The Canadian Institute for Health Information (CIHI) reported 83,576 abortions in Canada for the year 2019. However, the true number is likely much higher since the statistics are incomplete. Consider that CIHI reports 27,911 abortions for the province of Ontario. A Freedom of Information request to the Ontario Ministry of Health and Long Term Care (OMHLTC) revealed that there were actually 46,189 abortions billed for in 2019 in the province. This means that CIHI data is missing 18,278 abortions for Ontario. CIHI’s abortion numbers do not come from provincial billing records. They say that “Due to variations in use of fee for service (FFS) payments for induced abortion across the country, these figures are not based on pan-Canadian FFS data.”
Discrepancies between the Ontario data and CIHI data are a longstanding problem. Numbers for Ontario in the table below come from the OMHLTC. They are based on billing records and were obtained through Freedom of Information requests. Read more at Run With Life: 2021 (run-with-life.blogspot.com), March 23rd.
CIHI notes in its annual abortion statistics document: “For Ontario, volumes reported in the column Number of Induced abortions reported by clinics include services from non-hospital settings.” Non-hospital settings include clinics, surgical facilities, and physicians’ offices. CIHI reports 7,326 hospital abortions and 20,585 clinic abortions for the province of Ontario.
Nova Scotia’s abortion numbers from Nova Scotia Health and Wellness ministry show 2,226 abortions for 2019. CIHI reports 1,268 abortions for the province for 2019. Nova Scotia’s abortion numbers like that of the Ontario Ministry of Health and Long term Care are based on billing records. This is a difference of 958.
See Run With Life: 2020 (run-with-life.blogspot.com), June 10, 2020.
CIHI number for 2019 for Nova Scotia is 1,268 abortions.
Using CIHI data, we find:
⦁ Abortion continues to be most common among women in their twenties. They still account for higher abortion numbers than other age groups. The age of the woman undergoing abortion is unknown for thousands of abortion in 2019.
⦁ Clinics perform more abortions than hospitals; 24,852 hospital abortions versus 58,724 clinic abortions.
⦁ CIHI does not report numbers for abortions done using the abortion pill regimen, Mifegymiso.
⦁ Gestational age is unknown for 21.3% of hospital abortions. Information on gestational age is not available for clinic data or from Quebec data.
⦁ 31.6% of hospital abortions occur at 8 weeks or less gestation. 29.3% occur at 9-12 weeks gestation. 9.1% occur at 13 to 16 weeks gestation. 4.7% at 17 to 20 weeks gestation. 4.0% at 21+ weeks gestation. Quebec data is not included in these numbers.
⦁ Number of previous deliveries based on hospital data (excluding Quebec); 34.8% had no previous deliveries. 15.6% had one previous delivery.12.8% had 2 previous deliveries. 9.3% had 3 or more previous deliveries. The number of previous deliveries is unknown for 27.5 of hospital abortions (excluding Quebec).
⦁ According to hospital data (excluding Quebec), 47.0% of women undergoing abortion had no previous abortions. 16.0% had one previous abortion. 9.6% had 2 or more previous abortions. The number of previous abortions is unknown for 27.4% of hospital abortions. Information on the number of previous abortions is not available for clinics or Quebec hospitals.
⦁ The exact number of abortions done using the abortion pill regimen, Mifegymiso is unknown.
⦁ Hospital data (excluding Quebec) lists aspiration and curettage as the most common method of abortion at 65.9%. 7.4% of abortions were done using dilation and evacuation. 2.9% were done using dilation and curettage. 1.9% were done using “other surgical procedure.” Other surgical procedure includes hysterotomy, hysterectomy and menstrual extraction. 13.5% were done using surgical and medical procedures combined. Medical abortions involve the use of drugs. 8.4% of hospital abortions were medical meaning through the use of drugs only.
Complications reported for hospital abortions (excluding Quebec) within 28 days of initial procedure were as follows:
⦁ 97.6% had no complications.
⦁ 0.9% hemorrhage
⦁ 0.3% infection
⦁ 0.4% retained products of conception
⦁ 0.2% combination of complications
⦁ 0.5% other complications.
⦁ Information on complications “is not available from clinic data or from Quebec data.”
⦁ Complications occurring after 28 days “for cases where the heath care number was not recorded during the initial visit or hospitalizations are not included; complications may therefore be undercounted.”
Hospitals must report abortion data to government. However, there is no legislative requirement for clinics to report. Prior to the Supreme Court decision in Morgentaler in 1988, abortions were only available in hospitals. Following the Morgentaler decision, abortion clinics began to appear across the country.
In CIHI’s History of the Therapeutic Abortion Survey (as it was formerly called), it is stated: “Some hospital and provincial ministry respondents interpreted the absence of an abortion law as the basis for no longer having to report to the Therapeutic Abortion Survey. The law had contained a provision enabling provincial ministries of health to obtain abortion data from hospitals. At the federal level, however, Statistics Canada surveys (including the Therapeutic Abortion Survey) are mandatory unless otherwise specified, but Statistics Canada chose to treat the Therapeutic Abortion Survey as ‘voluntary’ and encouraged respondents to continue to supply data for health-related purposes.”
The quality and coverage of abortion statistics declined thereafter with clinics reporting only numbers, and no other demographic information such as the age of the woman undergoing abortion, the gestational age of the child, method of abortion, complications and previous number of deliveries or abortions. On occasion, some abortion clinics did not even report numbers for a specific calendar year.