Here’s a shocking reality: despite significant strides in abortion access, many women still face unnecessary barriers to obtaining a time-sensitive medication that could change their lives. But here’s where it gets controversial—while most pharmacies in British Columbia can provide the abortion pill mifepristone within days, gaps in access persist, leaving some individuals in a race against time. A groundbreaking study published on November 6 in JAMA Network Open sheds light on this issue, offering the first province-wide analysis of pharmacy-level access to mifepristone in B.C.
Mifepristone, a medication used for medical abortions, is available across Canada through prescriptions from physicians or nurse practitioners and can be filled at community pharmacies. Initially, access was restricted to pharmacists who completed specialized training and pharmacies registered with the manufacturer. However, Health Canada removed these barriers in 2017 to improve abortion care. While this move has led to dramatic improvements, the new research reveals that challenges remain.
And this is the part most people miss—time is of the essence in abortion care. As Dr. Elizabeth Nethery, the study’s lead author and a postdoctoral research fellow at UBC’s Faculty of Pharmaceutical Sciences, explains, “The medication is approved for use up to the ninth week of pregnancy, but most people discover they’re pregnant around six to seven weeks. Timely access is critical to respecting a person’s choice.” Additionally, medical abortion is a lifeline for those in remote areas, as it can be accessed through primary care or telehealth without requiring travel.
Overall, access is robust but not universal. In a summer 2024 “mystery shopper” survey, UBC researchers called over 1,400 pharmacies across B.C., posing as patients seeking mifepristone. Two-thirds (67%) could provide the medication within three days—a timeframe considered acceptable for timely care. Surprisingly, rural pharmacies outperformed urban ones, possibly because pharmacists in smaller communities collaborate more closely to ensure medication availability. In contrast, urban pharmacies, though more numerous, often lacked coordination, leaving callers to “try somewhere else.”
Interestingly, the study found no significant difference in access between independent, franchise, and large-brand pharmacies, suggesting corporate structure isn’t the issue. But here’s the real question—why do only one in three pharmacies unable to provide mifepristone within three days offer a valid referral? Weak referral practices create unnecessary stress and inequities, particularly for marginalized or low-income individuals.
“In Vancouver, a patient might have to call five or six pharmacies before finding one with mifepristone in stock, wasting precious time and adding stress to an already difficult situation,” notes Dr. Laura Schummers, senior author and assistant professor at UBC’s Faculty of Pharmaceutical Sciences. To close these gaps, researchers recommend improved communication between pharmacies, clearer referral systems, and refresher training for pharmacists.
Despite the challenges, Dr. Schummers emphasizes the progress made: “This is largely a success story. When treated as a routine prescription, B.C. pharmacies are supporting local access to this vital healthcare service.”
Now, we want to hear from you—do you think enough is being done to ensure equitable access to mifepristone? What steps should be taken to address the remaining gaps? Share your thoughts in the comments below and let’s spark a conversation that matters.
