Abortion clinics in the State of Maine are reporting a marked increase in the number of New Brunswick women seeking their services since the Morgentaler clinic in Fredericton closed about two months ago.
One clinic in Bangor says New Brunswick women accounted for about half of its dozen abortion appointments last week.
The American providers say they are happy to fill the gap in services and will even provide financial assistance for any New Brunswick women who can't afford the $500 fee, either by dipping into their national network funding or through local donations.
But they are urging premier-designate Brian Gallant to ensure access to abortion services in New Brunswick.
"Abortion is part of a woman's reproductive rights," said Kate Gawler, director of abortion services at the Maine Family Planning clinic in Augusta.
"Certainly it's an extra hardship to drive the four-and-a-half hours or five hours," she said of the round trip.
"The passport issue is another barrier."
The Maine Family Planning clinic used to get the occasional phone call from Canada, but now it's routinely getting about one or two calls a week from New Brunswick women, said Gawler.
"It doesn't surprise me that women are coming to Maine, because they have to go somewhere," she said.
Morgentaler clinic closed in July
The Morgentaler clinic in Fredericton was the only private abortion clinic in the Maritimes.
It performed about 600 abortions a year — about 60 per cent of all abortions performed in New Brunswick, but announced in April it would be closing at the end of July over a lack of government funding.
Under Regulation 84-20 of the New Brunswick Medical Services Payment Act, abortions are paid for only if they are performed in one of two approved hospitals after being deemed medically necessary by two physicians.
Gawler said she has many concerns about how the New Brunswick system is set up.
"First of all, this is a decision that a woman must be able to make for herself. She is the only one who can really understand everything involved. And it is not an equal situation, if she has to get permission from other people or if she has to plead her case. I mean, what does 'medically necessary' mean? That's a pretty high hurdle," she said.
"Why does it have to be medically necessary if it is a pregnancy that she cannot continue? With every fibre of her being, she is saying, 'I simply cannot do this right now. I know this.' To me, to ask her to get two doctors to write a paper that says it's medically necessary, it's demeaning, it's partronizing and it certainly doesn't foster the equality of women. It actually puts up a big barrier in her ability to be the moral agent for her own life."
Premier-designate Brian Gallant has promised a review of what he considers unconstitutional restrictions on access to abortions in New Brunswick.
Gallant has said he will convene a group of experts, either those inside the new Liberal government and perhaps some from outside, to identify the barriers to abortion.
Reproductive Justice New Brunswick says it plans to launch a "Days of Inaction Timer" on Tuesday after Gallant's government is sworn in.
Gallant "has the opportunity to create real change, but every day without access the lives of New Brunswickers are put further at risk," Jessi Taylor, a spokesperson for the organization, said in statement.
Ruth Lockhart, co-founder of the Mabel Wadsworth Women's Health Center in Bangor, and chair of the reproductive rights coalition, said she also worries about the New Brunswick women in need of services.
"We are seeing a spike in the number of women from New Brunswick," she said.
"So far, and we're new into this piece of it, it's the women with resources who are able to make it here," Lockhart said.
"So my concern is always the women without resources who don't come, who aren't able to come."
George Hill, the chief executive officer of the Maine Family Planning clinic, said he is "angry, quite frankly" about the situation in New Brunswick.
"I thought Morgentaler was a giant in his field. He was brave, persistent. This was his legacy and I think it deserves to continue," said Hill.
But Maine abortion providers are also busy dealing with their own battles.
Although the state legislature is pro-choice, the current governor, Republican Paul LePage, who is seeking re-election next month, is anti-abortion.
Planned Parenthood is trying to make reproductive rights an issue in the gubernatorial election, endorsing Democratic candidate Michael Michaud with an "I Like Mike" TV ad campaign.
Hill says opponents to abortion are getting smarter, targeting pieces of state legislation to get what they want.
"It's a state-by-state battle," he said.
In Texas, for example, the law changed, requiring abortion providers in clinics to also have hospital privileges. Since then, the number of clinics has dropped to seven from 40.
In June, the U.S. Supreme Court also struck down a buffer zone law in Massachusetts that stipulated people could not protest within 35 feet of abortion clinic entrances.
That law was enacted in 2007 in response to the killing of two receptionists in a shooting in Brookline, near Boston.
The opponents to reproductive rights are being very clever, very strategic. They're taking one law at a time, one procedure at time. And they're working it, very, very cleverly," said Hill.
"And on our side of the fence, we have to be thoroughly and completely vigilant. We cannot allow people who oppose what we do to gain traction with some of their hare-brained ideas," he said.
In the meantime, the abortion clinics in Maine operate in a state of high vigilance for people who might operate outside the law.
They have bulletproof glass, gated driveways and multiple locking doors throughout.
They do not advertise and do not use doctors' names.