Any New Brunswick resident who holds a valid Medicare card can be prescribed Mifegymiso through the Medical Abortion Program. The Medical Abortion Program covers the full cost of Mifegymiso. However, prescriptions can only be filled at participating providers, which means that prescriptions filled at private clinics are not expected to be covered.
Billing code
Billing codes are used by physicians to bill provincial/territorial health insurance plans for the different services that they provide. When there isn’t a billing code for medical abortion, physicians can be de-incentivized from providing it.
Telemedicine abortion has been found to be as safe and effective as medical abortions provided at clinics. Because telemedicine abortion allows patients to access care in their homes and often requires just one trip to a pharmacy or clinic, expanding its availability is critical to improving abortion access for people who live in rural communities, who can’t take time off work to go to appointments, or who are at risk of stigma or discrimination.
Telemedicine is listed in the New Brunswick Physician’s Manual. Payment of telemedicine services is limited to services provided in facilities approved by the Department of Health.
The College of Physicians and Surgeons of New Brunswick’s Professional Standards on Virtual Care encourage physicians to utilize virtual care when it is in the best interest of the patient.
Legislation, policies, and regulations
Regulation 84-20
From 1984 – 2024, Regulation 84-20 excluded abortion from provincial Medicare coverage unless it was performed at a hospital facility approved by the jurisdiction in which the hospital facility is located. This means that patients had to pay out-of-pocket for abortion care received at a clinic – a direct violation of the Canada Health Act.
In 2021, the Canadian Civil Liberties Association (CCLA) launched a legal challenge to restrictions under Regulation 84-20 of the Medial Services Payments Act that prohibited funding of abortion care outside of hospital settings, deeming clinical abortions to be non-essential services. In November 2024, the Government of New Brunswick amended the law, removing the legal barrier restricting funding for surgical abortions outside of hospitals.
During the 2024 announcement, Premier Susan Holt said that this amendment was the first step and that it would take time and collaboration to make procedural abortion services available outside hospitals in New Brunswick.
Access to abortion for minors
Under the Medical Consent of Minors Act, minors over the age of 16 have the same right to consent to health care treatment as a person who has reached the age of majority (19 years) in New Brunswick. If a minor is younger than 16 years of age, they may make their own health care decisions if, in the opinion of a legally qualified medical practitioner, they are capable of understanding the nature and consequences of the treatment and the treatment is in their best interests.13
Bubble zone legislation
Bubble zone legislation aims to prevent anti-abortion protestors from harassing people within the vicinity of a facility that provides abortion care. Even though criminalizing individual people will not effectively curb the larger anti-abortion movement, these laws can be effective in deterring anti-choice protestors from harassing providers and patients entering and exiting abortion clinics.
Currently, New Brunswick does not have any bubble zone legislation. However, federal Bill C-3, which makes it illegal to intimidate healthcare workers and patients or obstruct them from providing care or seeking treatment at locations where healthcare services—including abortions—are delivered, applies.
In May 2017, the Chaleur Regional Hospital in Bathurst New Brunswick was granted a permanent injunction against protesters by Court of Queen's Bench Justice Reginald Leger. The injunction bans protesters from demonstrating anywhere on the hospital grounds.
Belief-based care denial
Although abortion is an essential medical service, physicians and nurse practitioners can refuse to provide abortion care due to their personal beliefs under current legislation and policies set by regulatory bodies. This practice is often referred to as “conscientious objection,” although a more accurate term may be “belief-based care denial.”
Physicians
The College of Physicians and Surgeons of New Brunswick has a Code of Ethics and Moral Factors and Medical Care guideline that offers directives in cases of belief-based care denial. According to these guidelines, a refusal to provide care must be communicated to the patient, along with information to make informed decisions about their care, and timely access to another physician or resource that will provide accurate information about all available medical options. The responsibility to provide information does not constitute an effective referral.
Nurse practitioners
The Nurses Association of New Brunswick has a practice guideline called Duty to Provide Care that obligates nurses to work with their organization or employer to ensure uninterrupted care for their patients, and if needed, safe transfer to another provider in cases of belief-based care denial. It also instructs nurses to provide safe care to patients in situations involving imminent risk or death or serious harm.
The guideline also instructs nurses to:
Listen and, when possible, explore the client’s reason for the request or refusal
And their understanding of options that could meet their needs;
Do not attempt to influence or change the client’s decision based on the nurse’s conscientious objection;
Do not allow their beliefs or values to alter or interfere with a client receiving safe, competent, and ethical care;
Ensure that the most appropriate person within the organization is informed of the conscientious objection well before a client is to receive (or not receive) the requested/refused treatment or procedure
A New Brunswick specialist must submit a reimbursement application to New Brunswick Medicare and receive prior approval in order for the patient to be eligible for reimbursement. Approval is based on whether New Brunswick Medicare considers the treatment to be “reasonable and appropriate in the circumstances.”
If approved, the Medical Services Payment Act states that patients must submit their claim for reimbursement within twelve months after the date they received care. The amount payable is limited to the negotiated rate.
Travel support
Travel and accommodation fees are not covered by New Brunswick Medicare for out-of-country services.
Dr. Morgentaler's clinic was closed following an amendment to the Medical Act where physicians found performing abortions outside an approved hospital by the Minister of Health will be guilty of professional misconduct. The New Brunswick Court of Queen’s Bench found the amendments unconstitutional as they were beyond the jurisdiction of the New Brunswick government. The court also highlighted that the New Brunswick government aimed to prohibit abortions outside hospitals “with a view to suppressing or punishing what [it] perceived to be the socially undesirable conduct of abortion”.
In 2003, Dr. Morgentaler's challenged the constitutionality of Regulation 84-20, which stated that an abortion does not qualify as an “entitled” service unless: (1) two medical practitioners certify in writing that it is “medically required”; and (2) it is performed in an approved hospital facility by a specialist in the field of obstetrics and gynecology. The province challenged Dr. Morgentaler’s standing to bring the case, but he was granted public interest standing. The province appealed this decision in 2009, and the appeal was dismissed. However, by then Dr. Morgentaler decided not to continue with the suit.
7 Carmichael, B., Godfrey, A., Russell, P. H., Rosemary Cairns Way, Doucet, M., Whyte, J. D., A Wayne MacKay, Stratas, D., Daly, P., Coady, J. M., Lewans, M., Feldthusen, B., Dylan, D. W., Hughes, J., Vallance, K., Ginn, D. E., LaBoissonnière, L., Mercer, K., Robertson, J. T., & Heckman, G. P. (2017). University of New Brunswick Law Journal. University of New Brunswick Law Journal, 68, 1. https://www.canlii.org/en/commentary/doc/2017CanLIIDocs175#
50%urban points of service |50%rural points of service*
51% urban population |49% rural population*
5 known points of service per 155,000 women of reproductive age*
6unregulated pregnancy centre(s)*
5publicly listed point of service offering both medication and procedural abortion*publicly listed points of service*
4point(s) of service for medication abortion
3point(s) of service for procedural abortion
Functional gestational limit of16 weeksFunctional gestational limit of16 weeks*
Information about abortion is available on aprovincial/territorial website
Information about abortion is not available on the provincial/territorial website
