Mistreatment and Abuse is a Reproductive Justice Issue

My name is Kate Macdonald. I’m a patient advocate and complaint doula based in Toronto, Ontario and the founder of a patient advocacy initiative called The Reproductive Justice Story Project. With this year’s theme of “Sexual Health at All Ages” in mind, I’d like to highlight the epidemic of disrespectful and abusive treatment in sexual and reproductive healthcare in Canada. This is a wide umbrella that covers a lot of ground, but is rarely addressed in the public sphere, especially not as a set of interconnected issues. I believe it necessary to examine them together, framed as human rights issues —and therefore, Reproductive Justice issues— in order to imagine and implement meaningful solutions for the future.

Evidence of mistreatment and abuse across the spectrum of care providers and care settings in Canada is just a quick google search away. It’s no secret that Indigenous women in this country are still forced to undergo coerced abortions and sterilization,[1] patients’ symptoms have been dismissed and ignored by care providers leading to serious complications and preventable deaths,[2] incarcerated pregnant people have gone without proper care and labour support,[3] residents of some rural and remote communities are forced to leave their homes and families just to give birth[4] or to access abortion care,[5] and obstetric violence[6] is rampant across care settings and demographics.

These issues, and others, do not exist in silos. They are part of a wider set of societal problems: the normalization of violence against women, trans, two-spirit, and gender non-conforming people, compounded by social determinants of health and the fundamental faults in our patriarchal, colonial medical system that is often not person-centered or rights-based and does not consistently prioritize self-determination, informed decision-making, or even consent!

It’s one thing to have choice in our reproductive lives, another to have access to the care we choose. Far too often, our rights are forgotten from the equation. It is not enough to have choice and access if the care that’s available still leaves many of us feeling unsupported, traumatized, or physically harmed. As long as these truths remain—as long as some of us are still leaving our sexual and reproductive healthcare experiences feeling this way—there can be no justice.

This is the idea behind The Reproductive Justice Story Project. It’s a patient advocacy initiative aimed at exposing mistreatment and abuse in reproductive healthcare across Canada. On the Community Story Blog, our online story-sharing platform, folks have been sending in their own experiences of injustice; whatever that means to them. From non-consensual medical interventions, to verbal abuse, shaming and bullying from care providers, racism and discrimination and the fear of reaching out for perinatal mental health support under the looming threat of Children’s Aid involvement. Some have even shared their experiences undergoing painful reproductive procedures without anesthesia. The blog serves as a public body of evidence of the type of troubling treatment patients are facing today.

No matter where or how the mistreatment occurred, whether the experience was medically, legally, or emotionally troubling, there are common themes that continue to come up. These include a lack of dignity, autonomy, communication and consent in the experience, as well as healthcare providers, systems, and policies that undermine our embodied knowledge and decision-making power for our own bodies and our own lives.

The Community Story Blog began as a place for people in Ontario to share their own stories in their own words, anonymously or otherwise. Now we’re pleased to begin publishing submissions from patients and professionals across Canada! Consider sharing your own experiences on the blog.

Speaking up about these issues loudly and publicly is one way to hold harmful systems accountable and push for change in the culture of reproductive healthcare. Our voices can be powerful if we all speak up together!


The Reproductive Justice Story Project is a patient advocacy initiative aimed at exposing mistreatment and abuse in reproductive healthcare across Canada. The project centres on an online platform for those who wish to share their stories, and resources to help others speak up.

[email protected]

Kate Macdonald turned a personal experience of obstetric violence and Postpartum PTSD into a passion for patient advocacy. Kate is now a parent, activist and complaint doula based in Toronto, Ontario.
[1] “Examine ‘monstrous’ allegations of forced sterilization of Indigenous women: NDP” by Kristy Kirkup https://www.cbc.ca/news/politics/sterilization-indigenous-allegations-forced-1.4911837

[2] “Days after giving birth to a baby boy, mom dies of strep A in hospital” by Shanifa Nasser https://www.cbc.ca/news/canada/toronto/ayesha-riaz-new-mother-dies-strep-childbirth-1.4567078

[3] “Pregnancy, birth, and mothering behind bars: A case study of one woman’s journey through the Ontario criminal justice and jail systems” by Sarah Fiander https://scholars.wlu.ca/cgi/viewcontent.cgi?article=2980&context=etd

[4] “Ottawa changes policy to ensure women giving birth away from reserves aren’t alone” by Kritsy Kirkup https://www.theglobeandmail.com/news/politics/ottawa-changes-policy-to-ensure-women-giving-birth-away-from-reserves-arent-alone/article34644248/

[5] “Getting an Abortion in Rural Canada Isn’t Easy” by Tamara Khandaker https://www.vice.com/en_ca/article/kwpeyw/getting-an-abortion-in-rural-canada-isnt-easy

[6] “’Stop! Stop!’: Canadian women share stories of alleged mistreatment in the delivery room” by Annie Burns-Pieper https://www.cbc.ca/news/health/child-birth-mistreatment-complaints-1.3834997