Dr. Martha Paynter: Pharmacare for Contraception

Stuart Murray  0:00  
This podcast was recorded on the ancestral lands on treaty one territory, their traditional territory of the initial Albay, Cree, og Cree, Dakota and the Dene peoples and on the homeland of the Metis nation.

Amanda Logan (Voiceover)  0:19  
This is Humans on Rights, a podcast advocating for the education of human rights. Here's your host, Stuart Murray.

Stuart Murray  0:29  
Dr. Martha Paynter is director of nursing research with the contraception and abortion research team, and Assistant Professor in the Faculty of Nursing at the University of New Brunswick, where her clinical teaching and research focus on the intersection of reproductive health and the criminal justice system. She is the affiliate scientist for the rose clinic, which is the acronym for reproductive options and services, and the founder director and research and past chair of wellness within an organization of health and justice, which is the only organization in Canada dedicated to advancing reproductive justice for people experiencing criminalization. She is the author of abortion to abolition reproductive health and justice in Canada, which was released in spring of 2022. And she recently participated in a series called critical conversations at the University of Manitoba where I learned about Dr. Paynter Martha, welcome to humans own rights.

Dr. Martha Paynter  1:31  
Thank you for having me. Stewart's pleasure.

Stuart Murray  1:33  
So Martha, why was it important for you to write the book abortion to abolition reproductive health, and justice in Canada?

Dr. Martha Paynter  1:40  
So I'll start with the land acknowledgement we discussed earlier. I'm located right now in Fredericton, which is on the unseeded and surrendered Land of the Wolastoqey. And the University where I work overlooks the will list a river. Thank you so much for that. Why did I write this book? So the short answer is that Fernwood asked me to the longer answer is, I had an experience, you know, I'm a professor of nursing and I had an experience when I was teaching a small group of 20 year olds, and one of them asked me for help to get an abortion. And I realized that this student who was several years into her nursing program, who was obviously of the most obvious age to be aware, and concerned about access to pregnancy, termination care, had no idea what to do. And she was literally in a clinical placement 100 meters from the abortion clinic. And she had called her family doctor and waited for weeks to get in to see him. And he had said, he doesn't do anything like that. And all she had to do was call the right number one time and walk 100 meters. And she didn't know how to do that. And if she didn't know how to do it, then we were doing a very bad job educating people about how to get care. Abortion in Canada has been completely decriminalized for 36 years, there is no legal reason why this student should have had to jump the hoops she did. The reason she did is because of lack of information. And lack of information is a highly solvable problem. So that was the first part. And I also this was pre the dog's decision, right? So this was back in 2021. When I was writing this book, I also felt like what people did know about abortion was wrong, because they were absorbing so much news from the US. And then within our movement, I've been a part of the abortion movement since my childhood, I felt within our movement, we were too self involved. And we were not conscious enough about the very pressing reproductive justice issues that persisted. And if we had brought our energy and our zest for the fight to other areas, it would make a very significant debt. And most importantly, for me, because of the work I've been doing for over the past 10 years in the prison system, it's taking that ethos of bodily autonomy of liberation of the self and applying it to our understanding the prison system. So, the book aims to demystify some aspects of abortion in Canada, normalize it, talk about it. Hope people come to understand that Canada has the most liberal legal regime Even governing abortion in the entire world. And the barriers that we face largely are informational, informational slash geographic, but you can overcome a lot of geographic barriers with information. And then that we need to pay more attention to less visible, reproductive justice fights, fights that are less central to white feminism, and more relevant to people experiencing intersecting oppression, and discrimination. And so examples of that are, are no the forced sterilization of Indigenous women, the barriers that we as queer people face to parent legally, the cost and inequality and access to assisted reproduction. And of course, the sexual and reproductive violence that is incarceration. 

Stuart Murray  5:54  
I think it's such a great way to have this conversation, Martha, because when you talk about the issues in Canada, I mean, even the way you so eloquently just explained it, I'm sure that there will be people that we listen to this podcast go. I didn't know that sometimes, you know, when you talk about abortion, you have to kind of hush your tone, she got to be very quiet. Because, you know, there's a sense that somehow we just been convinced for so long as you say, you listening to American news, that this is something that you are still not is not a right. It's not, as you say, I think it was it was at the Morgentaler decision that decriminalize abortion in Canada.

Dr. Martha Paynter  6:31  
It did. Now, I want to acknowledge that while assaults on abortion are very heavy right now in the US, and certainly have always been heavier. Many of the elders and leaders of our movement in Canada, were there 36 years ago, and in the years just afterwards, where it was still a violent place, right, we did have shootings, we didn't have any killings, thank goodness. But we did have shootings and bombings, we did have these things happen. And people in our movement, remember that, and they remember the security that they needed to take. And we always need to keep cigars, our safety, and the safety of our patients in mind. But we have to think about what to safety really mean, right. And so for instance, for us, in this day and age, I personally, as a very vocal public person who talks about abortion all the time, I feel very safe. I'm very protected by many layers of privilege in my life. And I feel comfort and also responsibility to have these conversations. That's one way of thinking about safety. Another way of thinking about safety is in our abortion clinics, if we position security forces at the front entrance, how does that make our patients feel when we have patients, black indigenous people of color, who are more likely to be carted and assaulted and killed by security forces in this country? How does that make them feel when they come to get our care that is supposedly going to empower and amplify their bodily autonomy? Are they going to feel safe? And so we need to think about that? What does safety really mean anymore? And maybe you're going to feel safest? If you don't face three levels of questioning to try to get into the clinic doors. Why are you here? Who are you at that at that? All right, our understanding needs to evolve?

Stuart Murray  8:41  
So let me just ask you this question, Martha. I mean, it's kind of an obvious one in the sense that, you know, we talk about an abortion clinic. I mean, you in some of the writings that you've done, and some of the blogs and essays and all the stuff that you've been involved in the subject. You talk about abortion care as health care, I mean, you use that term. So why are we going to an abortion clinic, instead, we should be going to a health clinic. It's just It's good. It's a health clinic, that name attached to it. I understand the procedure. But the name itself in some respects, I think conjures up all of these other images that have a stigma to them, as opposed to something positive. I might suggest to you and I could be wrong, that there's a bit of a negative connotation to it. 

Dr. Martha Paynter  9:21  
And I guess we're trying to change that. We don't think of abortion as remotely negative. This is a service that we can provide that suddenly makes you able to finish school, able to escape a violent relationship, able to achieve your employment dreams, able to navigate your toxic family dynamics, able to live in the city of your dreams, like what other health service could we be doing that gives a person all that This is one of the most fulfilling types of work there is in healthcare. And one of the things that has happened that has truly revolutionized the abortion landscape in Canada was the approval of Mr. prestone for medication, abortion and 2015. And its implementation in primary care in 2017. So Canada is very unique globally, in that any primary care provider can prescribe medication, abortion, any nurse practitioner, any family doctor, and we saw almost overnight from 2017 to 2019. Research conducted by my peers at the contraception and abortion research team at UBC, found that the number of abortion providers in two years quadrupled because of the implementation of medication abortion, and that was couple years ago, so the next time we run that survey, it will be even more still. And most of those new providers are doing less than 10 abortions a year. That's because it's just a medication like any other medication, 10 scripts a year for strep throat 10 scripts a year. For abortion, it's normal, it's part of primary care. So you aren't necessarily going to an abortion clinic anymore. You're just going to a health center, student health, sexual health, primary health care clinic, it has changed. And it also is just something you experience at your home. It doesn't have to have any of that white coat anxiety. So we're very fortunate and very unusual in Canada's have this situation where not only are all of these, there aren't these restrictions on who is prescribing. But also the medication is always publicly funded if you have a health card. 

Stuart Murray  11:49  
And please remind me through this conversation, again, what you just said, because I really do believe that it is not as well understood, as you say, one thing you can always change is misinformation. And the notion that Canada is kind of a leader in this regard, you know, is something we should be celebrating, you know, from from it just we don't, I mean, I want to say forget human rights, I don't mean it in the sense, I just think it's just something that is logical, it makes sense. And sometimes Canada is lagging behind on many things. The fact that we're a leader in this thing, Martha, I think is something we should you know, shout from the rooftops, I think we should be so proud that we are doing it not because tomorrow's not going to still have some challenges. And the day after that there's still going to be some challenges against this. But that's just the nature force of what a democracy is about. And the fact that people like you and others in this whole movement. And again, thank you so much for coming on this podcast to continue to talk about and other listeners to engage them to understand that this is something that Canada has, and is a leader in. And it's just, frankly, just the right thing to do. 

Dr. Martha Paynter  12:53  
And with all of these winds, right like last week or two weeks ago, we had the announcement of federal PharmaCare coming in the near future for contraception, that is a huge win, a huge win that we have been asking for. And so rightly, we are celebrating that we are chomping at the bit for it to be implemented, implemented. But we are also saying, now do migrant labor. Now do people without papers. Now fill in the blanks, because there's always going to be the next step. And so within our movement, that is the rhythm, that of course we're going to celebrate the things we've achieved and we have achieved extraordinary things in the past decade, the end of a referral requirement for services in New Brunswick, the creation of the first abortion clinic in PEI, the implementation of medication abortion, centralization of referral in Nova Scotia, it goes on expansion of gestational duration capacity in Ontario and BC, it goes on and on and on, the things we have achieved are monumental. But still, there is work to do. And the things that we are identifying as work to do are much more along those lines of reproductive justice theory as we have been educated by black feminist leaders in the US. So what are those bigger social justice pieces? And when we look at the miracle of medication, abortion in our society, great, but what if you have no home? How is medication abortion at home, a convenient, private and preferable choice if you have no home? So their lines where our efforts have to go now? Is that bigger picture and you were talking earlier before we started this about period poverty? Yes, yes. But what about poverty, poverty? The past we experienced period poverty because we experienced poverty, poverty. So within our movement, it's thinking about how these big picture assaults on our personal herds are obviously also assaults on our reproductive freedom. 

Stuart Murray  15:04  
When you look at some of the great things that have happened, and you've just mentioned some of the Martha in terms of the advancement, what do you put down as the best platform or platforms to try to continue to advance this conversation and you look at, you know, migrant workers, as you mentioned, you know, the whole issue about people that are imprisoned, and you know, you talk about the abolitionist piece of that, which I want to get your thoughts on. But you know, one of the challenges, I think, always through misinformation, which is a social media disease, but you have, obviously had success, and I just would love to, for you to share how you feel the best way to continue to grow this movement that you've been on this positive movement you've been on? What's the best platform to make that happen? Is it through? Is it through government through legislation through politics? Is it through, you know, what, what is, from your perspective, the best way to educate people?

Dr. Martha Paynter  16:00  
I haven't several responses to this. So in abortion, abolition, I tell 23 stories, 23 stories about individual people, normal people, everyday people in Canada, who fought, who had the legal fights, and who won to some extent or another. And that had very important implications for how the rest of us get to live. And it cannot be underestimated how important it is to fight things in the courts. We took PTI to court for the right to abortion, and we didn't even go to trial. They said, Yeah, you're right. Sorry, we'll open a clinic. It's just nobody had sent them before. And it's, of course, terribly intimidating to sue a government. But sometimes you have to and we have case after case of that example, and certainly Dr. Henry Morgentaler is leadership for decades, using that lever. Right now we have a suit against the New Brunswick government over policy 713 and transphobic hate promoted by the provincial government in schools, right. That lever is very important. But not everybody can use that lever. Another lever that I think is really important, obviously, for me as an academic, his research, if members of my team had not produced in my mentor, Dr. Wendy Norman, had not produced those findings in BC, that showed that young people all people were not using contraception, because they couldn't afford it. If her research had not shown the cost benefit of preventing unintended pregnancies, then BC would never have started the universal contraception program. And we would never have had the headway we've had federal So research is essential. But also persistence, persistence, persistence, and although the book abortion abolition is about these legal cases, it really puts the emphasis on the human beings who are totally normal humans who lead those cases. And individual stories really do matter. In case after case, when people realize when they see the human element to what our political environment has caused, they are shocked. They're changed. They are deeply affected and deeply motivated. For whatever reason, the example that comes to mind to me right now is Lisa Adams, who was imprisoned in the Nova institution for women and Truro. And when she was in, first in prison there she was held in a dry cell. So a dry cell is a cell with no plumbing, no water and no toilet and a sink. And you are observed in all your consumption and all of your toileting. And Lisa was held in this dry cell on suspicion of holding contraband and asked her sick 16 days of holding her in that cell, observing her by at least three guards at all times. Finally, they ended this process realizing there is a sexed nature to the assumption that you will pass contraband held in your gastrointestinal tract because you won't pass contraband held in the vaginal canal. Lisa's torture was something she used.  She was public about to her extraordinary credit. She took them to task she took them to court and now it is banned.

Stuart Murray  19:53  
By Martha I'm sorry just stop it what is banned just to be clear, right selling by selling Okay.

Dr. Martha Paynter  19:58  
Of women of For people with a vagina, it is bad. Because you could do it forever and ever and ever and ever, and nothing would ever come up. So it is inherently torturous. So just that's just an example. And that's an abolitionist example. When we care about bodily integrity, when we care about someone's autonomy, what are those things that our state is responsible for? We have decriminalized abortion, that's not something we can fight the State to win, because we have it already. Move on. What about the fact that our federal prison holds people in torture cells and watches their vagina for weeks on end? How about we fight about that. So we need to be conscious of the places where Canada is very, very far behind. Sure, celebrate our wins with abortion, but be conscious of the things that are less visible, less obvious, because they're not being barked about from US news media. 

Stuart Murray  21:05  
Right. And from your perspective, only because the case that you just cited, there's many platforms, and I understand that, but it seems that the courts at this stage are one of the best ways or the best avenues to go.

Dr. Martha Paynter  21:19  
No, I don't want that to be the conclusion.

Stuart Murray  21:21  
I hope not either.

Dr. Martha Paynter  21:22  
It's complicated. I think the conclusion is that we have to be having this conversation. You know, Lisa, just going to the media about what happened to her. That was extraordinary, and that everybody was like what, bad muffins here that happens down the road. That is grotesque. And so part of my objective with abortion abolition was to expose what we do in Canadian carceral facilities, to pregnant people and new parents. We treat them very badly. And that's our tax dollars, our public servants. So there are different ways to have these conversations. But I think the moral of the story is that we need to be having these conversations. Some platforms have different types of impact, but you're only going to get a court case. If you talk about something first, and somebody says, you know, that's a really good court case. That's gonna work. And sometimes court cases don't work. You look at also the extraordinary leadership of somebody like Carrie Lowe, who has taken the Halifax police to court several times because of their mishandling of her gang sexual assault several years ago. And she has not had success. But she has exposed the inadequacy, the toxicity of police forces, how inappropriate it is for police forces to be dealing with sexual assault, how victims suffer in the current regime. Dr. Lane Craig has done extraordinary research to expose how the courts just do not work for victims of sexual assault. And that's one way to do her scholarship. But then you have Carrie Lowe story. And that shows that makes it human. So we need all of these pieces.

Stuart Murray  23:16  
You just mentioned the issue around, you know, policing, with respect to sexual assault. We're in a tremendous conversation that I think you know, that go back to the George Floyd incident, Martha, you know, that was such a earth shattering moment. For so many people yet you talk to any black person, they're going, yeah, like for the last 100 years, this is exactly what we've been witnessing. But only now because of social media. does this become a topic of the day? And you know, this thing about defunding the police becomes a conversation. What's your advice? Or what's your research show Martha with respect to policing and sexuality.

Dr. Martha Paynter  23:58  
What we know is that we are not special in Canada, our rate of incarceration is no twin to the US, but it is quite high for the Western world higher than average. And we certainly have all of our own incidents of extreme racist police violence. The same season, as the George Floyd protests, we had the killing of Sean talmor, the killing of Rodney Levi, you've had killings course many in Winnipeg. So this is not something that we get to excuse ourselves because it's worse than the US. And it's another area where I wish we would pay attention to our own backyard and our own. See No Evil Hear No Evil speak no evil approach to ignoring how racism manifests in public services, including policing We do not collect race disaggregated data in this country in any way, shape or form, as is done in the US. And as a result, we don't have the data. And we're able to say, Oh, well, we we don't have data that shows that, because we didn't collect the data in the first place. Because we felt like we would be very comfortable just saying, well, race doesn't matter, some foolishness. Now, with respect to sexual assault, this is this strange converging of where nursing and policing and the carceral system and community organizations and the nonprofit industrial complex, a lot of different things are converging on the issue of sexual assault. And certainly, it is very clear from what victims have asked for, from what the research has shown that the involvement of police in response to sexual assault is not working. Survivors are asking for third parties to be involved to protect them. Police are sources themselves of sexual assault. They are not people that victims trust in these contexts. And the adversarial nature of the criminal legal system means that they're very unlikely to experience any kind of justice from participation. So we really have, broadly speaking, we have to adjust our addiction to increasing funding to the police, this carceral feminist impulse to increase funding to policing and surveillance, whenever we are despairing about sexual violence. That's the lever we use over and over again and without any positive results. Yeah, I liken it to just this this addiction that we can't stop ourselves.

Stuart Murray  27:07  
Martha, let me ask you, is there a sense that from a training perspective, that 

Dr. Martha Paynter  27:12  
no, no, not at all? Okay, no, no, no, you cannot train your way out of a system that no amount of training is going to make healthcare in prisons appropriate. You cannot give appropriate health care to someone in a cage. It doesn't matter how many courses, sensitivity training, trauma informed PowerPoints, the principle is a problem. You cannot consent to care in shackles, behind bars, it's impossible. And so we're at this fundamental fracture in our professional responsibilities. And no, and we have to stop imagining that we can put more more training more money, more training or resources. No, no, it just feeds the sick system and makes the cancer bigger. 

Stuart Murray  28:08  
So Martha, one of the conversations that I had with with somebody else that was dealing similarly on what we're talking about today, it was more to do with the fact that there's been a sexual assault in a home, of course, you know, the police arrive. And this was with a social health out advocate said, you know, there used to be a situation, I think in Manitoba, but again, I stand to be corrected, I could be wrong, but my understanding that they explained was that there used to be a situation where police officers would never go alone to a sexual assault, they would take somebody who is a social advocate, a social care worker, somebody so that they can actually be the mean, if there's something physical going on, perhaps and maybe I don't know, you may disagree. Maybe there's a role for the police at that point on a physical standpoint, but on the emotional on the standing of the trying to understand what just took place here. A social worker, somebody who's got social understanding of what that situation is about may be better to be an intervention is to help to bring this to a more positive outcome than simply something that the police would look at. Have you got any comments or thoughts on that?

Dr. Martha Paynter  29:13  
The evidence is not terribly compelling, that when you add something to policing, that policing doesn't continue to dominate. So I am skeptical. Just as I am skeptical when you add nurses to a prison environment, the prison environment continues to dominate. This is unfortunately, the institutionalization happens very quickly and very pervasively. So I cannot endorse these plans. 

Stuart Murray  29:46  
Martha, is there any research that you can share that your your team have done? That, you know, really looks at some success rates or some movement in a successful more human pattern? With the abolition aspect of incarceration in terms of some of the areas you're talking about, is there a country, a state, a city, anywhere that you could point to?

Dr. Martha Paynter  30:09  
Oh, I'm often asked this, and I don't like to say, Oh, they're doing a great job and x y Zed place, because all of our contexts are different. And our particular situation in Canada, where the prison is a contemporary evolution of the residential school regime, and is a genocidal institution. This particular manifestation is unique to our colonial, anti indigenous racist history. I also, I think that listeners, viewers, whatever would be disappointed to learn, things are getting worse, things are not getting better, things are getting worse, we incarcerate far more people than we did. When I started this work in 2012, it's the first time I became involved in prison justice work. And from that time, the number of Indigenous women in the federal prison system has gone up, and up and up every year. In 2015, the Truth and Reconciliation Commission called for an end to the over incarceration of indigenous people, and the opposite has happened. We aren't doing any auditing of guests, you know, the Office of the criminal investigator does audit this, but there's no consequences. There's no consequences to us going in the opposite direction, of what every report, every best practice. Everything tells us to stop doing this. And we keep doing it worse and worse every year. 

Stuart Murray  31:40  
You know, I had some involvement with Murray Sinclair, of course, as a matter of Tobin, he was a senator, he headed up the Truth and Reconciliation Commission. So I've had many conversations with him. I guess the question, I would say, to ask you, from your perspective is, after we've gone through this whole trc, this listening and understanding and trying to get a sense of, of the colonization, that that we have inflicted upon our First Nations, why is it getting worse, as opposed to better? Like, were we not supposed to take this conversation and try to learn and become a more open and a more Kinder, and a more understanding and a more just society? But we seem to have, as you say, I mean, the research shows and the number shows you say, things have gone the other way? Yeah, we are becoming more punitive. Where's that gone off the rails in your perspective? 

Dr. Martha Paynter  32:27  
I don't exactly know where it happened. But I know that each one of us needs to reckon with our own sentiments and our own reaction. And how, when things shift when we lose power, and certainly the the erosion of the social safety net has a lot more people feeling powerless. When we lose power, how we cling to those toxic emotions and toxic reactions that give us a semblance of power. And so when we are Most Enraged, when we are most violated, we turn to vengeful, punitive, hateful reactions. And it takes a lot of strength to work through those into something that's more justice oriented. Each one of us each individual person has some reckoning to do I have recommended, we all have reckoning to do about what are the things we aren't very forgiving about. We're impatient, we're intolerant. And also we need to recognize the things that we have done that have taken us in the opposite direction. And an example of that is pro Arrest policy and domestic violence. So that is something that white feminism wanted. We wanted, every time there was a call to a domestic that somebody got arrested. And we just didn't think how this would affect women of color, indigenous women, that they would get arrested, they would get incarcerated. We didn't realize that the system is always hardest on the people who are hurt hardest by the system. And if we centered, people who are experiencing the most marginalization, in policy construction in the way that we design our society as a collective, then we would be far better. But that is not what we were doing. And right now, we're dealing with a lot of populist, toxic politics, that again, you know, trying to make some people feel powerful, because big picture, they've lost power, they've lost economic power they've lost COVID was so disruptive and our sense of power over ourselves. 

Stuart Murray  34:49  
 I will make lots of reference to your book, because I think you know, that knowledge and that information is so so important. There was one thing that I wanted to ask you about that you made a Comment on. And I hope I've got this right. So please, if I didn't correct me, but my understanding is that you said a third of people who can get pregnant in Canada will have an abortion in their lifetime. Is that an accurate statement? And if so, all I can say is, wow.

Dr. Martha Paynter  35:17  
Yeah, it is we're getting a little bit closer to two, only a fourth of people as sex education improves. And that's the number one access to contraception improves, those are the things we can do. Yeah, abortion is extremely common. It's one of the most common clinical procedures that happens. Yeah. Interesting. Has 100,000 Every year in Canada. 

Stuart Murray  35:41  
Yeah. I don't want to get too much in the weeds, Martha. But I know I listened to I think one of your podcasts that you had done. And the question became, I think was asked of you with what's going on in the states now that the Roe v Wade thing has been overturned, and it's now state by state? Is that going to put pressure on, say some of the borders between some of the states in in the United States and Canada, for those people to come in to access health care in terms of an abortion in Canada? And I think the comment was, the challenge is, of course, a lot of Americans don't have passports. I mean, it's not going to be as easy as it appears to. But the one thing that I guess I took away in the question I had was that there's a cost then of I think the number was $2,000, if somebody wanted to get an abortion in Canada, and I was struck by that, when I heard that, I thought, who makes up that cost? Like how did they decide that number?

Dr. Martha Paynter  36:32  
Well, that number is a bunch of different things, right? So you have the cost of phlebotomy of bloodwork of the lab doing the analysis to determine your beta hCG, your pregnancy hormone, we also have the cost of ultrasonography, which although not required for medication, abortion is typical for all procedural abortion and is very frequently used in medication abortion as well. You have the physician or nurse practitioners salary or fee fee for service depending on how they operate, you have the nursing staff, if that's relevant to where they're getting it. So a procedural abortion involves like a tray of sterile trays with a sterile processing costs, the cost of several nurses labor in the procedure room in the recovery room, doing intake, stuffing, the phone lines, all of this goes into determine what the cost of an abortion is. But should that be something that people are paying out of pocket? Of course, I don't think I think that we could probably, we certainly said we we'd be happy to as abortion providers, happy to accommodate us patients. But there just hasn't been an influx. I didn't know this, but the US has one of the lowest rates of passport holders. And then the other thing is the border states, with the exception of like Dakotas, they're actually they're pretty good in terms of which, which are the states that have access to abortion. So what we're seeing in the US, I'm a member of the Society of family planning, and the society of family planning collects all the statistics on how abortion changes in the US. And so what we've seen is, since the dogs decision, the number of abortions in the country has gone up. Interesting. I mean, that's, of course, because people don't want to bring children into a world that hates women. But what's happened is, of course, all those individual states that have banned it, they're not doing any, and the burden on states that are more progressive, has just amplified and amplified and our peers, colleagues in the states are so burnt out, working so hard to expand capacity. And we're seeing provider movement into states where they can work, right, because you have health professionals who have no work to do anymore. So anyway, it's very complex, but it really hasn't. It's even less than we expected. We didn't expect it to be much and it's less than we expected. In terms of movement north.

Stuart Murray  38:59  
Yeah. And I was just hit by that number, right? Because like $2,000 is, that's a big chunk of change for anybody. And so I just didn't know from your perspective, if you would say, here's the number but it's still punitive. It is punitive, but in a different way, is how you're explaining it.

Dr. Martha Paynter  39:14  
I mean, in Canada, we don't think about what are health care costs, because we don't get the bill and it costs, nursing expertise costs, money, phlebotomist expertise, cost money we're paying with for it to our tax dollars, but it costs money and it should cost money like these are services. And by no means is this punitive because it's abortion. Absolutely not. It's what it is.

Stuart Murray  39:38  
I was so infatuated. When I heard the title of your critical conversation here, which is the title of your book,' Abortion to Abolition' and I thought, wow, I mean, it is huge. It is poignant. And yet when you look at it, I tried to figure out, I'm trying to understand what this is all about. And you explain it beautifully. And I guess the question that I would just like to say maybe close our conversation Should on is on abolition, I guess when you look at systems, I mean, you know, the prison is a system that we just have embraced. And it is an understanding for so long that if somebody's bad, put them in jail, get them off the street. I mean, you know, that's been kind of how we have as a society, trained ourselves. And now in the same way that we have to unlearn a lot of things that we have discovered through the Truth and Reconciliation Commission, about what we've been taught about colonialism, what we need to unlearn about some of those elements. From your perspective. I mean, you're, you've done so much research, and you're such a knowledgeable scholar on this. How do we look at looking at the whole abolitionist piece? I mean, I know you'll say we need to start a conversation. And I appreciate that, and you've done an amazing job with that. But if somebody's listening to this podcast and said, I really want to get a part of this movement, to understand how incarceration, particularly for women, is so harmful, and we need to correct and stop it. What would you give people advice on that.

Dr. Martha Paynter  41:04  
We really need to be looking at the evidence, right? So in healthcare, we don't move forward and do something, if it's proven to be harmful. We can't do that, that's unethical, you're not allowed to do it can't do that. And so similarly, we shouldn't be able to do that to people in the justice system, the quote unquote, justice system, you shouldn't be doing things that we know are bad. Stop doing that, you can't do that. And yet, that is what we do. And so part of this is, we absolutely have to have the data that proves what we see, as people working in the prison justice movement, we see what's happening. So we need the data to prove it. And in my field, there is an absolute vacuum of data about sexual reproductive health. We do not know how many children have incarcerated parents in this country. We don't even collect how many kids you have. We don't know. This is outrageous, when every single policy in Canada is supposed to uphold the UN Convention on the Rights of the Child, every single thing we do, as a public is supposed to be in the child's best interest. And we're not even counting the kids who are affected by them. It's scandalous. So this, I think, is the starting point. Why are we doing things when we have no proof that they're good? What are we trying to achieve? And I need some proof. If I want my tax dollars to go into something. And I really need for those of us who are in health serving professions. We need to be thinking about, okay, but my code of ethics says I can only do X. So I can only do X Bostock, I cannot participate in a system that prevents me inherently from my professional obligations. That will work. 

Stuart Murray  43:03  
Right? There's always sort of look at the difference between, you know, people hope, something and the know something. And sometimes the hope and the know, don't always necessarily come together. But you know, I look at the intersectionality of how the religious debate is starting to permeate more and more particularly south of the border, Martha, you know, we've had instances here in Manitoba and Brandon, where all of a sudden, some school districts have had presentations by certain parents to say we need to ban certain books in libraries, and it was like, This is 2024. And that's even a conference. I mean, you're kidding me. But it's reality. And I think one of the challenges is when you start to think about that, is there concern from your perspective, I know, decriminalization took place in 1988, in terms of the Morgentaler decision, and so that that is a breath of fresh air for Canada. And I think we, as you say, we're a leader in it. Do you sit awake at night, sort of wondering if that might find its way and trickle its way into Canada?

Dr. Martha Paynter  44:05  
No, no, no, no. I'd say good drugs. I sleep at night, because I have a lot of work to do in the day. And this is this is actually part of my point. That is not what they are coming for. Right yet. Let's focus on the things that are actually happening right now that are bad. We are right now torturing people in our jails right now. It's not a hypothetical. It's not something that religious right are bringing to us. We are doing it right now with our tax dollars right now. So we have to stop it with the hypothetical things that might happen one day when a bad guy comes. We are the bad guy. We are doing bad guy things.

Stuart Murray  44:44  
Yeah. That is sobering. And again, I you know, for the opportunity to have this conversation, Martha. I look forward to it. So much when I had the sort of green light that we were going to have this conversation. I just I said to you at the beginning that when I said I was looking forward to it, there was a part of me that was a little bit skeptical because from time to time when you get thrown into an arena with somebody who is so intelligent, so highly articulate, and so studied on something, I mean, at the end of the day, why I love doing this podcast Marth is because I always learned something. And I have learned a tremendous amount from you. I'm going to learn more, when I continue to follow you and I want to promote your book as much as I can. Anything I can do to support what you're doing in my way, please let me know, I just think the good work that you're doing is needs to be supported. And, you know, I didn't want to get into this conversation that it needs to be supported, because I happen to be a male. But the fact of life is, is that our voices have to be one voice continually. One solid voice. And so on that note, thank you for taking the time to join me on humans on writes. There's so much more than I'll put into the Episode notes for people that can follow you get some of your research some of your background, some of your education, it is only an opportunity to have an open mind to learn and to participate. And what you do is you say, you've take good drugs, you sleep good at night. I'm happy for you. Thank you so much. But I appreciate you taking time to speak with me, Martha on humans on rights.

Dr. Martha Paynter  46:16  
Thank you, Stuart. Have a great day.

Stuart Murray  46:18  
Thanks very much.

Matt Cundill  46:19  
Thanks for listening to humans on rights. A transcript of this episode is available by clicking the link in the show notes of this episode. Humans on rights is recorded and hosted by Stuart Murray, social media marketing by Buffy Davey music by Doug Edmund. For more go to human rights hub.ca produced and distributed by the sound off media company