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Based in an isolated northern B.C. town, the obstetrician-gynecologist learned early on that his willingness to perform abortions would not go unnoticed in the tight-knit community.

Shortly after the doctor enrolled his children in the local Catholic school — which colleagues had said was the best around — the town’s priest told him his kids were not welcome.

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“He said ‘We can’t take any money from you … We can’t be associated with you in any way,’ “ recalled the physician, who asked that his name and home town be withheld.

The school expulsion was later overturned by the area’s Catholic bishop and the doctor says he has grown to love the community. Elsewhere, however, the challenges of providing abortion outside Canada’s largest cities appear to be taking a toll.

The number of rural and small-town doctors offering the service has dropped dramatically over the last several years, B.C. research suggests. And a new study concludes that those who remain face a raft of obstacles, from difficulty getting operating time, to hostility from some medical colleagues and the perceived need to keep a low profile.