Exploring women’s experiences using mifepristone in Ontario
Awarded 2017
Trainee Grants
Kathryn LaRoche, MSc
University of Ottawa

Background: After one of the longest drug review processes in Canadian history, in July 2015 Health Canada approved mifepristone/misoprostol, the gold-standard of medication abortion, for early pregnancy termination. However, Health Canada’s decision included a number of non-evidence based restrictions with respect to both gestational age eligibility and service delivery. Mifegymiso was finally introduced in early 2017. However, most provincial insurance schemes do not cover the medication and thus women will have to pay approximately USD 250 out-of-pocket. Objectives: Our qualitative study aims to understand how these regulatory, systems, and financial dynamics impact the accessibility of medication abortion in Ontario, Canada’s largest and most populous province. We will document women’s experiences accessing and using mifepristone in Ontario, evaluate women’s opinions about Health Canada’s restrictions on the drug, and identify women’s perceptions as to how access to mifepristone could be improved at both the systems and service delivery levels. Methods: We will conduct 60 semi-structured telephone/Skype interviews with Ontario residents who obtained a medication abortion using mifepristone/misoprostol. We will audio-record and later transcribe all English- and French-language interviews. Using ATLAS.ti software to manage our data, we will analyze our interviews for content and themes. Implications: This project represents the first effort to explore the use of mifepristone among women in Ontario. We will engage with Ontario abortion providers to operationalize ways to act on women’s suggestions regarding service delivery improvements. We will also actively engage decision-makers to support regulatory and systems reform that align with the global evidence.