Abortion rates remain stable in Ontario despite global spike

Abortion rates remain stable in Ontario despite global spike

A new study found that unlike countries in the United Kingdom and Europe, abortion rates in Ontario, Canada, did not respond from 2020 to 2022.

After decades of declines in almost all high-income settings, abortion rate trends reversed in many countries between 2020 and 2022. For example, 2022 and 2023 recorded the highest abortion rates in Scotland, England and Wales.

Researchers from the University of British Columbia and ICES found that after accounting for changes in abortion rates when abortion medication was introduced in Ontario in 2017, abortion rates in Ontario were fairly stable through 2022.

Canada has been well-positioned to seamlessly continue abortion services through the pandemic, with policies supporting primary care and telemedicine abortion care since 2017. “

Dr. Laura Schummers, lead author and assistant professor of health outcomes, collaboration for outcomes and evaluation at UBC

Abortion trends from 2012 to 2022

Long-term abortion rates fell in 2016 and were highest for those younger than 25, while rates for those ages 30 to 44 remained stable.

Rates then rose slightly between 2017 and 2020 when mifepristone became available, followed by a decline during the Covid-19 pandemic in 2020 and 2021. In 2022, the abortion rate returned to the pre-pandemic trend and continued to increase gradually.

The population-based cohort study examined all medications and procedural abortions provided to women (biological sex at birth) aged 15 to 44 years from 2012 to 2022. Connected health data at ICES was used to report patient primary care, outpatient, same-day, and pharmacy prescription use.

This research found steady gains in the percentage of abortions provided by medication, accounting for more than 50% of abortions in Ontario by 2022.

One limitation of the study is that “pregnancy intention”—an individual's self-reported desire or plan to become pregnant—is not available in health administrative data, meaning that underlying trends in the treatment of unintended pregnancy may not have been captured.

Canadian policies may affect abortion rates

The study notes that the abortion rate reported in some settings from 2020 to 2023 may be due to declining use of the most effective contraceptive methods. "If declining contraceptive use is due to misinformation or disinformation, such as through social media or concerns about the cost of living, these future rates may be impacted in Canada," Schummer said. "If spike rates elsewhere are due to reduced access to contraception or increased access to abortion, Canada's unique policy and service environment means we are unlikely to see similar trends in Canada."

Policies to improve access to contraception are being rolled out across Canada, including universal free contraception through the Federal Pharmacare 2024 legislation. Over time, this may mean we see declining abortion rates.

But the researchers note that it remains to be seen whether the socio-cultural forces driving increased abortion rates in some countries in future years may lead to a precipitous increase in Canada.

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