The abortion pill may now be free in Ontario, but women across the province trying to get the drug still face one major hurdle: finding a doctor to prescribe it.

The province’s plan to cover the $300 cost of the pill, called Mifegymiso, kicked in last Thursday. The Liberal government had included plans to cover the cost in last spring’s budget.

Mifegymiso is a combination of mifepristone and misoprostol, which block the production of progesterone and induce a miscarriage. The pill, listed by the World Health Organization as an essential medicine, was approved by Health Canada in 2015 for women up to seven weeks’ pregnant.

But few Ontario doctors are authorized to prescribe it.

Just 1,800 physicians and pharmacists in the province have taken, or are registered to take, a five- to six-hour course that is required to prescribe or dispense the pill, according to the Society of Obstetricians and Gynecologists of Canada.

There are nearly 30,000 practising physicians in Ontario, as well as more than 15,700 pharmacists.

Yet even though some doctors have taken the course, Catherine Macnab, executive director of Planned Parenthood Ottawa, estimates there are just 10 places in the province where women can go to get a prescription for the pill right now.

In the U.S., where the pill has been available since 2000, it’s prescribed outside of hospitals or major clinics just two per cent of the time, according to Macnab.

“This idea that a family doctor can prescribe it isn’t what’s happened in the U.S., and so what we’re seeing now in Canada is that the same thing is happening,” she said. “We don’t want it to be seen as something you specialize in, we want it to be that people who’ve missed a period can go see their family doctor and get their prescription.”

Carolyn Egan of Ontario Coalition for Abortion Clinics said it will take time to establish the level of access that many advocates are hoping for.

“It is quite low,” Egan said. “My sense is that we will be seeing more now that it’s become available in the way that the cost will be covered. I think you’ll see more facilities choosing to provide it for women.”

Dr. Michael Kam of Onyx Urgent Care, a clinic in Kitchener, Ont., described it as a “work in progress.”

“This isn’t part of standard training so there are a lot of physicians who may not be as familiar with (it),” said Kam, who took the course about two weeks ago after seeing an increased number of requests for termination of pregnancy at his clinic.

“The only access for it at this point in time was in Toronto, so any patient in the whole entire southwestern Ontario area had to travel to Toronto. That was causing some difficulty. We started discussions and felt that this was a need for the community.”

The abortion pill has been touted as a safe alternative to surgical abortion for women living far from major urban areas. But the shortage of trained doctors able to prescribe the pill, especially in rural or remote communities, still poses a challenge.

Smaller centres also face the complication of lacking the necessary resources to prescribe it. Health Canada requires an ultrasound examination to first take place in order to determine how far along the pregnancy is.

Joyce Arthur, executive director of the Abortion Rights Coalition of Canada, said she’s hoping barriers to access fade over time.

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As more provinces begin to cover the cost of abortion pills, she said she’d like to see doctors receive the necessary training to prescribe the pill during their schooling so that courses won’t be required later on in their careers.

“With the registration process, it does sort of make it an optional thing, which is too bad because abortion has been designated as a required, necessary medical service by all the provinces and territories,” Arthur said. “I don’t think patients should be turned away or refused because the doctors don’t want to, or are anti-abortion, or aren’t registered. These are just barriers to abortion access that other treatments don’t have.”