Harrowing Experiences of Medical Abortions on Canada's Prince Edward Island Renews Criticism

When Courtney Cudmore was prescribed a medical abortion by a doctor at a Charlottetown walk-in clinic, the instructions seemed simple enough.

Get medical help if she bled too heavily, or if she hardly bled at all.

She took the two pills that would induce the miscarriage as prescribed. But a couple of days later, she had barely bled, and it was weighing heavily on her. She went to the emergency room at the Queen Elizabeth Hospital, in the capital of Prince Edward Island, where she waited for five hours.

Finally, she was taken into the examining room.

That's when she found out the doctor was refusing to examine her.

She said he told her he was "uncomfortable" with the situation, saying only that her urine test said she was still pregnant, and that she could go to a clinic in Halifax, four hours from PEI, to get examined further.

She left, confused and scared about what was happening inside her body.

"If I had gone in with a natural miscarriage they would have helped me, but since it was induced, I was garbage and a bother," she wrote on her personal Facebook page.

The PEI health minister has said in a statement to the local newspaper that they're satisfied the hospital reacted according to protocol and won't be investigating further.

Her story made headlines across Canada last week, but for people familiar with navigating the convoluted and often covert methods of getting an abortion in the country's smallest province, her case was neither isolated nor surprising.

Getting an abortion, surgical or medical, on PEI is like so many other things on the island: hard to do unless you know someone who knows someone, who can help you out via social connections.

Medical abortions are legal, but are doled out under a veil of secrecy on PEI. The island is Canada's sole hold out in terms of providing surgical abortions, and doctors who prescribe medical abortions do so quietly for fear of raising the ire of the large and influential anti-abortion groups.

For lots of women — particularly those who make a lower income — taking a pill to induce a miscarriage is a more appealing option than taking days off of work and paying for travel to Halifax to get the surgical procedure, which itself is paid for by the PEI government.

But they're difficult to come by. Though she was denied care almost every step of the way, Cudmore was lucky in the sense that the doctor at the walk-in clinic prescribed the pills in the first place.

Over the past few years, pro-choice groups have acted as gatekeepers to accessing medical abortions. Though it's not written down anywhere, people in the know are familiar with the friendly doctors, and pharmacists, who are willing to prescribe and then fill the prescriptions of medical abortions.

But it's far from a perfect system. Research out of the University of PEI has revealed that not a single doctor on the island provides post-prescription care or check-ups, while other women risk being shamed or refused care, like Cudmore, if they go into walk-in clinics asking for medical abortions.

Related: As Women Die From Illegal Abortions in Brazil, Presidential Candidates Remain Silent

Anastasia Wansbrough lived through a veritable horror show when she had a medical abortion in 2013.

Until now, she's been hesitant to speak to the media, but she says she's sharing her story so people know there's no medical support if procedures go awry on PEI.

Wansbrough thought a medical abortion made the most sense for her when she discovered she was pregnant on July 1, 2013.

A friend told her about a doctor who provided medical abortions, all hush-hush.

"It seemed very cloak and dagger, but the stats that something would go wrong were very low, and the doctor had positive results in the past," Wansbrough told VICE News.

But after she took the medication as prescribed, her body didn't react how she expected. There was very little bleeding and only average cramping. She became worried.

"I had no way of contacting the doctor during all of this — no email, no personal number, nothing," she said.

She was afraid of blowing the doctor's cover, so she waited. But fear and worry overtook her, and she returned to the doctor's office three days later. He didn't see her: a nurse took her blood work, told her that her hormones were higher than usual, then sent her home without an explanation.

Upon her insistence, she returned again for another follow-up less than a week later.

"This time, the nurse was even colder as she quickly got the job done and left me crying alone in the office," said Wansbrough.

She was assured her period would come back within two weeks, but it didn't happen. At that point, it had been over a month since she discovered she was pregnant.

"The panic and anxiousness I felt at this point was overwhelming. I felt I was drowning and people were just shrugging, indifferent, unsympathetic. I was hysterical, shaking."

After repeated calls to his office, she spoke to the doctor again, and he suggested she get an ultrasound. He said he'd book it, but another week later, she heard nothing from the hospital. She says she called him multiple times a day, but received no response. Finally, she got ahold of him, and they found a time for an ultrasound.

At that point, it had been nearly two months since she discovered she was pregnant. Other than online articles, she had no support from anyone, leaving her depressed and isolated.

During the ultrasound, Wansbrough found out the fetus was not growing, but she had leftover uterine lining that needed to be expelled. If she didn't get her period soon, then they'd have to perform a Dilation and Curettage — a procedure that risks miscarriage in the future.

"Still, the relief I felt was staggering," she said. "There wasn't a fetus growing inside of me. I finally had clear knowledge of what was happening inside my body."

A couple of days later, Wansbrough got her period. Painful cramps coursed through her; she took an extra strength Tylenol as the doctor recommended.

"I was wearing a tampon at the time when all of sudden the power of a contraction pushed the tampon out and blood splattered all over the floor."

With every contraction, she lost pools of blood and clumps from inside her body.

"There was constant pain but at every 60 second mark I felt the most pain I have felt in my life. I couldn't cry, I could barely moan. It left me breathless," she said.

She said if she had lost any more blood, she would've felt too unsafe to stay in her home any longer.

Eventually, the contractions subsided, and Wansbrough's two-month saga ended. She has never revealed the name of the doctor who prescribed the pills, because she feels more access to abortion services is better, even though her experience was gruelling, painful and riddled with anxiety.

Wansbrough, as well as others in the pro-choice community, are adamant that the problem isn't medical abortions: it's that everything must be done in secret, out of fear for political and social ramifications from the Prince Edward Island government or the anti-abortion community.

University of PEI psychology professor Colleen MacQuarrie has been researching how women have been affected by the province's abortion policies since 2011.

"I had hoped that we were past that now," she told VICE News in reaction to what happened to Cudmore.

If the doctor's reservations were moral, they would have been moot, argued MacQuarrie, because the fetus wouldn't have been viable when Cudmore was being treated.

"I think that he was ill-prepared to deal with a medical abortion gone wrong."

In his statement to the local newspaper, PEI Health Minister Doug Currie said while he was initially highly concerned about Cudmore's case, he has since been "reassured that the standard quality of care was followed and I continue to be even more motivated to work with stakeholders to continue to remove current barriers that are facing Island women that are looking to access this service."

In an open letter, the PEI Abortion Rights Network outlined suggestions, including establishing local, dedicated clinic days for women seeking abortion care.

"First and foremost, anything that gives women a better range of options for reproductive care is beneficial overall," said MacQuarrie.

"But it's like any kind of technology … If it isn't used appropriately, if it doesn't have the right kind of support, then there can be harm."

Follow Kate McKenna on Twitter @katemckenna8