MONTREAL — Kemlin Nembhard, head of the Women's Health Clinic in Winnipeg, Manitoba, says there has been no way to plan for a post-Roe world. No signal of how many Americans might look for abortion services in Winnipeg, a little over an hour's drive from the U.S. border, now that the Supreme Court ruled Friday to overturn Roe v. Wade.

"Are people going to be coming north? Or Are they going to go to another state? We don't know," she said.

The clinic already saw some patients from neighboring North Dakota, which has had a trigger ban ready to take effect once the Supreme Court overturned Roe. Canadian clients come from across a huge area, some driving up to 10 hours, or flying in from remote northern communities for abortion services.

Canadian researchers and abortion advocates say they expect most Americans from states with abortion bans to travel to nearby states that allow them. But, Nembhard says, even relatively small numbers coming to Canada could strain capacity in certain areas.

"Every year, we actually provide about a quarter to a third more abortions than we get funded for," she said. "Realistically, if the population of North Dakota, people that wanted to access abortions, or even if there were a whole bunch of northern states, right, that came to us, there's no way we can meet that need."

The executive director of Canada's National Abortion Federation, Jill Doctoroff, says patient support groups in the United States had already begun inquiring about options for Americans to come to Canada, but that she also foresees potential impacts on Canadians.

"I know that there are many groups, including governments, that want to help and support Americans accessing care," she said, while noting that Canada already struggles to deliver abortion services to rural residents as well as later in pregnancy, after 24 weeks, when serious health problems can become apparent.

Karina Gould, the federal Cabinet minister of families, children and social development, told the Canadian Broadcasting Corporation in May that Americans could seek abortions in Canada but said she also worried about impacts for Canadians.

"One of the concerning factors here is that there are many Canadian women who maybe don't live near a major city in Canada, that will often access these services in the United States," Gould said.

The organization Action Canada for Sexual Health and Rights runs a hotline that helps people seeking abortion referrals. Frédérique Chabot, the organization's director of health promotion, says they sometimes support travel to U.S. clinics, mostly in Colorado, where abortion is expected to remain legal.

"But," said Chabot, "there's gonna be so much more pressure on those points of services from neighboring states and people needing to travel internally in the United States, which may mean that care is delayed by weeks."

Chabot also expressed concern about the political impacts the decision could have in Canada "in terms of is considered possible for anti-choice activism."

Days after the draft decision leaked on May 2, Jack Fonseca of the Campaign Life Coalition, spoke outside Canada's Supreme Court, calling on anti-abortion activists to support politicians and Supreme Court justices who would ban abortion in Canada.

"We have a lot of work ahead of us but the overturning of Roe vs. Wade will help us towards that goal because it will enable Canadians to have kitchen table conversations," Fonseca said.

A poll conducted in May by the Canadian opinion firm Leger found that 79 percent of Canadians somewhat or strongly supported the right to seek an abortion.

Associate law professor Kerri Froc, at the University of New Brunswick, said she considers the legal rights to abortion "fairly secure" in Canada for now.

"For us," Froc said, "the devil is more in the details in terms of making sure that women practically have access."

University of Ottawa law professor Daphne Gilbert, who also serves on the board of an international nonprofit called Women Help Women, recommended anyone assisting Americans traveling to Canada, "be very careful about how public you are about your arrangements and the networks that you're building."

States intending to ban abortion, she predicted, will also seek to pursue women who leave the state for procedures elsewhere.

While she does not expect Canadian authorities will help facilitate investigations, and does anticipate legal challenges to such restrictions, in the short term, she said, "it's going to be a very cowboy sort of vigilante system of citizens turning in citizens."

"It's, you know, ridiculous and unbelievable to think that in the United States, we're going to have to start taking the same measures that we take in, in Poland and Thailand," Gilbert said, "but that's I think, where we're going."

Copyright 2022 NPR. To see more, visit https://www.npr.org.

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