The illusion of choice: Canadian women stonewalled when it comes to reproductive rights
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The illusion of choice: Canadian women stonewalled when it comes to reproductive rights

Last Updated Jun 19, 2019 at 12:43 pm MDT

Summary

Doctor says women should be getting referrals, not stonewalled

‘What would your husband say?’ Women say doctors offering sexist, old-fashioned comments and questions

Doctors who refuse to provide information should lose their licenses: prof

EDITOR’S NOTE: Some names have been changed to protect the women who wanted to stay anonymous.

CALGARY – “‘You’re not going to find a doctor who’s going to be willing to do this. You’re too young,’”

When Emily was 25 years old, she claims doctors first started telling her she could not have a uterine ablation or hysterectomy.

She started menstruating at a young age and claims there are several severe side effects as a result. She missed time during elementary school as she became anemic. She suffers from some complications because of a blood condition, mostly leaving her feeling weak and fatigued, but they could in rare circumstances kill her.

Emily is one of several women speaking out about a lack of control over their own reproductive rights. The conversation has recently been reignited as Canadians watch legislators in the U.S. reopen the abortion debate.


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“I don’t understand why I have to suffer like this for the next 30 to 40 years,” Emily lamented.

When she went to doctors to look for a more permanent solution she was met with a sentiment many women have heard.

“‘You might change your mind.’ I countered with, ‘Why am I able to make the decision to have children–which is permanent–but I’m not able to make the decision to not have children?’”

READ MORE: Women recount struggles in seeking permanent birth control

The rules across the country vary, but Dr. Mike Caffaro with the College of Physicians and Surgeons of Alberta says there are common links in how doctors in each province deal with cases like this.

“Our standards of practice are fairly clear. If a patient comes in and is requesting, let’s say a vasectomy or tubal ligation, you know, obviously there should be a conversation between attending primary care provider, the family doctor, and that patient about the pros of that procedure the cons of that procedure, whether it fits well with other considerations for that patient,” he explained.

“But at the end of the day, if the patient is saying, ‘I think this is the best course of action for me,’ the primary care provider, the family physician, is expected to provide the appropriate referral of that.”

He does note there are options for doctors who do have a conscientious disagreement with a patient.

“That’s not the physician’s decision to make–it is the patient’s… Our job as physicians is to connect that patient with the individual colleague who can provide that service. We certainly have guidance to physicians who feel uncomfortable. If they conscientiously object to considering that sort of procedure for someone who, in their eyes, is young or hasn’t had enough children or whatever, well, that’s okay. But the conscientious objection guidance says you refer that patient on to a colleague who can then talk to them and possibly provide them that procedure.”

Recently, Ontario’s highest court ruled doctors in the province must give referrals for medical services they are unwilling to provide.

RELATED: Doctors must give patients referrals for services they oppose, says Ontario appeal court

Marina is a mother of three. When she went to a doctor to find a permanent solution for birth control, she was astonished to find resistance. While shorter-term birth control is an option for some women, she is left in pain because of the hormones involved with the pill.

They didn’t even offer a referral, she says.

“If I wanted an abortion I could get that, but if I want to prevent a pregnancy I can’t and there’s just something very broken about that,” she said.

Marina says after bouncing between resistant doctors over a handful of years, she’s too emotionally exhausted to go back.

“I don’t want to have to keep jumping through hoops and keep getting frustrated by it. It’s just too frustrating.”

‘What would your husband say?’ Women say doctors offering sexist, old-fashioned comments and questions

Amanda F. claims doctors seem to think women will change their mind and their husbands’ opinion is more important than hers.

“It just kind of seems [like I’m] to be dismissed in favour of a potential husband who could make me change my mind about wanting to have children in the future,” she said.

“No one has really ever wanted to actually try and find out why I would be seeking something more permanent… We’re not allowed to take that a step further if we have no interest in pursuing that life for ourselves.”

Janet was told something similar when she asked for an intrauterine device (IUD), a long-term but still temporary form of birth control.

“[The doctor said] it’s not really a birth control option for me, being that I was an unwed person who never had children before and that I should not be pursuing that form of birth control at this time,” she said.

“It was a very, kind of patriarchal way that I was treated–but it wasn’t even discussed [further].”

Melissa had a difficult first pregnancy and after she found her family in a less-than-ideal financial situation, she went to the doctor to seek out permanent birth control. Her husband tagged along.

She says what she was expecting to be a productive conversation turned offensive when the doctor assumed she didn’t understand that what she was asking for was permanent. Then, to top it off, she says the doctor turned away from her to hear what felt like a more important opinion.

“He asked my husband if he was okay with not having any more children. And for me, this is just not what this appointment was about,” she said, adding she felt the question was insulting and rude.

“It was medically necessary for me to not be in pain and he still asked my husband if he didn’t want to have any more children.”

Doctors who refuse to provide information should lose their licenses: prof

These questions from doctors are particularly frustrating for University of Calgary Women’s Studies professor Rebecca Sullivan.

“What if your husband wants kids?” She scoffed. “[Doctors] are not marriage counsellors.”

She says these questions go back to a deeply-rooted idea that women are still property, an idea that beckons back to a long history of how women have been treated.

RELATED: It’s a long story: The history of birth control in Canada

“They can’t control our health decisions, but they sure as heck seem to want to when it comes to women and pregnancy.”

Sullivan says there are very few reasons that a doctor should be refusing any service to a patient.

“We need to recognize, fundamentally, the rights of all people over their reproductive and sexual status. And as long as it is safe and ethical and consensual, then there should be no question. But there is a constant question about whether or not we can allow certain members of the population–and in this instance, it’s for the most part women, but also trans people–are denied bodily sovereignty,” she said.

“They’re denied authority over their own bodies and that just needs to stop.”

And of physicians who refer patients to other like-minded doctors who give the same dead-end responses, Sullivan calls it an abuse of the system.

“That’s abuse. You’re asking for so much time, energy, emotional labour. You know, that is damaging to the mental health and well-being of a person who has a right to the information and is being stonewalled and denied their right,” she bemoaned.

“Any doctor who refuses to provide information on a safe and legal procedure should lose their license.”

-Diana Pereira, Lauren Boothby, and Justin Slimm contributed to this report 

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In 2003 I had the same experience with a doctor when I wanted a tubal ligation.
Said I would change my mind and want a reversal, I was 37 at the time and did not want to even think about starting a family in my 40’s. I did not have a great experience with him, when it was my choice and I knew I would never change my mind.

June 11, 2019 at 10:24 am