The One Policy Change That Made Abortion Way Easier to Access

AbortionHistory

May 12

We talk a lot about the barriers to abortion care. They are many and multifaceted in their intersectionality, and this entire project exists because regular people struggle for find the care they need.

Across the country, and here in Alberta, people still run into delays, confusion, and outright denial when trying to access abortion care. Not because of a single overarching law, but because of a thousand smaller barriers like provider hesitation, stigma, and inconsistent systems.

But there is one policy shift that has quietly made a measurable difference.

And it’s almost boring in its simplicity.

Self-referral.

Wait, What Is Self-Referral?

Self-referral means you don’t need a doctor to send you somewhere to get abortion care.

You can just…walk into a clinic yourself.

Okay you should probably call ahead and make a appointment. But the point is you can make that call, and not wait for another doctor to do it.

The ability to do this is a direct result of Mifegymiso being approved in Canada, with more people able to self-manage their abortion. Before 2017, the vast majority of abortions were procedural, which required a trained provider using specialized tools to empty the uterus in a controlled environment. Now, someone seeking an abortion can get a prescription for mife, take it to a pharmacist, and have pills in hand within a week.

The ability to self-refer is huge for access. It streamlines a process that eats up precious time, as abortion care is even safer and more effective the earlier it is accessed. It protects against people having to advocate for their health and needs multiple times, and prevents denial of care at a single point.

Why This One Change Matters So Much

When people can contact abortion providers directly, a few key things happen:

1. Care happens faster
No referral = fewer delays. People get medication sooner and can make decisions within the timelines that work for their bodies and lives.

2. Gatekeeping is reduced
Abortion stops being dependent on the beliefs, knowledge, or availability of a single provider.

3. The system becomes easier to navigate
In a landscape where abortion care is fragmented and varied by province, direct access simplifies the process.

But Let’s Not Pretend It Solves Everything

Self-referral is powerful. It has already changed the way abortion is accessed in Canada. But barriers still exist:

A lack of clear, centralized information on where to go
Pharmacies that may refuse to dispense medication abortion
Social stigma that makes people hesitate to seek care at all
Uneven access depending on geography/rural locations

And in a healthcare system increasingly shaped by privatization, even basic services like lab work and imaging can become harder to access.

So yes, self-referral helps.

But it exists within a system that still makes people work far too hard for care that should be straightforward.

The Bigger Picture: From Access to Justice

There’s a tendency to treat abortion as a binary issue: legal or illegal, available or unavailable. But what this shift in access shows us is something more complicated.

Access isn’t just about legality. It’s a web of logistics, of infrastructure, of morality politics. It’s about whether the system actually works for the people moving through it.

This is where the shift from abortion access to reproductive justice matters.

Because reproductive justice asks different questions:

Can you actually get care when you need it?
Can you afford to take time off work? Do you have supports to navigate family obligations?
Are you treated with respect when you ask for help?

Self-referral is a step toward a system that trusts people.

If removing one bureaucratic hurdle can feel transformative, then it says a lot about how many barriers are still in place.