Barriers to Abortion Access

A woman waiting on a train platform as the train pulls in
While access to abortion has improved in many regions in recent years, many people in Canada experience persistent barriers to accessing it. Not everyone is impacted the same by these barriers, with those most marginalized experiencing the most obstacles to accessing care.
When there are many barriers, being able to get an abortion can be out of reach for many people. Some are only able to access an abortion after significant delays, or by spending hundreds or even thousands of dollars out of pocket. Others are forced to carry unintended pregnancies to term, which has devastating impacts on pregnant people, their families, and their communities.
There are abortion rights organizations and grassroots groups that provide information, resources, and support for people seeking an abortion, but these services are very limited and cannot adequately fill the gap of abortion access in Canada.

What are the most common barriers to abortion care in Canada?

These obstacles can overlap and build on each other, making accessing abortion in a safe and timely way even more challenging.

Who faces barriers to abortion in Canada?

People who have access to money, freedom of movement, job security, and practical support can often manage barriers such as having to travel and/or pay for their abortion.
For people who are already dealing with other barriers in their everyday lives, the process of getting an abortion can look like an impossible obstacle course. Roadblocks to accessing medical care are not individual failings. Rather, they demonstrate that our healthcare systems are exclusionary and that not everyone is meant to be served the same way.
Factors that disempower people often overlap, leading to further vulnerability. Below is a brief summary of some groups who experience greater barriers to access. People who belong to multiple groups experience increased negative impacts.
Four women facing away from the camera, with their arms around each other's backs

What about gestational age limits?

Since abortion is decriminalized, there are no laws limiting care based on gestational age.
However, many other factors affect the availability of abortion care at different gestational age limits. The combination of these factors means there are functional – not legal – gestational age limits for abortion care in every province and territory. These factors include:

What are some other barriers to access?

There are also several barriers related to mental health that can impact access to abortion care and can make accessing abortion more complex.

Belief-based care denial

Although abortion is an essential component of reproductive health care, physicians and nurse practitioners can refuse to provide abortion care due to their personal values or religious beliefs under current laws and regulations. This practice is often referred to as “conscientious objection,” although a more accurate term may be “belief-based care denial.”
Physicians who refuse patients care due to personal values or beliefs are not obligated to provide a referral in many provinces and territories, but nurse practitioners are. Denying timely access to abortion care has undeniable social and health consequences.
A young woman wearing a fairy outfit at a protest holds a sign that says "Abortion is Healthcare"

Want to learn about belief-based care denial in your province or territory?

Access to abortion after 20 weeks

In Canada, the majority of abortions happen in the first 12 weeks of pregnancy.28 That said, ensuring access to abortion care after the first trimester is crucial for advancing reproductive health equity. Many barriers to abortion access can prevent a person from accessing care earlier in their pregnancy. Delays can be caused by:

  • The lack of available services nearby
  • Not having access to a transportation
  • The inability to pay for travel costs or needing more time to save money
  • Not having access to paid leave or the risk of losing a job if time off is taken
  • Experiencing family or intimate partner abuse where the ability to make and attend appointments can be limited

People who are experiencing homelessness, severe drug addiction, who are undocumented or uninsured, or who face constant emergencies because of single parenthood, poverty, or family violence are also all more likely to have difficulty accessing timely care. People should not be denied their right to make informed and autonomous reproductive choices because of the stage of pregnancy, especially since those who have been delayed are often in vulnerable and precarious circumstances. However, these are the people who are most often denied their right to abortion and bodily autonomy when access to abortion services after the first trimester is limited.

Because of limitations to residents of certain regions, as well as overwhelming demand while being severely under-resourced, there is low availability of abortion care after 20 weeks in Canada. This increases the likelihood that those who are already vulnerable and have less resources will face increasingly complex logistical issues, more out-of-pocket expenses, farther travel distances, and longer wait-times. This in turn results in delays which increase the likelihood of being denied an abortion and therefore, being forced to carry an unwanted pregnancy to term.

In recent years, a number of hospitals in Canada have started to offer abortion services after 24 weeks. Prior to this, people in Canada had to travel to the United States to access services after that functional gestational time. 

Every year, it is estimated that hundreds of people travel across the border to access services that are unavailable in Canada despite being covered by universal healthcare.29 Accessing care in the United States is still the most accessible option for many people seeking abortions over 24 weeks, though the Dobbs decision that reversed Roe v. Wade and the subsequent banning or severe restriction of abortion in over half the states has overwhelmed the points of services where Canadians travel to for care. 

While provinces are required to cover the procedure costs of all medically necessary services, including abortion care, delivered outside of Canada, not all provinces have the infrastructure and processes necessary to do so. Traveling outside of Canada to access care is often limited to those with the means and ability to travel. In practical terms, this excludes undocumented people or migrants without the authorization to travel, those needing visas, people with severe mental illnesses, those who have criminal charges, many people needing to carry methadone or with severe addiction, youth, people in abusive relationships, and other vulnerable individuals.

The impacts of being denied an abortion

When a person isn’t able to access an abortion that they want and need, they become more likely to experience worse financial, health, and family outcomes.30 These outcomes have been well-documented in the Turnaway study. A person who is denied an abortion is at higher risk of:

  • Experiencing economic hardship and insecurity that lasts for years
  • Staying in contact with a violent partner 
  • Suffering from more serious and long-lasting health problems 

The negative impacts of abortion denial also affect families and communities. Children born as a result of abortion denial, as well as any existing siblings they have, experience worse child development and financial outcomes.

Being able to access abortion is crucial to the health and wellbeing of individuals, their families, and their communities.


1 Sethna, C., & Doull, M. (2013). Spatial disparities and travel to freestanding abortion clinics in Canada. Women’s Studies International Forum, 38, 52–62.

2 Sorhaindo, A. M., & Lavelanet, A. F. (2022). Why does abortion stigma matter? A scoping review and hybrid analysis of qualitative evidence illustrating the role of stigma in the quality of abortion care. Social science & medicine (1982), 311, 115271. Advance online publication.

3 Ennis, M., Renner, R. M., Olure, B., Norman, W. V., Begun, S., Martin, L., Harris, L. H., Kean, L., Seewald, M., & Munro, S. (2023). Experience of stigma and harassment among respondents to the 2019 Canadian abortion provider survey. Contraception, 124, 110083.

4 LaRoche, K. J., & Foster, A. M. (2015). Toll free but not judgment free: evaluating postabortion support services in Ontario. Contraception, 92(5), 469–474.

5 Rudrum, S. (2022). Student Encounters with a Campus Crisis Pregnancy Centre: Choice, Reproductive Justice and Sexual and Reproductive Health Supports. Canadian Journal of Sociology, 47(1).

6 LaRoche, K. J., & Foster, A. M. (2015). Toll free but not judgment free: evaluating postabortion support services in Ontario. Contraception, 92(5), 469–474.

7 Bombay, A., Matheson, K., & Anisman, H. (2009). Intergenerational trauma: Convergence of multiple processes among First Nations peoples in Canada. International Journal of Indigenous Health, 5(3), 6-47.

8 Ibid

9 Silverman, J. G., & Raj, A. (2014). Intimate Partner Violence and Reproductive Coercion: Global Barriers to Women’s Reproductive control. PLOS Medicine, 11(9), e1001723.

10 Assifi, A. R., Kang, M., Sullivan, E. A., & Dawson, A. J. (2020). Abortion care pathways and service provision for adolescents in high-income countries: A qualitative synthesis of the evidence. PloS one, 15(11), e0242015.

11 The Health of LGBTQIA2 Communities in Canada: Report of the Standing Committee on Health. (2019). In House of Commons of Canada.

12 Access for Everybody: Disability inclusion in abortion and contraceptive care. (2018). Ipas. 

13 Gleason, J. L., Grewal, J., Chen, Z., Cernich, A. N., & Grantz, K. L. (2021). Risk of adverse maternal outcomes in pregnant women with disabilities. JAMA Network Open, 4(12), e2138414.

14 Lee, J., & Pausé, C. (2016). Stigma in practice: Barriers to health for fat women. Frontiers in Psychology, 7.

15 A Reflection on BMI Limits. (2021). Choice in Health Clinic.

16 CityNews. (2021, November 22). 

17 Paynter, M. J., & Norman, W. V. (2022). The Intersection of Abortion and Criminalization: Abortion Access for People in Prisons. Seminars in reproductive medicine, 40(5-06), 264–267.

18 Paynter, M., Hernández, P. P., Heggie, C., McKibbon, S., & Munro, S. (2023). Abortion and contraception for incarcerated people: A scoping review. PLOS ONE, 18(3), e0281481. 

19 Ibid

20 Procedural Abortion Care for People in Prison in Canada. (n.d.). Wellness Within.

21 Paynter, M., & Heggie, C. (2023). Identifying abortion access barriers and facilitators for people in prison in Canada. 45(5): 364.

22 Stern, C. (2021, May 8). Why BMI is a flawed health standard, especially for people of color. Washington Post.

23 Gordon, A. (2021, December 12). The bizarre and racist history of the BMI - elemental. Medium. 

24 Mishra, K., & Floegel-Shetty, A. (2023). What’s wrong with overreliance on BMI? AMA Journal of Ethics, 25(7), E469-471.

25 Tomiyama, A. J., Hunger, J. M., Nguyen-Cuu, J., & Wells, C. (2016). Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005–2012. International Journal of Obesity, 40(5), 883–886.

26 Stern, C. (2021, May 8). Why BMI is a flawed health standard, especially for people of color. Washington Post.

27 Canadian Policies and Laws on “Conscientious Objection” in Health Care. (2023). In Abortion Rights Coalition of Canada.

28 Induced Abortions Reported in Canada in 2021. (2023). Canadian Institute for Health Information.

29 Connolly, A., & Browne, R. (2019, May 28). How the wave of U.S. restrictions will affect Canadian women sent there for abortions - National | Global News.

30 The Turnaway Study. (n.d.). ANSIRH.

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