Access to Abortion for Undocumented Persons during the COVID-19 Pandemic mandatory letter from their health care provider stating they are accessing essential health care so they could cross the border (and being at the mercy of border agents’ goodwill), mandatory COVID-19 testing before boarding flights, the cancelling and rebooking of flights, lockdowns and quarantine requirements. 10 For someone who does not have Canadian citizenship and/or a passport that enables travel to the United States, it is a dead end. Likewise, for those whose visas have expired due to extended stays in Canada during the pandemic, they are unable to cross into the United States for fear of deportation and/or being unable to reunite with their family when they return to Canada. As a society, we do not often appreciate why abortion seekers need access to care in the second and third trimester. We know one of the main reasons that people need care later in pregnancy is because struggled to access care in the first place. This is one reason why undocumented people and those in precarious immigration situations are a group of people we often support accessing later abortion care. Many of them do not know where to go for an abortion as they are not connected to health care services, face waiting period before they can access health insurance because of immigration policies and provincial health coverage eligibility requirements, need time to collect money to pay for the abortion out of pocket or for travel to a point of service, are afraid of seeking health care because of their immigration status or statelessness, are fearful of deportation should they engage with the health system, experience linguistic barriers or experience restriction on their movement from employers or sponsors for numerous reasons. This means that many people who are already in extremely vulnerable situations find themselves more likely to face complex barriers in accessing an abortion. This is without considering the difficulty in accessing culturally safe and relevant abortion services and protecting confidentiality. For undocumented individuals whose primary language is not English, language barriers and a lack of translation/interpretation resources within health care settings often result in complex situations where communication is hindered. This makes creating an appointment, coordinating financial support, establishing informed consent and communicating about the procedure and aftercare incredibly difficult and time intensive. When hospital or clinic-based interpretation services are not available, community-based interpreters are sought. 11 However, in many cases, this can jeopardize the patient’s anonymity or confidentiality as members of their potentially small communities may be engaged to provide interpretation services. Likewise, since the majority of providers require patients to have a support person on the day of their procedure, undocumented individuals may have less access to supportive networks or communities depending on their situation, and this may pose a significant barrier. Where possible, doula collectives meet this need, but are often only accessible in large urban centres. 10 11 ‘COVID-19 Information — Canada’, US Embassy & Consulates in Canada (Web Page, 13 July 2021) <https://ca.usembassy.gov/covid-19-information-canada-3/>; Loprespub, ‘The COVID-19 Pandemic and Air Ticket Reimbursements’, Hillnotes (Web Page, 15 April 2021) <https://hillnotes.ca/2021/04/15/the-covid-19-pandemic-and-air-ticket-reimbursements/>; ‘Fact Sheet: DHS Measures on the Border to Limit the Further Spread of Coronavirus’, US Department of Homeland Security (Web Page, 22 October 2021) <https://www.dhs.gov/news/2020/10/19/fact-sheet-dhs-measures-border-limit-furtherspread-coronavirus>. Anjum Sultana et al, Language Interpretation Services in Health Care Settings in the GTA (Wellesley Institute 2018) 5, 11. 145