Canada’s ‘Lower’ Abortion Rate Is Deceptive
The apparent discrepancy between the U.S. and Canadian abortion rates stems partly from flawed abortion data that’s only getting worse.
Two University of Notre Dame professors are sharing an interesting and surprising message for pro-life Americans: If you want fewer abortions, copy Canada.
Writing in the Daily Beast, Susan Osterman and Tamara Kay argue that Canada’s abortion rate is lower than that of the United States and that this can be credited to universal health care, paid family leave and contraception.
As has already been pointed out, this surface-level analysis ignores a few obvious facts, including the reality that the U.S. abortion rate has been dropping for decades and the lack of any evidence that large, government-sponsored contraception programs have any major impact on abortion rates.
But there’s another problem with the Notre Dame professors’ efforts to ascribe Canada’s comparatively low abortion rate to the nation’s social policies: That low abortion rate is almost certainly not real.
The Daily Beast writers draw their broad conclusions from Canada’s 2020 abortion rate as reported by the Canada Institute for Health Information (CIHI), which publishes annual abortion reports compiled from a combination of hospital discharge data and voluntarily reported abortion facility records. This they compare with the U.S. abortion rate estimated by the Guttmacher Institute. (The official reports published by the U.S. Centers for Disease Control are incomplete, since not every state collects abortion data.)
That single-year comparison doesn’t tell the whole story. CIHI and Guttmacher data show that in recent years, the Canadian and American abortion rates were virtually the same. That changed in 2017, when the American abortion rate ticked up and the Canadian rate started to drop. The increase in the U.S., and the purported decrease in Canada, is likely attributable to the same cause: chemical abortion.
In 2017, mifepristone — also known as RU-486 or the abortion pill — became available in Canada for the first time. This was almost two decades behind its neighbor to the south, but Canada soon caught up. The chemical abortion regimen was approved in January 2017 for use through 49 days of pregnancy with careful medical oversight, but by November of that year, Canada had pushed the limit to 63 days and scrapped most of its health safety regulations, including where abortion pills could be dispensed and who could provide them.
As abortions have moved out of hospitals and abortion clinics, and into doctor’s offices and other providers that are mostly excluded from the CIHI reports, CIHI has responded by adding a caveat for the first time to its 2020 report, warning that its reported totals “underestimate the true number of induced abortions in Canada.”
A recent study in the New England Journal of Medicine provides a clue to Canada’s actual abortion rate.
In contrast to the hospital discharge data and clinic aggregates used by CIHI, the researchers used claims data from the Ontario Health Insurance Program (OHIP), Ontario’s government-run public insurance plan. This means that all abortions paid for by Ontario were included in the study, regardless of the type of facility where they occurred.
From 2017 to early 2020, the OHIP data reflects approximately 21,000 more abortions than were reported to CIHI. When the Ontario numbers are extrapolated across Canada, it’s clear that the abortion rate is just as high as ever.
The study also suggests that the abortion complication rate is higher than ever, too, despite the careful efforts of the authors to downplay this fact. Studies from countries with better data consistently show higher rates of complications from chemical abortion. As chemical abortion increases throughout North America, complications will, as well.
The apparent discrepancy between the U.S. and Canadian abortion rates doesn’t stem from any policy difference between the two nations. Instead, it’s a byproduct of what we have in common: extreme, no-limits abortion laws in many states and flawed abortion data that’s only getting worse. Scholars and writers need to be the first to question the data and avoid broad and inaccurate conclusions.