Abortion and Contraception Policy in Prisons in Canada

• Published date: 01 January 2025
• DOI: http://doi.org/10.1177/00328855241292790
• Author: Martha J. Paynter,Clare Heggie
• Date: 01 January 2025
• Subject Matter: Articles

Abortion and

Contraception Policy in

Prisons in Canada

Martha J. Paynter

1

and Clare Heggie

1

Abstract

Little is known about abortion and contraception policy in prisons in

Canada. The aim of this study was to determine policies governing access

to abortion and contraception in prisons in Canada. Between 2022 and

2023, we sent freedom of information requests to each province and terri-

tory and to the federal government of Canada, requesting any information

with respect to policies governing abortion and contraception in prisons

and jails. Our review identif‌ied only one outdated policy pertaining to abor-

tion access, and no policies governing hormonal contraception. The lack of

proactive policy to assert access to commonly required services threatens

reproductive autonomy.

Keywords

abortion, contraception, policy, Canadian prisons

Introduction

Women and gender diverse people are the fastest growing population in

prisons in Canada, with the population increasing to 39% between 2013

and 2018 (Malakieh, 2019). However, institutions of incarceration are often

ill-equipped to address gendered needs, including health services. In

Canada, most prisoners are in custody in provincial/territorial facilities

1

University of New Brunswick, Fredericton, NB, Canada

Corresponding Author:

Martha J. Paynter, Faculty of Nursing, University of New Brunswick, P.O. Box 4400, 33 Dineen

Drive, Fredericton, NB E3B 5A3, Canada.

Email: martha.paynter@unb.ca

Article

The Prison Journal

2025, Vol. 105(1) 44–61

© 2024 SAGE Publications

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/00328855241292790

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(Paynter et al., 2020), where the majority are held in pretrial detention. Most

incarcerated women are of reproductive age, and Indigenous people, Black

people, 2SLGTBQIA +people, people with disabilities, and other marginal-

ized groups experience disproportionately high rates of incarceration.

There is evidence people in prison have higher rates of fertility than the

general public, and approximately 4% may be pregnant on admission to

custody (Liauw et al., 2016). Challenges experienced by pregnant

people in prison include the stress of surveillance, unhygienic environ-

ments, inadequate nutrition, lack of access to over-the-counter medica-

tions and vitamins, and poor access to prenatal care (Carter Ramirez

et al., 2020a). Liauw et al. (2016) found people in prison have much

higher rates of lifetime experience of abortion (57%) compared to the

general public (approximately 33%, Norman, 2012). Incarcerated people

report delays and denial of reproductive care (Liauw et al., 2021;

Paynter et al., 2023) and barriers to health information (Liauw et al.,

2021). Having experienced incarceration before or during pregnancy is

associated with preterm birth and babies of low birth weight and small

for gestational age (Carter Ramirez et al., 2020b). Further, limited

access to health care and health information prevents incarcerated

people from making informed reproductive health choices.

Our recent scoping review of international research addressing contracep-

tion and abortion among people in prison (Paynter et al., 2022) found barriers

to care include lack of onsite access to options, experience of contraceptive

coercion by health care professionals, out-of-pocket f‌inancial costs, and

periods in custody that caused disruptions to medical coverage and insurance

status. US researchers have found rates of abortion vary considerably between

jurisdictions, indicative of unequal access based on where an incarcerated

person is located (Kirstein et al., 2023; Sufrin et al., 2021).

In Canada, abortion services were completely decriminalized in 1988 and

are publicly funded with few exceptions. There are no limitations in criminal

law with respect to gestational duration, mandatory waiting times, or parental

consent requirements for abortion. Self-referral for care is available in all

provinces and territories. In 2015, Health Canada f‌irst approved mifepristone

for medication abortion, and it became available in 2017 as a publicly funded

service with primary care providers including family doctors and nurse prac-

titioners authorized to prescribe (Dunn & Brooks, 2018). Uptake of medica-

tion abortion among the general population has been swift, with procedural

abortion falling from 96% of care in 2016 to 66% of care in 2019 (Renner

et al., 2022). The introduction of mifepristone also prompted signif‌icant

growth in the abortion provider workforce: the number of abortion providers

rose four-fold from 2019 to 2021 (Dunn et al., 2022; Renner et al., 2023;

Paynter and Heggie 45