Abortion Decriminalization in Canada: Why Criminal Law Should Stay Out

Interview with Dr. Martha Paynter, author of Lawless: Abortion Under Complete Decriminalization.

In this episode of Choice Chat, host Tara speaks with Dr. Martha Paynter—nurse, researcher, and author of Lawless: Abortion Under Complete Decriminalization—about why keeping abortion out of the Criminal Code matters for evidence-based care and equitable access in Canada. They explain how access is shaped through health policy and service delivery, and why efforts to re-legislate abortion can create real barriers for patients and providers. Dr. Paynter also discusses how mifepristone has expanded access by enabling timely care closer to home, while gaps persist across regions and populations. They close with a call for cross-movement solidarity—reproductive justice, labour, affordability, disability and migrant justice, LGBTQ2S+ inclusion, and anti-violence work—because reproductive autonomy requires safety, economic security, and real access to care.

If you’re looking for practical information about abortion or pregnancy options in Canada, these evidence-based resources may help.

Where to buy the book

Fernwood Publishing

Columbia University Press 

Indigo/Chapters

Action Canada for Sexual Health & Rights – Access Line
Confidential information, options counselling, and referrals anywhere in Canada, seven days a week, from 9 AM to 9 PM ET.

Call: 1-888-642-2725  Text: 613-800-6757

Email: access@actioncanadashr.org

Choice Connect – Shore Centre

Helps you find your nearest abortion provider based on your needs. 

 National Abortion Federation (NAF) – National Abortion Hotline
This is the largest national, hotline for abortion provider information and financial assistance.  

Call: 1-877-257-0012 

 Abortion Care Canada – I Need Support

Offers systems navigation, options counselling, and financial assistance.

Email: info@abortioncarecanada.ca 

 Abortion Rights Coalition of Canada - ARCC

ARCC is the only nationwide political pro-choice group devoted to ensuring abortion rights and access. 

Wellness Within - Reproductive justice and criminalization, including information on accessing abortion while incarcerated or experiencing criminalization. 

Sources

Black women

Thanks for listening to Choice Chat, a Humanist Canada podcast about choice, dignity, and reproductive justice. We’re glad you’re here. Do you have a story to share? Do you want to suggest a topic? Email us at choicechat@humanistcanada.ca or connect with us on social media. We look forward to hearing from you. 

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Transcript

LAWLESS, ABORTION UNDER COMPLETE DECRIMINALIZATION – AN INTERVIEW WITH DR. MARTHA PAYNTER 

 Tara (0:09)

Welcome to Choice Chat, where we talk about abortion, sexual health, and reproductive justice through an inclusive and compassionate humanist lens. Our goal is to advance the dialogue around reproductive rights by talking with the individuals who inspire us, by working directly on these issues in Canada. I'm a member of Humanist Canada and your host, Tara.

Today on Choice Chat, have one of these inspiring individuals with us. We’re talking with Dr. Martha Painter about her book “Lawless, Abortion Under Complete Decriminalization”, which is an absolute treasure trove of information for anyone seeking to understand the current landscape and history of abortion rights in Canada. Martha has done a lot of heavy lifting in this space. Martha's a nurse, writer, and researcher who has spent over 20 years advancing abortion access in Canada. She's an Associate Professor in the Faculty of Nursing at the University of New Brunswick and the founder of Wellness Within, an organization for health and justice that works with individuals who are criminalized and incarcerated. She's also the author of “Abortion to Abolition”, and now her latest book, “Lawless, Abortion Under Complete Decriminalization,” was published by Fernwood just this past fall. 

 Congratulations on the book, Martha, and welcome to Choice Chat.

Dr. Martha Paynter (1:38)

Thanks very much, Tara. Thanks for having me.

Tara (1:40)

You've dedicated so much energy over such an expansive career to the issue of abortion and reproductive justice. Can you tell us a little bit about what set you on this path and why this is so important to you?

 Dr. Martha Paynter (1:59)

I do get this question a lot, and the very short answer is my mother. My mother was always in this space. My mother was the head of Planned Parenthood in New Brunswick back in the day. And prior to that was very, and continues to be, very involved in the social justice movement. Right now, she does a lot of anti-poverty work. When I was young, she did a lot of international global health work and sustainability work. So probably be where it started, right? People grow up going to church, and I grew up going to protests. And that's the foundation that I was raised within, the value system that we have human rights to protect, and that we are all equal and deserve to be treated as such. So I've just worked on living those values forever.

 Tara (2:58)

Well, thanks to your mom. 

To get straight into talking about the issue of abortion and focusing on “Lawless”, for listeners who may only have that broad understanding that abortion is legal in Canada, how do you describe what makes Canada's situation unique?

 Dr. Martha Paynter (3:20)

Canada is the only country in the entire world that has complete decriminalization. So, we're the only place where it is treated only and entirely as a health service. And therefore, no different from a prescription for penicillin, when you have a strep throat or an arthroplasty for your knee, right? It's a service delivered by professionals according to clinical guidelines. And that's that. And there's no criminal law involvement, and it's regulated in the ways that health services are regulated and, of course, funded. And that's the other part that's quite unique about Canada. Both procedural and medication abortion are entirely publicly funded.

 Tara (4:05)

Can you tell us a little bit about who you were thinking of when you wrote “Lawless”? Who did you have in mind? Who is the reader? And why is that book needed now?

 Dr. Martha Paynter (4:08)

I do have about a paragraph early on in the first section, the preamble, that talks about who it's for. And it's really for everybody. It's for youth so that they understand their rights. It's for parents so that they understand their obligations to their children and their children's rights. It's for students in law, sociology and women's studies, and poli sci who really need to have a foundational understanding of what this is. It's so central to those areas of study. And of course, it's for clinicians, clinicians who are so misinformed. And it's honestly also for the media, for journalists who also often don't get it right and with such severe consequences. So, what I have witnessed in particular since the dismantling of Roe v. Wade in the US, and the deluge of US news that has infiltrated Canadian minds, is really a very severe misunderstanding about how abortion works. 

And, you know, I live in New Brunswick. There's also an extremely severe misunderstanding about how abortion works in New Brunswick. These discourses, they're dangerous clinically, because if you do not understand how abortion works, you do not understand how to get one. And you will be delayed in getting one. Abortion is extremely safe. Extremely safe! But its safety is highest, earliest in gestation. So, we want you to get care earlier because it's, of course, more convenient and easier for you, you have more options, but also, it’s clinically safer. It's better for your body. So, there are physical manifestations of misinformation in this realm. And unlike strep throat and arthroplasty, there is so much stigma and secrecy about this health service that, although yes, it is 100 % legally a health service, it does get different treatment. The most effective way to address that stigma and that secrecy and the consequent misinformation and barriers to care is to normalize discussion about abortion and to tell people how to get one. And so that's really my purpose here. And the audience for the book, therefore, is anybody who could want an abortion or who could know someone who would want one. 

And abortion is the most common outpatient procedure in this country. We know someone who's having one. And one in three of us with a uterus are going to have one ourselves. So, it's urgently needed. This is more common than diabetes. It's treated as this thing that needs to be in the dark.

Tara (7:08)

That was a fantastic response. Indeed, it's for everyone. All Canadians need to understand how they can access abortion here when the time comes that they or somebody that they know needs that access to that service. One thing that we observe reading your book, the Morgentaler decision is often summarized as abortion was decriminalized and indeed it was. But your book talks really extensively about the nuances of that situation and how complicated that the lived reality of accessing abortion is in the context where it's decriminalized here in Canada. So, you really seem to get at this complexity where abortion is not governed by the criminal code, but it's still highly governed. Can you talk a little bit about that context or that situation in Canada? What does that look like? What does it mean for access?

 Dr. Martha Paynter (8:16)

With the 1968 Omnibus bill under the former Trudeau government, we had partial decriminalization of abortion, and that is what Morgentaler responded to. And that partial  decriminalization in 1969 is similar to what every other country has, that it's decriminalized if you meet certain criteria, whether that's gestational duration limitations or, you know, in Canada, you had to jump through the hoop of a therapeutic abortion committee - a trio of physicians had to approve that your care was medically necessary, either for mental or physical health. You know, and that's what other countries continue to have in one way or another, with varying gestational limitations and varying hoops. And Morgentaler noticed immediately that that was inadequate and started his clinic in Montreal, and broke the law, and once arrested and proceeded to go through two decades worth of legal fights, which he then won. Now, that win was really contingent on other elements of the 1980s, really critical legislation in Canada. The first being our Constitution, the Charter of Rights and Freedoms, that stipulates our right, Section 7 rights to security of the person and to liberty. So, we have the right to our bodies. And that's very different, for instance, from how Roe was positioned and what Roe hinged on. 

So, there was that, and there was also the Canada Health Act.  So, that all medically necessary care provided by physicians or in hospitals was publicly funded. Right? So, from 1980, we have this foundation. Now the problem after 1988 was one of, of course, stigma, whatever, but most importantly, geography. So, Canada is a giant physical country, second biggest landmass in the world and pretty small population. As a result, we really had very few providers and we didn't see a massive expansion in post-88 in terms of who was doing this work. It was only allowed to be physicians. We didn't have any medication abortion. Most of the clinics were along the US border in major urban centers. So we have to travel at great personal expense, whether that's direct costs or indirect costs, childcare, missed work, blah, blah, blah. And that persisted for a really long time. And we also had some other things, you know, like the PEI fight, the disputes in New Brunswick over Regulation 8420, the different other things, but the dominant issue was a geographic one.

 Dr. Martha Paynter (10:55)

And that really changed, in a revolutionary way, with Mifepristone. And so, I have a whole chapter that is a really dense chapter, a thick chapter that talks about the Mifepristone revolution. And that really changed everything in Canada. And we still have an inadequate understanding. It's been over 10 years since Mifepristone was approved, almost 10 years since it was on the shelves. And we still do not understand that abortion now mostly it happens at your house. And, it’s a miscarriage you have in your bathroom. That's what it is now most of the time.

Tara (11:28)

Right.

Dr. Martha Paynter (11:35)

We need to change this understanding and shift the discourse about what it is, and now nurse practitioners can prescribe it. All family doctors can prescribe it. You can pick it up in your local pharmacy. You can have a lot of the care through telemedicine. Like, it’s so different now. Really, the delay to get Mifepristone approval by Health Canada – because Mifepristone was invented in the 80s and it launched in France in 1988, the same year as the Morgentaler Clinic. So, in Europe, they've had this revolution for decades. We've had Mifepristone since 2000, so 15 years before we did. So, on the one hand, I'm exceptionally proud, and I want people to understand our really unique leadership position in Canada as the only country with complete decriminalization. We are very far behind in terms of the potential impact of medication abortion.

 All that said, since it was launched in 2017 and deregulated, it's really expanded access, and we know that it has expanded access most for people in rural areas. So, we are definitely seeing a shift in that de facto, that lived access, but we have yet to completely maximize the potential leverage that we can have with this mode of care.

Tara (13:01)

What are the steps to do you think ahead of us to do that?

Dr. Martha Paynter (13:07)

Mostly, it's people understanding that medication abortion is medication abortion. It's not Plan B. It's not emergency contraception. You can't just get it at the pharmacy on the shelf like you can at Plan B. You do need a prescription, but it will be publicly funded. It will not be publicly funded if you don't have a health card. 

 Earlier, you talked about how Canadians understand abortion, and one of the greatest threats we have right now, to abortion access is the unequal treatment of people without papers. So, undocumented people, people without a health card. Oftentimes, this is actually international students, migrant workers that we are super reliant on for their essential work in agriculture and childcare. These people may not have a Medicare card. And the consequences to them of unintended pregnancy are very severe.

Tara (13.54)

Right.

Dr. Martha Paynter (14:04)

And of course, our healthcare system is going to have to deal with that eventually, right? We failed to provide funded care for their abortion. So that's one of the areas where we see increased attention and a real, it's both a real focus for those of us in the movement who recognize that there are more and more people who fall into this category that need care.

Tara (14:27)

Right. 

Dr. Martha Paynter (14:29)

And, it’s also a focus for our movement in terms of advocacy. Is this a population who we believe, of course, are equal people and should have equal access to rights to health services?

 Tara (14:44)

This sort of line of talking where we're landing here has made me think about something that you write in your introduction to “Lawless”. Actually, it's about your first book, Abortion to Abolition. But if it's okay, I'll just read this little passage. 

 Dr. Martha Paynter (15:00)

Yeah, sure!

 Tara (15:05)

You’re talking that your first book, you “criticize the overemphasis some feminist activists and health professionals place on abortion in lieu of attention to other issues in reproduction critical to health equity in Canada.”Gender affirming care, sexual violence, queer parenting, forced sterilization, assisted reproductive technologies, toxic water supplies, contemporary foster care, and the carceral system are focused on overall, reproductive health must remain in these areas even as we make progress in abortion care.” That really struck me and as so, so important. Seeing this as part of a broader social justice movement, can you talk a little bit more about that passage that I read and why that is nested in this broader vision?

 Dr. Martha Paynter (15:59)

Yeah, Absolutely. Without rehashing “Abortion to Abolition”, which we could have a separate talk about, what I'm doing in “Lawless”, is making those connections between we don't have an abortion law, but we have other laws and norms and practices in our country that affect how you access abortion. They have social justice implications. So, like I just said, one of these is that we don't pay for care for people who do not have health services. So, I have a whole chapter in Lawless about our obligation to provide the right to health to anybody in this country. But there are other dimensions that I talk about, and one of them is our freedom of speech, freedom of assembly, freedom of religion. These are things that are captured in Section 2 of the Charter.

 Dr. Martha Paynter (16:50)

And I think one of the examples would be for instance, the abortion movement we worked very hard to introduce bubble zone legislation that would protect our patients and protect us as abortion care providers from violence from anti-abortion extremists violence and intimidation. And we've had in different places in different forms bubble zone legislation now for decades. And in the 90s, when Morgentaler’s clinic in Toronto 

 Tara (17:09)

Right.

 Dr. Martha Paynter (17:20)

was firebombed, when he was attacked, when there were sniper attempts on the lives of several abortion. The 90’s were really very violent and scary. We're not in a time like that now, but we just not to say that it couldn't happen again. We've certainly seen escalation of that kind of terrorism in the US but what happened with the bubble zone legislation that we pushed for, for good reason is now it's being foundational to restrictions on freedom of assembly. It's being used against our really social justice oriented foundation. And so we see these restrictions that are being proposed federally on the ability to assemble in front of places of worship, in front of public, et cetera, et cetera. And, so we need to be conscious that as people in the reproductive justice movement, we are also obligated to stand up for colleagues, our siblings in Gaza. We have an obligation to big picture reproductive justice activism. That means we have to assemble publicly, and we have to be able to say things and we have to protect that right to say things. And sometimes that butts up against our great discomfort with people saying things about us that we don't like, and with people saying things about us that we find uncomfortable or even threatening. And so, we're in this moment now where we have to reckon with that tension between our need to, frankly, be courageous, our need to be present and vocal about the rights of people who are deeply oppressed internationally and be very cognizant of the consequences of increasing carcerality and control by our government.

 Tara (19:16)

Interesting. This is not the dialogue that normally comes up around abortion where we're talking very specifically about abortion as healthcare. And I think we've come a long way in getting to talk about it in those terms using that framework of healthcare. I think what you're doing is even pushing beyond that boundary to say actually, yes, and. Yes, it's healthcare and it's a lot more. You write about reproductive justice rather than being the bigger umbrella, I guess, to abortion rights. And that in addition to being an individual right, you talk about abortion as a public good. And I think that idea is crucial. Can you talk a little bit about that abortion as a public good?

 Dr. Martha Paynter (20:12)

Yeah, happily. So, I, of course, want to credit the Black feminists that pioneered the Reproductive Justice Movement and the persistent leadership of critical race theory in reproductive justice consciousness.

 Abortion as a public good, what I see as an abortion care provider in front of me on the exam table, somebody who's receiving this care, is that this is someone who is willing to take the physical burden. Of course, a pregnancy takes two, right? There's two people who are responsible here and only one body bears that burden. And so then it is this woman or a person with a uterus who is experiencing it. And, it is painful. It hurts. It hurts. And they take that on themselves. They take that on because they see their life and their contribution, their potential contribution as really valuable. They have that self-esteem and also that care for their entire family. Most people who are getting abortions are already parents and they're doing the math. They're thinking, I can be a better parent. I can be a better contributor to my society if I am able to control my reproduction. I'm able to do more in terms of my education. I'm able to do more in terms of my employment. I'm also able to escape a violent person, right? We really need to understand how access to abortion and access to contraception are incredibly important basic tools in our work to end violence against women and girls.

 So, abortion is is a tool that we publicly - we can fund it. We can make it available and that makes a concrete difference in women's safety and the safety of children and families and their economic safety, their physical safety. This is a public good. This makes our society richer. And I don't want that to only be interpreted as meaning like we have more money and we have more economic potential. That is true and that does matter.

Tara (22:22)

It does matter.

 Dr. Martha Paynter (22:24)

We absolutely should value things that allow women to themselves address the systemic gender pay gap. Allow themselves to address systemic violence against women. These are tools that we can use. As a whole public, we need to value what those really mean.

 Tara (22:46)

Especially as you point out in “Lawless” and in your other writings that the people most impacted by a lack of access or delayed access to abortion care are often the most disenfranchised, at risk, economically fragile, and so on. So, that I couldn't agree more. The economics of it is very important. It's very important to people with uteruses. It's very important to the people who are seeking out that care. But as you also point out, when that care is denied, there are cascading impacts and expenses to society, to the healthcare system.

 Dr. Martha Paynter (23:35)

And what we're seeing right now in this current moment is opposition to later care, right? Care in the second and third trimester. We're seeing different in Quebec and Alberta, we're seeing different discourses emerge trying to limit access to this care and that the lever that's being proposed is the public funding for this care. And all of what you just talked about is why this is the most ridiculous approach. So people who are seeking care later in pregnancy are, it's either because of a terrifically horrifying situation with fetal and maternal health, right? That's column A. And there are a lot of those. And we need to understand the connection between this economic climate and the inability for people to handle disability in their family. And they're making decisions because they can't do this in this society. We don't have the social safety net to support this.

 Dr. Martha Paynter (24:33)

So taking away the ability to make that decision is really clinically and

ethically and economically just so - it's just seeing the picture so incorrectly. For those people who are not necessarily facing severe maternal or fetal health issues, they're facing severe social realities. People seeking care in the second and third trimester are often extremely young. That's where we're seeing people who are grossly misinformed or in denial or scared, maybe we're talking about family violence, maybe we're talking about extreme rurality, lack of education about this stuff, all kinds of reasons. And to deny the care for somebody in that situation is also so grossly wrong.

 Tara (25.29) 

Yes. 

 Dr. Martha Paynter (25:31)

And I think we need to, in the movement, for a long time we didn't talk too much about later care. We were worried about the discourse moving too much into that direction. And later care is rare, relatively speaking. So, another thing, and I do talk about this in the book, but I think that this is an increasingly important element of discussion is for us to recognize that this does happen and we need to provide the care and we need to actually improve this care availability.

 Dr. Martha Paynter (26:00)

Even though it's rare, it does happen.

 Tara (26:03)

Because time, time moves swiftly and time is of the essence to that care. There are all kinds of cascading delays that can happen in a person's life that can postpone the care. So even when they are seeking it later, it's not necessarily their choice to be at that stage and seek it maybe several things have failed them along that trajectory.

 Dr. Martha Paynter (26:36)

And, the other thing is, like in this healthcare system, we are in a crisis. So, at every stage, we are facing difficulties in providing all types of care. And it's not necessarily that we as clinicians are against doing this or that anybody is telling us we're allowed to do it. It's that we don't have capacity. The nurses are leaving the profession.

 Tara (26:45)

Yes.

 Dr. Martha Paynter (27:01)

The profession of nursing, not of abortion nursing. They're not there to draw the blood. They're not there to do the counseling. There's so much need in different ways on a healthcare workforce, that works interdisciplinarily and collaboratively. It's very difficult for us to talk about needs within the abortion movement or within abortion services without recognizing that the healthcare system is in crisis and that has a trickle-down effect on abortion services just like it has an effect on hips and knee surgery.

 Tara (27:42)

Yeah, that's a very important reality to bring up. And actually, it's pulling me over to want to talk about the idea of a system. So, we have federal context and you've informed us about that context beautifully where abortion is not governed by the criminal code. Yet you talk about something called quiet policy limits. So in theory, there's every Canadian or person living in so-called Canada should have access now. People without a card, that's not covered. That's another injustice issue. But assuming you have a card, you're entitled to that care and to have it covered. But then you talk about this variety of situations about other constraints. For example, clinic in Alberta can't provide care beyond 20 weeks. Whereas similar clinics in Toronto can provide up to 24 weeks. You really talk about the geographical challenges around access. So ,what about those other levers, billing issues, hospital policies, scope of practice? What as advocates for reproductive justice, which by and large our listeners are, what should we be watching just as closely as government, as parliament?

 Dr. Martha Paynter (29:22)

I want to tease apart, there’s two separate things here. And one is, it is important for people to understand that a context like Canada, where we have legal free care, the things that we need to improve care access are often extremely complex. So as an example, in New Brunswick the main abortion clinic is at the Moncton City Hospital. It's open five days a week, beautiful services, wonderful, wonderful. But they were only able to go to 16 weeks’ gestation because of the equipment they had the way their day was organized. And with COVID and difficulties moving patients around everybody across the country did work to improve their gestational duration capacity. So Moncton City improved it. They got the equipment. They did you know, did some training and now they can do 18 weeks and that's great. But, they can't go beyond because this is an outpatient clinic. It has certain hours. You need  different access to anaesthesia. You need different protocols for cervical ripening. It becomes clinically complicated.

 It's not because somebody is mean. It's because of the capacity literally of the human beings doing this work. There needs to be an understanding that human beings do this work. And, human beings have differences in their skills, in what they're comfortable with morally. So we may very well have a host of people who are totally willing to prescribe a medication abortion pills to 10 weeks. But, they don’t want to do anything else? And that great.  That’s okay.  That’s good.  

 So we need to understand humans are behind this work and humans have limitations. But we need to be aware of the connectedness. Alberta, Danielle Smith, using the notwithstanding clause to force clinicians to not provide evidence-based care, gender-affirming care to young people is a gross, a huge threat to our democracy.

 Tara (31:30) 

Right.

 Dr. Martha Paynter (31:31)

It is a huge threat to health services, to the integrity of health services. A Premier, with no healthcare background whatsoever, is going to tell us what hormonal medications we can prescribe.

 Tara (31:46)

It's beyond the pale.

 Dr. Martha Paynter (31:49)

This is a huge threat to everything. To every single person with a uterus who's thinking about menopause right now. Every single person who could get pregnant, to every single young person whose right to consent to treatment has now been stripped from them. So, this is not abortion, but this is, and this is my point. It's not about abortion. It's about these fundamental liberties - our Charter of Rights and Freedoms that protect us. And when a right wing politician riding on this really vile populist anti-trans agenda succeeds in using the notwithstanding clause everyone in Canada should panic. This is very bad. So those are the kind of things. 

 It's not the average feminist listener is not going to be able to make a dent in like the clinic hours only go to 1500, and therefore, we okay they can't yeah they can't fix that.

 They can be very worried about these types of threats to our democracy generally. And, I think that that's hard because, yeah, the clincial care of abortion has become so good that making the changes requires real specificity. It's complex. You have to know so many different things and like it's like this one pharmacy and this one hamlet really should start stocking it and the only reason they haven't stocked it is because nobody asked. Like these kind of things are not big enough picture to mobilize activism. But what Danielle Smith is doing - that should mobilize us.

 Tara (33:39)

Okay, that is sobering to say the least. We were also aware and maybe this is backtracking or smaller potatoes than the really big picture stuff and the use of the notwithstanding clause as a threat to rights more broadly. We were reading about in Quebec Parliament Bill 1 includes a provision to legalize abortion. In response, over 400 doctors signed a letter calling for the removal of that provision and writing and I'll quote here, "Any law on abortion ultimately becomes a law against abortion." We wanted to ask you, what's your take on this?

 Dr. Martha Paynter (34:28)

Absolutely, you know, absolutely. And these feminist groups, this is a really nonsensical move. No feminist group supports this. I think the Quebec government is relying on misinformed voters to think this is good. And that's why “Lawless” was so important. We need to understand lawlessness is optimal. We don't want any law over this. We don't want law over strep throat. We don't want law over knee surgery.

 Tara (34:59)

Right. 

 Dr. Martha Paynter (35:02)

No! The law should have nothing to do with how we do health services. We're going to do health services the best way to do them clinically. We're going to adjust our care as new evidence becomes available. We learn about new potential ways to do things that are even better for the patients. We do research. We improve. We do research. We improve. That has nothing to do with law. It has everything to do with our clinical competence and support for clinical research. And absolutely, governments should be supporting clinical research, 

 Tara (35:31) 

Yes.

Dr. Martha Paynter (35:31)

To advance the quality of abortion. And we should be doing things, like for example, governments should be supporting efforts to improve education among health professionals about Indigenous rights, Indigenous health. That's an area that we have a lot of work to do as clinicians. By all means, we should have government support to do that work. We do not need government quote unquote support through a law about abortion. When you look at something like France, where abortion was added to the 

Constitution as a reaction to the dismantling of Roe. But abortion in France is only to 16 weeks. So, with laws come limits. What is the law? What does it say? What are the specifics? With any law it can be changed and it can be made more restrictive.

Tara (36:22)

Right. 

 Dr. Martha Paynter (36:31)

And what are you doing anyway involving yourself in this? It's not a politician's business. So I absolutely agree, and speak often with my Quebec colleagues clinically and in research and in activism and this is a resounding – No! No one wants this. Stop!

 Tara (36:54)

Stop! And hearkening back to Trudeau one there as well that the government doesn't belong.

 Dr. Martha Paynter (37:04)

 So, you know at the time, that was 1980. He said the government doesn't the state has no place in the bedrooms of the nation. And he was partially decriminalizing homosexual and partially decriminalizing. And he was decriminalizing contraception at the time.  But it's more than that. It's not just about privacy. This is about our competence as health care providers. Nurses are the biggest workforce in the entire country in Canada. Healthcare providers are as a whole, all of us, are an enormous workforce. We do not need lawmakers telling us how to do what we learn to do clinically. We follow clinical guidelines. If we do a bad job, we have discipline repercussions through our college, through our regulators. That's how this works. It does not work for there to be laws stipulating how we do health services.

Tara (37:56)

That is very clear. Two things that I'd like to end on. Is, one is where do you see the hope right now is making you feel optimistic? Let's start with that. Where do you think the light is in the coming days and years?

 Dr. Martha Paynter (38:17)

I'm an incredibly optimistic person as a general baseline, and that possibly even to the point of being criticizable. One of the other point about “Lawless” is that we have so much to be happy about. We've done so much. In ten years we did wild things. We created services on PEI, that are possibly the best care you're gonna get in the nation. Wow. Once it opened, it opened the PEI clinic opened with 24-7 backup nursing services to support people who are having medication abortion at home. It provides 100 % free contraception to all patients long before PharmaCare in BC or federally came to the table. I've been there. It's a gorgeous clinic. So we did that. We have Mifepristone.

We have Mifepristone for free. We have Mifeprestone completely deregulated. It's a normal prescription that you get from any primary care physician or nurse practitioner. You pick up at any pharmacy. That is is wild! So unique. So convenient. 

Now we just need people to know about it, and these prescribers to do it. We'll get there. We're getting there. And the first two years of having Mifepristone on the shelves, we quadrupled the size of the abortion workforce. We are so innovative. We made massive changes over COVID to improve access to care. Radically normalized telemedicine. That has implications for all types of care. But, for abortion? So convenient. So private. So time saving, so much better for our patients. We expanded gestational duration. We used to send patients to the US quite routinely. We do that much less because we expanded our own capacity.

 I think we can look to the US and in the three years since Dobbs, the number of abortions in the US has gone up by 25%. Dobbs did not end abortion. It did not reduce abortion. There is more abortion in the US than ever. Our colleagues have reacted to Dobbs through innovation, collaboration, massive fundraising efforts.They are doing things in new ways. They are finding new ways to do things. In this reproductive justice movement, we will always respond. We will always innovate. We will never be defeated. We will keep going with creativity and energy, being convinced that equality is correct and we're going to work for it. This new assault, by the Smith government, we will now fight this. It's annoying. We didn't want to spend our time doing this, but we will. We had other things to do, but we will do this. Perhaps it will build more connections between our movements, between queer liberation and reproductive health, which have always been linked and always will be linked, but building those connections is one of the most important things we can do right now. Seeing how we are connected and our struggles are connected. So, when faced with doomsday news, which we are, all of us, every day, every time we open our phones, the best tonic I can offer is that we all connected, of our struggles are connected, and we have an obligation to each other to participate in each other's struggles. To learn. To mobilize. To be creative and collaborative. And we're just going to keep doing that.

 Tara (41:58)

Thank you. That is a very inspiring note to end on. And, I think that we'll leave it there for today. We'd love to possibly talk to you at a later time to dig in a little bit more. We just scratched the surface and you have some very, very crucial issues that you address in “Lawless”, including the indigenous situation with the history of genocide and forced sterilization, to how we can address and what are our obligations to address and correct the injustices there. As well as how we can support newcomers and in that broad reproductive justice movement that you have spoken so inspiringly about today. Thank you so much for joining us on Choice Chat. 

 Dr. Martha Paynter (42.51)

My pleasure, Tara.

 Tara (42.52)

I really appreciate it. Dr. Martha Paynter's new book is “Lawless, Abortion Under Complete Decriminalization”. We'll link to the book and to Wellness Within, which is another area that we would love to talk to you about down the road if we get the chance. We'll also link to some of the research and organizations and other supports in the show notes. So thank you for listening and until next time remember, abortion is healthcare and in Canada, it's most of our rights. We got some work to do there. Thank you for joining us and bye bye for now.

Producer (43:25)

Thanks for listening to Choice Chat, a Humanist Canada podcast about choice, dignity and reproductive justice. If you have an abortion story you'd like to share, in your own voice or anonymously, we welcome you to reach out. Do you have a topic you'd like us to explore? Email us at choicechat@humanistcanada.ca or connect with us on social media.

 We believe that by speaking truthfully and listening with care, we help shift the conversation. Because abortion is healthcare. Language matters, and silence serves no one. Talking about it is how we change everything, and we're grateful you've joined us. Keep the conversation going with your friends, your family, your community. 

 Say the word, share the truth and break the silence.