The Transition to Medical Abortion at the Vancouver Island Women’s Clinic
The only standalone abortion clinic on Vancouver Island has stopped offering the service that was once its raison dâêtre: Surgical abortions. The Vancouver Island Womenâs Clinic made the decision quietly last fall after it became clear that the vast majority of its patients preferred to end their unwanted pregnancies with a pill instead of a procedure. This huge demand for mifepristone â better known as the abortion pill â at the clinic on the outskirts of Victoria came as a shock even to Konia Trouton and Dawn Fowler, the couple who founded the clinic.
âWe were really surprised that within a year of it being funded, our surgical numbers tumbled to being under 50 per cent of what we had been doing the year prior,â Dr. Trouton, the clinicâs medical director, said. Although mifepristone use is on the rise at other Canadian abortion centres, the Vancouver Island Womenâs Clinic is believed to be the only one to have quit providing surgical abortions because of the demand for the abortion pill. Currently, Dr. Trouton is fulfilling the remaining demand for surgical abortions during her operating-room time at the nearby Victoria General Hospital.
The Role and History of Mifepristone
Mifepristone was developed in the 1980s by the French drug maker Roussel-Uclaf and was originally known as RU-486. As a medical option, mifepristone blocks the hormone progesterone, causing the lining of the uterus to break down. Women must take a second drug 24 to 48 hours later called misoprostol, which induces contractions similar to a natural miscarriage. While France approved RU-486 in 1988, Health Canada only approved mifepristone in 2015, by which time the drug was already available in nearly 60 other countries.
Comparison of Medical and Surgical Abortion Elements
| Method | Description and Requirements |
|---|---|
| Medical Abortion (The Pill) | Involves taking mifepristone to block progesterone, followed by misoprostol 24-48 hours later to induce contractions. |
| Surgical Abortion | A clinical procedure that once served as the primary service of the clinic; now performed by Dr. Trouton at Victoria General Hospital. |
| Patient Shift | Demand at the clinic shifted such that surgical numbers fell to under 50% within a year of pill funding. |
Advocacy and the Founding of the Clinic
It is, in many ways, a fitting turn of events, considering the role the clinicâs founders â especially Ms. Fowler â played in the decision to approve the drug. Ever the methodical goal-setter, Ms. Fowler made a list of the highest barriers to abortion in Canada, including the lack of mifepristone, and began plotting to topple them. She and Dr. Trouton worked in near-obscurity for more than a decade to help bring mifepristone to Canada.
Ms. Fowler, the executive director of the Vancouver Island Womenâs Clinic, became the first Canadian director of the National Abortion Federation [NAF] and eventually found a Canadian partner willing to distribute mifepristone. Reflecting on the current state of reproductive health on the island, Ms. Fowler said of the abortion pillâs success at her clinic: âIâm thrilled with it."