In the 10 months it was open, the Alpenglow Women鈥檚 Clinic in Squamish provided 156 abortions, primarily for women living in the Sea to Sky Corridor, but also for those as far away as Lillooet and Kamloops.听
In total, 120 medical and 36 surgical abortions were conducted at the small clinic. Around 59 of the patients also opted to take part in the Safe Methods Program, which offers free contraception (both IUDs and birth control pills) to eligible 小蓝视频 residents.
If you think those numbers are high, consider this: the clinic ran quietly without even some Whistler non-profit organizations knowing it existed. Instead, organizations unaware of it referred women to Vancouver clinics like the Elizabeth Bagshaw Women鈥檚 Clinic.
Dr. Kim MacDonald, the Squamish Hospital鈥檚 obstetrician-gynecologist, opened the clinic鈥攚hich was not run by Vancouver Coastal Health (VCH)鈥攅arlier this year with a nurse and two other GP doctors, one from Whistler and another from Squamish.
But in the wake of his complicated decision to move with his family to Victoria, the clinic has had to close, leaving what some say is a gap in services for women in the corridor.
鈥淢aybe the way to look at it is it鈥檚 a great proof of concept,鈥� MacDonald said. 鈥淚 think women really appreciated and deserve the timely access, local access. The privacy of being in the corridor, but nobody knows who you are or what鈥檚 happening. There鈥檚 definitely a need for that service.鈥�
MacDonald鈥攚ho has served on various provincial and federal committees regarding maternity and women鈥檚 health and works as an assistant professor at the University of British Columbia鈥檚 Department of Obstetrics and Gynecology鈥攚as the only obstetrician-gynaecologist in the corridor.
While a VCH official said in an email that 鈥渁bortions are conducted in the corridor,鈥� they later said that 鈥渢herapeutic abortions are provided to women in the Sea to Sky region. VCH provides these services.鈥�
A therapeutic abortion is when a pregnancy is terminated out of medical necessity for the safety of the mother or because the fetus has been deemed unviable.
The VCH official would not say that medical and surgical abortions are not provided in the corridor, but other sources said that they did not know of any local facilities that provide it. The spokesperson also declined to comment on the closure of the Alpenglow Women鈥檚 Clinic because VCH did not run it. The official would not go into further detail about the closest locations for women in the corridor to access abortion services.
For a medical abortion, the woman first takes a pill to disrupt the pregnancy, and then later a second pill to make the uterus contract and push out the fetus. A surgical abortion is when a doctor uses a suction to remove the pregnancy.
MacDonald said that he and others running the clinic discussed ways to keep it open after his departure, but there were several complications.
鈥淭he problem is the surgical services were only offered by me as an obstetrician. There鈥檚 no one else with that skill set or access to the OR in the community,鈥� he said. 鈥淭he economic model to make it work, I had to be involved. We billed through MSP, but everything got shared. I didn鈥檛 make much from it鈥攊t was about providing a service. And it鈥檚 really hard to make that work if you don鈥檛 have a specialist in the group.鈥�
His hope is that the region will see 鈥渟ome health authority leadership and funding to support and prioritize women鈥檚 health鈥攎aternity services, sexual assault, abortion care, etc. Maybe then it could take off again.鈥澨�
It might not be a great distance for women from Squamish to access abortion services in the city, but for those as far out as Pemberton, Mount Currie and beyond, it can be complicated to arrange a ride down for multiple appointments, he said. Part of the clinic鈥檚 appeal was that it offered an all-in-one service鈥攊ncluding ultrasound, counselling and birth control to prevent second unwanted pregnancies鈥攖o cut down on travel.
鈥淥ne of the areas I felt was important that we don鈥檛 have services for in the corridor was reproductive choice,鈥� MacDonald said. 鈥淭hat was feedback from patients. It was my experience from people having to be sent to the city, especially for Mount Currie and beyond. The First Nations communities鈥� it can be harder for them to access resources. What often happens is they have to travel somewhere for an ultrasound and then they have a separate appointment and they have to travel again for that. It鈥檚 just like barrier after barrier.鈥澨�
Those challenges were compounded when Greyhound ended its bus service in the region last month. At the Howe Sound Women鈥檚 Centre (HSWC), which primarily helps women fleeing abuse in the Sea to Sky Corridor, workers have had to come up with creative solutions like providing gas cards for women to hire drivers.
鈥淭ransportation is such a key in providing services,鈥� said Laurie Hannah, community programs manager with the HSWC. 鈥淚f you don鈥檛 have services, I feel at the very least you should be providing transportation. It鈥檚 one or the other. Right now, we鈥檙e putting it in that crisis situation where there鈥檚 neither. It just makes people more vulnerable. I hear that number 156 (abortions provided at the Alpenglow听 Women鈥檚 Clinic) but then I wonder how many more went out of town.鈥�
For its part, Whistler Community Services Society refers women who reach out to them for help to the Elizabeth Bagshaw Women鈥檚 Clinic. Abortion is a big enough issue in the community that the organization is looking at creating a support group for those who have gone through it.
鈥淲e received some feedback around creating a group to support people,鈥� said Jackie Dickinson, executive director of WCSS. 鈥�(We鈥檙e looking at) developing a program for people who have experienced abortion and are looking for grief support.鈥�
But transportation to help Whistlerites get to any type of medical appointment outside the corridor has also become increasingly challenging, she said.
鈥淲e no longer have a volunteer driving program that can transport people, but we receive quite a few calls,鈥� she said. 鈥淔or people who have health needs and health concerns, sometimes a bus is not always an option. People going through chemo or people who have to be sedated, they can鈥檛 hop on a bus without support鈥� We look at other options. Transportation continues to be a concern for all medical needs that can鈥檛 be served locally.鈥�
But this issue is not unique to the Sea to Sky Corridor, said Dr. David Snadden, the Rural Doctors鈥� U小蓝视频 Chair in Rural Health. 鈥淓mergency transport is one issue, but a bigger issue is the transport to medical care for non-emergency situations,鈥� he said from Prince George, where he moved in 2003 to lead the development of the northern medical program. 鈥淭hat鈥檚 a huge challenge for many, many patients.鈥�
Decisions around which services are offered in which areas is up to each health authority, he added. There is no set formula to determine at what population an area would start to receive certain services.
鈥淚n health care, if you start looking at population stuff, it doesn鈥檛 help the individual,鈥� he said. 鈥淣o matter what the number, if an individual has an issue, they need help.鈥�
Part of the problem for rural communities is that decisions around standards of care are made in urban centres.
鈥淭he protocol that comes out almost can鈥檛 be applied in rural areas,鈥� he said. 鈥淐hange often comes from a number of things coming together. That鈥檚 often the medical professionals, the patients and others working together to raise voices.鈥�
Meanwhile, MacDonald believes the Sea to Sky鈥攁nd Squamish in particular鈥攊s currently at a crossroads. For now, women in need of help accessing abortion services can reach out to non-profit organizations like WCSS to navigate the system in Vancouver.
鈥淎s the corridor has changed, the needs have changed,鈥� he said. 鈥淲e need a bigger scope of services that are available and we need more expertise in certain areas.鈥�
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