the term limits set. After all, this is a pretty time sensitive procedure. I had a friend who found out she was pregnant, and when she spoke to her boyfriend about how she wanted to have an abortion, he told her it was illegal in Alberta. I shudder to think if she hadn't trusted her problem to someone who was able to correct her.

CARAL produced a really great paper going over the availability of the procedure in every province a few years back, which you can get a free copy of by calling them, or you can check out the synopsis on their website that gives the situation province by province. Here's the link:

CARAL home page

And (oh this is gettig really long - thanks for reading this far! ) as for menstrual extraction, Michelle's description is fairly accurate - it involves slipping a very thin cannula(e?) into the cervix and using a syringe to create gentle suction to remve the contents of the uterus, be they normal menstrual fluid or the tissue from an early pregnancy. There is a cannister between the two parts to collect the contents.

It's been shown to be safer and easier than a d & c, which carries a higher risk of rupturing things, but then again, this is normally done in far different circumstances (much earlier, in most cases - in most abortion clinics, you must be past a certain date after your last mentstrual period, and before a certain other date at which they establish a cut off, whereas a ME can be done as soon as you think or know you are pregnant). As with other procedures, there is a risk of leaving tissue inside, necessitating another ME or a d & c, and care must be taken to ensure the environment is sterile, and not to damage the cervix.

I personally wouldn't advocate it as a way to alleviate all your periods (its a cervix, not a garage door - all that opening and closing seems as bit scary, but this is perhaps only a prejudice I have), but I would love to see this talked about, mabye even taught.

Oh, and you don't have to be a OBGYN to do an abortion - GPs are fine. All this is regulated by provincial medical associations, which is why midwifes wouldn't be able to.

(Whew!) Sorry for the terribly long post. Probably should have just posted the thesis I wrote on the issue - would have been shorter, and better documented!


From: the bushes outside your house | Registered: Feb 2002  |  IP: Logged
Timebandit
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posted 10 October 2002 01:39 PM      Profile for Timebandit     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
Zoot- Midwifery is actually fully legalized in Quebec, we also have one of the two midwifery schools in Canada at present.

Ah, so glad I am wrong. I thought otherwise, my SIL wanted to have a midwife-assisted delivery with her babies in Montreal (youngest is 9 now), and was told that only OBs could catch babies there. I am nost familiar with Saskatchewan, where I dealt with the prejudices and fearmongering firsthand. And had to scrape up the money for a midwife delivery, as Sask Health refused to pay for it.

I was under the impression that Ontario is the only province where midwives are fully legal and active within the health system (and covered by medicare). My information may be out of date.


From: Urban prairie. | Registered: Sep 2001  |  IP: Logged
angela N
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posted 10 October 2002 03:37 PM      Profile for angela N   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
Are you suggesting that simply 'unleashing the profit motive' will take care of any problems with access to abortion?

It might make a difference; but it would likely mean that instead of women in some areas of the country being unable to get abortions, women anywhere who couldn't afford it would be unable to. Hardly an improvement, indeed a step backwards, away from the widely accepted idea that medical care is for everyone, not just those with money.


Lance, your argument would be valid if abortions were not free.

Canada is one of the very few countries in the world that has NO criminal law restricting abortion at all. Abortions in Canada are paid for by the government (at least in hospitals) All provinces are required to fund clinic abortions - and most Provinces do, with a few exceptions, but access to a hospital abortion is universal here in Canada eh.

In most cases a woman will have her transportation paid for if she needs to travel for the abortion. A lot of these changes have happened since the beginning of the 90s thanks to the vigilant activists, and with the exception of the Maritime's, we have the most progressive system in the world. I agree that we need to continue to keep our ears to the ground, but in this arena, we are doing very well.

My original point was that where there is money to be made, there will be access. Where doctors can make money, they will. Maybe not in a town of 700 people, but then again there are a lot of limitations that arise from having a town of 700 people.


From: The city of Townsville | Registered: May 2002  |  IP: Logged
swirrlygrrl
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posted 10 October 2002 05:56 PM      Profile for swirrlygrrl     Send New Private Message      Edit/Delete Post  Reply With Quote 
Angela N - I'd love to hear more on your positions, as most of the information I have seen contradicts them.

Its true that hospital abortions are reqired to be covered under the government's interpretation of the Canada health Act, but provinces like PEI get around this by simply not having a hospital that will perform a non-emergency abortion. And it is key to note that, across the country, the number of women choosing hospital abortions is falling (perhaps because of issues like those mentioned by rosebuds), and the number of clinic abortions is rising, though hospital still outnumber clinic abortions as I undertand. As well, some provinces (was it Nova scotia or New Brunswick that tried to outlaw freestanding clinics?) are really hostile to clinics, including western one (the fight in SK over freestanding clinics is an interesting case).

As for covering transportation costs, as I understand it, this is a rare service offered by governments, with BC (under the NDP - anyone know if the Libs have taken this away yet?) and ON being some of the only provinces to cover travel costs, and in Ontario I know the Northern Health Travel Grants program only covers, as it implies, people in some of the most northern areas of the province, (I don't think North Bay counts) and even if you qualify, you still have to pay the costs up front and apply for reimbursement later.

As for the money angle, one way governments have been sqeezing providers is through the money paid to physicians for abortions as compared to other services requiring similar skills/time. Every service a doctor does on an insured person in Canada earns them a certain amount of money, depending on the list in the province. As I understand, the payment for an abortion is relatively low, meaning that some physicians who aren't committed to providing the service decide that considering the risks (and harassment from anti-choice operatives can be a key factor here) decide its not financially feasible or productive enough to perform abortions.

Anyhoo, we certainly aren't the worst country in the world on abortion access, and compared to our lovely southern neighbors in the US and their gd Hyde Ammendment, we're a socialist paradise, but I'd say the situation is pretty far from ideal.


From: the bushes outside your house | Registered: Feb 2002  |  IP: Logged
'lance
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posted 10 October 2002 07:14 PM      Profile for 'lance     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
My original point was that where there is money to be made, there will be access. Where doctors can make money, they will.

Doesn't follow at all (or else, given that doctors do receive a government fee for providing abortions, it leaves you with the problem of explaining why so many doctors don't do them, and why so many medical schools don't teach the technique).

swirrlygrrl's comment is persuasive:

quote:
As I understand, the payment for an abortion is relatively low, meaning that some physicians who aren't committed to providing the service decide that considering the risks (and harassment from anti-choice operatives can be a key factor here) decide its not financially feasible or productive enough to perform abortions.

and gets down to cases, i.e. to the details of how the system actually works, instead of falling back on the assumption that money will guarantee access. Obviously, it isn't working.

edited to add:

Can you expand on that Hyde Amendment comment, swirrlygrrl? What exactly is that?

[ October 10, 2002: Message edited by: 'lance ]


From: that enchanted place on the top of the Forest | Registered: Jul 2001  |  IP: Logged
rosebuds
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posted 10 October 2002 07:16 PM      Profile for rosebuds     Send New Private Message      Edit/Delete Post  Reply With Quote 
Swirrlygrrl, thank you for your information and insight. I really appreciate it. You have made yourself clear and corrected me in some of my ignorance, and you have managed to do so without offending! Remarkable!

I must say that I'm quite impressed and pleased that, despite such a sensitive topic and obviously different views, it has not descended into a frenzy of disagreement, accusation, and swearing.

I find it notable, as well, that not many (if any?) of our male posters have weighed in. Do you think, perhaps, it is because their interests only go so far? Or might they just be wary of posting on such a sensitive topic?


From: Meanwhile, on the other side of the world... | Registered: Mar 2002  |  IP: Logged
kate greenaway
recent-rabble-rouser
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posted 10 October 2002 08:45 PM      Profile for kate greenaway        Edit/Delete Post  Reply With Quote 
hello all - i just wanted to say hi and see how the discussion was going... things seem to be getting sorted out just fine!
thot i would explain a couple of things from my end: abortions in canada are often done by family doctors (and aging ones at that). altho' ob/gyns are trained in D&Cs (dilation and curettage) this is a bit different than the usual procedure used by abortion providers. the most common method is manual vacuum aspiration (MVA) wherein the uterine contents are suctioned out. my understanding of "menstrual extraction" is that its a euphemism for abortion.
even tho' our legal situation and our health care system would seem to ensure that a women's choice is, well, her choice, this often doesn't pan out - as some of you pointed out. almost everywhere in canada is under-serviced in terms of abortion providers, only metropolitan areas can meet the demand (if they even can...).
anyway, that's the point of medical students for choice - we want to make sure that women everywhere can access abortion providers when they need them. yep. that's all for now...

From: halifax | Registered: Oct 2002  |  IP: Logged
swirrlygrrl
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posted 11 October 2002 12:57 PM      Profile for swirrlygrrl     Send New Private Message      Edit/Delete Post  Reply With Quote 
As per 'lance's request -

The Hyde Ammendment was passed in 1977 in the US, shortly after abortion was made legal. It was tacked on to another bill, and said that federal funding could not be used to pay for the abortions of women on Medicaid, the health insurance provided by the government to low income people. This in spite of the fact that other pre-natal health services were covered. As such, any state that did wish to cover this service for women who are poor had to do it without federal funds. At the time, the only exception was if the life of the pregnant woman was in danger, though in 1994 it was expanded to allow for women who had become pregnant as a resault of rape or incest. The Supreme Court ruled, in 1980 I believe, that this was constitutional, that because a woman had a right to abortion did not mean that the state was obligated to provide medical coverage of the procedure.

Of course, what this has done is set up a two-tier system of access, whereby women who can pay for their abortions can often (but not always) receive them, and women on social assistance cannot. The very sad thing about this is that middle class women essentially abandoned their poorer sisters, and while there was some outrage over this, it was never strong enough to get it repealed.

And I too am really glad that everyone is being so civil on this thread - maybe we should share the secret with the porn and Israel/Palestine boards!


From: the bushes outside your house | Registered: Feb 2002  |  IP: Logged
'lance
rabble-rouser
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posted 11 October 2002 01:01 PM      Profile for 'lance     Send New Private Message      Edit/Delete Post  Reply With Quote 
Thanks for the information, swirrlygrrl.

Was this amendment moved by the same Henry Hyde who was later to figure in the Clinton impeachment fiasco, I wonder? And has he ever been confused with someone named Jekyll? Inquiring minds!


From: that enchanted place on the top of the Forest | Registered: Jul 2001  |  IP: Logged
josh
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posted 11 October 2002 01:07 PM      Profile for josh     Send New Private Message      Edit/Delete Post  Reply With Quote 
Oui.
From: the twilight zone between the U.S. and Canada | Registered: Aug 2002  |  IP: Logged
janew
webmistress
Babbler # 199

posted 11 October 2002 02:21 PM      Profile for janew     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
hello all - i just wanted to say hi and see how the discussion was going...

Thanks for joining us, Kate!

I don't have a tremendously high regard for doctors/interns on the whole, but the ones like you, who are acting to improve the health care system, are gems.

What do you think of having abortions performed by some kind of paramedic? Would that be possible or do they require more intense medical intervention or equipment?


From: Toronto, Ontario | Registered: Apr 2001  |  IP: Logged
audra trower williams
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posted 13 October 2002 06:36 PM      Profile for audra trower williams   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Or Nurse Practitioners. I love those women.
From: And I'm a look you in the eye for every bar of the chorus | Registered: Apr 2001  |  IP: Logged
swirrlygrrl
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posted 14 October 2002 10:14 PM      Profile for swirrlygrrl     Send New Private Message      Edit/Delete Post  Reply With Quote 
There was a really interesting documentary on CBC radio tonight on midwives. Taught me, who not interested in that whole motherhood thing has a big info gap, a lot. Anyone else catch it?
From: the bushes outside your house | Registered: Feb 2002  |  IP: Logged
audra trower williams
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Babbler # 2

posted 27 January 2005 01:58 AM      Profile for audra trower williams   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Bump!
From: And I'm a look you in the eye for every bar of the chorus | Registered: Apr 2001  |  IP: Logged
Rabelais
rabble-rouser
Babbler # 6230

posted 30 January 2005 06:59 PM      Profile for Rabelais     Send New Private Message      Edit/Delete Post  Reply With Quote 
Last year in our Reprodution unit, we had a brief lecture (1 hour) on birth control and abortion techniques so that we all knew what was meant by the various terms. As far as i know, that's it for our formal training in the first two years of medical school. I think we may get some exposure in our obstetrics/gynaecology rotation in clerkship, though it's probably an elective rotation.

There was some talk last year from our MSFC chapter on organizing a trip to the termination of pregnancy unit at the IWK Grace, but we haven't heard anything this year.


From: Halifax, Nova Scotia | Registered: Jun 2004  |  IP: Logged
audra trower williams
rabble-rouser
Babbler # 2

posted 31 January 2005 03:56 PM      Profile for audra trower williams   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Hey, you should email me. I might be able to get MS4C some local coverage. Also, do you know Kate, who the article is about?
From: And I'm a look you in the eye for every bar of the chorus | Registered: Apr 2001  |  IP: Logged

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