women’s clinic. choice in the health clinic. Health Options for Women.
What do these clinics have in common? They all offer abortion services, though it may not be obvious from the names, and advocates say the names themselves could exclude some of those in need of help.
But now there’s a movement within abortion care that’s more concerned about the language they use — whether it’s to be more inclusive or to drop the euphemisms and be more outspoken.
“I think it’s very important to be very clear about what we’re doing,” said Martha Paynter, an assistant professor in the School of Nursing at the University of New Brunswick and author of Abortion to Abolition: Reproductive Health and Equity in Canada.
“We have allowed the anti-choice movement to dominate much of our language and conversation about what abortion is. And it’s really necessary and timely for those of us who work in this care to provide clarification of the facts and to help the public to come along in their understanding.”
The Abortion Rights Coalition of Canada lists 76 clinics in Canada (both community and in-hospital) that perform abortions, although it does not include every single hospital that offers them. Of those clinics, only four — three in Ontario and one in Quebec — had “abortion” or “termination of pregnancy” in their names.
There have been many variations on “women’s health” and some mentioning “wellness” and “choices,” but very few names spell out the medical procedure on offer.
A history of stigma
In a 2021 online guide, the American Civil Liberties Union (ACLU) called for more “abortion language” or, in other words, to refer to abortion as “abortion,” rather than using euphemisms like “women’s health care” or “reproductive choice.”
“The use of euphemisms for the word abortion gives the opposition control of the narrative,” the ACLU noted.
This call is also reflected in the #Say abortion Hashtag, that was a 2019 campaign Planned Parenthood and still used today by lawyers.
So why don’t we just say “abortion clinic”? Part of this is the turbulent history of abortion. Many of Canada’s abortion clinics were established shortly after 1988, when the Supreme Court ruled in R. v. Morgentaler that a law criminalizing abortion was unconstitutional, Paynter said.
In the 1990s there were three non-fatal attacks on abortion providers in Winnipeg, Vancouver and Hamilton. In 1992 the clinic was founded by Dr. Henry Morgentaler firebombed in Toronto. In the US, abortion clinics have become targets of violent extremists, and some doctors performing abortions have been attacked in their homes and killed.
“There was still a lot of stigma and safety concerns around offering abortion treatments,” said Jill Doctoroff, executive director of the National Abortion Federation Canada.
Doctoroff says there’s also an issue of confidentiality. She used to work at a clinic that didn’t have abortion in its name, and that clinic sometimes had to provide medical records as a requirement for a patient’s work or school. Not offering “abortion” on behalf of the clinic would protect her privacy, she said, noting that the same goes for referrals.
But today, people are becoming more accepting of the term abortion, especially in Canada, Paynter said.
“In response to the fall of Roe [v. Wade] In the US, there has definitely been a very proud and grateful response from the Canadian public to our regulatory system, where abortion is fully decriminalized in this country and there are no criminal law restrictions,” she said.
“The clinics haven’t quite caught up with the change in public attitudes towards the word abortion.”
The problem with “women’s clinics” and “choices”
However, once a clinic name is established in a community, it can be difficult to make a change, explained Joyce Arthur, executive director of the Abortion Rights Coalition of Canada. It can also be quite expensive, she added.
“Some clinics may be on a tight budget and don’t have the money to make a big name change,” Arthur said.
That doesn’t mean it’s not happening, but so far it’s not about adding “abortion” – it’s about eliminating “women”. Two Vancouver clinics recently dropped “women” from their titles: the Willow Clinic (formerly the Willow Women’s Clinic) and the Elizabeth Bagshaw Clinic (formerly the Elizabeth Bagshaw Women’s Clinic).
And in December, Health PEI announced that it had changed the name of Women’s Wellness and Sexual Health Services to Sexual Health, Options & Reproductive Services (SHORS), noting that the new name reflects the population it serves in a more comprehensively and accurately reflected.
“The language we use in healthcare is important,” said Andrew MacDougall, Executive Director of Health PEI for Community Health and Elderly Care, in a press release. “If you try to access the services of such a program and find that the name doesn’t include you, it can be a real barrier to receiving care.”
Anastasia Preston, Trans Community Outreach Coordinator for the PEERS Alliance, noted that the change will help enable people of all gender identities to access the health care they need.
This is part of a nationwide trend in abortion treatment that recognizes that not everyone who can conceive identifies as a woman, Paynter said. According to the 2021 Census, approximately 1 in 300 Canadians age 15 and older identify as transgender or non-binary.
In its online statement on language, the National Abortion Federation Canada states, “We embrace and respect each individual’s gender identity, expression and experience.” B. pregnant person, pregnant people, she, her and patient.
Doctoroff says the organization has offered sessions on inclusive language as well as inclusive care and they’ve had a really positive reception.
A number of clinics and abortion advocates in Canada also use the term “choice,” another word some proponents have used to question despite its past popularity.
“Certainly in the ’90s when the clinics opened, ‘pro-choice’ was the buzzword,” Arthur said.
Paynter says the use of the word is misleading and the notion that it is an election is almost superficial.
Some studies have shown that those who request abortions and are denied them can suffer long-term health consequences, are more likely to experience poverty and unemployment, have higher levels of anxiety, are more likely to remain in abusive relationships, and their children are worse off than their peers.
“It’s not like you’re choosing between equal options,” Paynter said. “It is our individual social, economic and structural circumstances that drive our decisions. And while abortion is a choice, for most people who get one, it really doesn’t feel like a choice.”
Arthur also notes that a number of anti-abortion groups or pregnancy crisis centers have adopted the use of “choice” into their language. The Woman’s Choice clinic in Charleston, W.Va., for example, aims to discourage women faced with unwanted pregnancy from choosing to have an abortion, reports the Associated Press.
People also often refer to “a woman’s right to choose,” Arthur said.
“Please, let’s retire that phrase,” she said, noting that a better term would be “reproductive rights.”
“A Difficult Line to Walk”
Our choice of language is important because it helps shape public perception and education, Paynter said. For example, the moniker “surgical abortion” is also misleading, she said, since a first-trimester abortion is a seven-minute, no-incision procedure.
“If we educated people on what it was really all about, there would be less fear and less stigma.”
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At the same time, renaming all clinics “abortion clinics” would not include all of the services many of those facilities offer, such as trans care, fertility testing and Pap smears, she said. And now that general practitioners can prescribe abortion drugs, it’s important for abortion clinics to diversify.
Doctoroff noted that the language changes aren’t always easy for clinics as they try to balance confidentiality and security without contributing to the stigma.
“It’s a hard line for many institutions.”
