Clinics offering abortion care can be found on the Government of Quebec’s website (in French only), however many individual listings are out of date with incorrect information.
Information about abortion is not available on the provincial/territorial website
Anyone enrolled in Quebec’s RAMQ public health insurance plan or a Quebec private insurance plan can receive Mifegymiso with full cost coverage.
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.
Quebec’s Physician's Manual includes billing codes for medical abortion.
Telemedicine
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.
Physicians in Quebec must apply for a “special authorization” from the Collège des médecins du Québec in order to practice telemedicine in Quebec. In-person and virtual care are billed at the same rate.1 However, existing barriers have resulted in Quebec having a low proportion of telemedicine providers.2
Legislation, policies, and regulations
Access to abortion for minors
Under the Civil Code of Québec, minors under 14 years of age are required to get parental consent for medical treatment, including abortion. The decision must take into account the minor’s options and must be made in their best interest. If a minor and their parent(s) or guardian(s) disagree on the decision to make, a local community services centres (CLSC) worker can be consulted to help them. If they are unable to reach an agreement, the court might be called upon to intervene and determine a decision.3
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.
Bill 92, which was passed on December 7, 2016, establishes a 50 metre bubble zone around facilities or premises providing abortion care in Quebec. The law prohibits impeding access to a place where health or social services are provided, and demonstrations in the vicinity of places where voluntary abortion services are offered.
The following is forbidden within 50 metres from abortion facilities:
Attempt[ing] to dissuade a woman from obtaining such a service or contest or condemn her choice of obtaining or having obtained the service; or
Attempt[ing] to dissuade a person from providing, or from participating in the provision of, such a service or contest or condemn the person’s choice of providing, or participating in the provision of, such a service or working in such a place
Anti-abortion protesters who violate the "security perimeter" will be subject to a fine of $250 to $1,250. Those who, in addition, "threaten or intimidate a person who goes" to a clinic that provides abortions will incur a doubled fine of $500 to $2,500.
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
Physicians in Québec must “offer to help a patient find another physician” in cases of belief-based care denial, as per the Code of Ethics of Physicians. However, the directive to “offer help” is vague and the ambiguity may cause refusers to interpret the Code as not requiring an effective referral.
The Code also specifies that a physician must disclose their own personal convictions with a patient if those convictions prevent the physician from prescribing or providing professional services, and that they must inform the patient of the possible consequences of not receiving those services.4
Nurse practitioners
Quebec’s Code of ethics of nurses does not address belief-based care denial explicitly, but includes directives that suggest nurses must provide care to patients despite any personal or religious beliefs they might have:
A nurse shall fulfill her or his professional duties with integrity.
A nurse shall subordinate her or his personal interest to that of her or his client.
A nurse shall safeguard her or his professional independence at all times. In particular, a nurse shall practise [their] profession with objectivity and disregard any intervention by a third party that could affect the performance of her or his professional duties to the detriment of the client.
A nurse may not refuse to collaborate with health professionals engaged in providing care, treatment or services necessary for the client’s welfare.
Portability
Québec residents who access abortion care in another province or territory are only reimbursed at the rate of abortion costs in Québec. This means that residents are responsible for paying for any amounts above the Québec rate out-of-pocket. Quebec's approach contravenes the Canada Health Act: "Physician services received by Quebec residents when out-of-province are not reimbursed at host province rates, which is a requirement of the portability criterion of the Canada Health Act.”5
The Québec Health Insurance Plan issues reimbursements at amounts not exceeding Québec rates for insured medical services acquired outside the province, with patients being responsible for paying fees that exceed standard rates of equivalent services offered in Québec.
In Quebec, doctors practicing in private clinics who performed a specific number of abortions had their fees significantly reduced. Consequently, under pressure, these private clinics charged patients additional fees for abortion services to recoup the costs. The Association pour l’accès à l’avortement filed a class action lawsuit against the Quebec government to recover these additional fees paid by patients. The Quebec Superior Court held that the Government of Quebec must reimburse patients who underwent abortion procedures in private clinics and paid extra fees between 1999 and 2006.
2 Renner, R. M., Ennis, M., Kyeremeh, A., Norman, W. V., Dunn, S., Pymar, H., & Guilbert, E. (2023). Telemedicine for First-Trimester Medical Abortion in Canada: Results of a 2019 Survey. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 29(5), 686–695. https://doi.org/10.1089/tmj.2022.0245
50%urban points of service |50%rural points of service*
81% urban population |18% rural population*
59 points of service per 1,783,510 women of reproductive age*
10unregulated pregnancy centre(s)*
59publicly listed point of service offering both medication and procedural abortion*publicly listed points of service*
55point(s) of service for medication abortion
54point(s) of service for procedural abortion
Functional gestational limit of25 weeksFunctional gestational limit of25 weeks*
Information about abortion is available on aprovincial/territorial websiteClinics offering abortion care can be found on the Government of Quebec’s website (in French only), however many individual listings are out of date with incorrect information.
Information about abortion is not available on the provincial/territorial website
