In 2015, mifepristone, the international gold standard for medical abortion, was approved for use in Canada. Our content analysis of Canadian newspaper coverage describes arguments in favor or against medical abortion and the evolving regulatory framework for mifepristone from six months before approval until the last province included the medication as a publicly insured health benefit (2015-2019). Our study found an exceptionally high level of support for the approval, introduction and removal of regulatory barriers to mifepristone for medical abortion. Of 402 articles, 67% were pro-medical abortion, 25% presented balanced or neutral coverage and only 8% presented solely anti-medical abortion viewpoints. Of the 761 stakeholders cited, more than 90% made positive or neutral statements about medical abortion. Most articles discussed medical abortion as a health issue and contained arguments about how liberalization of the regulatory framework and public payment for mifepristone would improve abortion availability (68%), accessibility (87%), acceptability (34%) and quality (19%). Mifepristone’s introduction in Canada was presented in newspapers as a way to increase women's health, specifically in rural areas where disparities in abortion access exist. Rather than formal balance, which presents contrasting arguments as equally valid even when the scientific evidence for one vastly outweighs the other, our study identified evidentiary balance where coverage aligned with the majority of evidence and expert opinion. Our results differ from analyses in other high-income countries (United Kingdom, United States) that have found that media frame abortion as a stigmatized and controversial issue or mention abortion predominantly with respect to electoral politics rather than as a health issue. The Canadian print media presented overwhelmingly favorable arguments towards the expansion of mifepristone medical abortion and served to destigmatize abortion by framing the introduction and universal coverage of medical abortion as fulfilling core components of the right to health.

The authors have declared no competing interest.

This study is supported by the Canadian Institutes of Health Research Partnership for Health System Improvement Grant (PHE148161), in partnership with Michael Smith Foundation for Health Research (Award #16743). WVN is supported as a Scholar of the Michael Smith Foundation for Health Research (2012-5139 (HSR)), and as an Applied Public Health Research Chair by the Canadian Institutes of Health Research (2014-2024, CPP-329455-107837). The other authors have no additional funding to report that is relevant to this study.

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