Exploring women’s healthcare in Revelstoke

This story first appeared in print in the July issue of Revelstoke Mountaineer Magazine.

It’s rare the stories I’m tasked with contain controversial subjects. The truth is, however, if we’re going to have a conversation about women’s healthcare, then we need to talk about abortion. Because, despite abortion’s legal status Canada, it remains an emotionally charged topic with people firmly camped in one of two beliefs: either you are pro-choice or you are not.

The idea behind this story began innocuously enough: a conversation about recent changes to abortion laws in the U.S. leads to a request that I explore how well Revelstoke is doing when it comes to women’s healthcare. In truth, Revelstoke’s care providers seem actively engaged in ensuring a wide-range of women’s healthcare services, including both medical-model and alternative care options. Dr. Cam MacLeod, Selkirk Medical Group’s managing associate, tells the Mountaineer Revelstoke’s physicians consider women’s health an integral part of their practice. Certainly there are gaps, many of which are likely correlated to the fact that, from a medical-care perspective, Revelstoke is a smaller centre.

“As primary care physicians we all have experience with a large range of women’s health issues and would feel very comfortable discussing these topics with our patients in a safe and confidential environment,” said MacLeod. “When confronted with a problem outside of our scope of practice, we would all feel equally obliged to refer and co-ordinate care with colleagues and/or specialists and act as advocates on behalf of our patients.”

Vernon-based obstetrician and gynecologist Dr. Nick Half has recently begun travelling to Revelstoke on a regular basis, providing outpatient specialist consultation and surgical services in addition to providing continuing education to local physicians.

“It will be great for Revelstoke women to have the option of specialist care in Revelstoke. With that said, where planned surgeries require resources above and beyond what can safely be provided at our small hospital, patients will at times be required to travel to Vernon,” MacLeod said.

Over the past year, Revelstoke care providers have begun to focus on available maternity options, working towards optimizing accessibility, communication and follow-up care. Katherine Brown, Revelstoke Health Services Development Project Manager, said locally there are eight physicians providing maternity services in two groups of four.

“[It’s] a care model that helps to ensure patients are able to develop a relationship with the physician who will ultimately be present for their delivery,” said Brown.

Safety concerns, misinformation and myths continue to create barriers around the topic of abortion

When it comes to women’s health, pregnancy is a safe and socially acceptable subject matter to speak about. So too are carefully worded discussions about mammograms and contraceptives, and maybe a paragraph or two talking about menstruation or menopause. From a comprehensive perspective, however, abortion is a part of women’s healthcare. So why am I met with resistance when I ask local care providers to speak about available abortion services?

Cheryl Davies, chief operating officer of BC Women’s Hospital + Health Centre tells me that in spite of the many years of advancement in this area of women’s health there are still stigmas, misinformation and myths that continue to exist around the topic of abortion. She shares that the concerns care providers in smaller centres have when it comes to speaking publicly about abortion are extremely valid.

“The reality is there are often anti-choice people who are trying to get at information, and so often care providers are very cautious about people approaching them for information because they’re not sure what their intentions are,” said Davies.

At present, both medical and surgical abortions remain legal in Canada. In July 2018, the BC Ministry of Health announced it would provide universal, no-cost coverage for Mifegymiso, more commonly known as the abortion pill. Pharmacists are able to dispense Mifegymiso to patients with a valid prescription, which can be obtained by visiting a physician or nurse practitioner. Davies said women’s increased accessibility to the abortion pill, which can be used to terminate pregnancies up to nine weeks from the start of the last menstrual period, means it’s less likely for women or girls to rely on surgical services, which are typically delivered in a hospital or clinic setting. From a statistical point of view, Davies said more than 90 per cent of abortions performed within the province are done early on, with few complications. Late-term abortions are typically only done for more serious reasons, with women needing to access specialist services.

Currently, there is legislation in place providing protection not only for care providers, but also women, by preventing acts such as taking photographs or harassing people around places where abortion services are provided. However, Davies said while the legislation has been helpful in reducing violent-related acts against abortion services, there is still a stigma and concern over psychological harassment and social ostracism that can occur, particularly for medical practitioners in smaller communities.

“The objective risk of physical harm and safety is low, but it’s still important to respect providers who prefer to be low key and not identified,” said Davies “There are other providers who like to take on the role of advocacy on behalf of the provider community.”

It’s understandable then, that I am only able to elicit a brief and careful response from a local care provider after offering anonymity. The local practitioner I’m able to connect with shares that Revelstoke care providers have a strong belief in supporting their patients around what is an emotionally charged issue.

“All of our doctors will ensure that women have access to the information they need to make informed decisions around pregnancy termination, will ensure that they understand the various topics available at the different stages of pregnancy, and will facilitate the connections with the required services and follow-up,” the care provider wrote in an email to the Mountaineer. “We’d encourage all women confronting issues around abortion to seek the assistance of a family physician. If their own family physician is not available, any of our doctors would also be happy to see them through our walk-in clinic.”

Locally, women can also seek out information from the Options for Sexual Health (OPT) weekly drop-in clinic. OPT’s website, optionsforsexualhealth.org, also provides information and resources about abortion and other women’s health topics. In addition, The Pregnancy Options Line: 1-888-875-3136 provides information, resources and referral for all abortion services, including counseling. The Sex Sense Line: 1-800-739-7367 is a service offering general sexual and reproductive health information, as well as referral resources.