A/HRC/41/34/Add.2 Contact visits and residential mother-child options should be guaranteed for pregnant women and mothers, and alternatives to incarceration for women should be developed, including adequate housing, income, health services and mental health support. 90. In Manitoba, the Special Rapporteur visited NorWest Centre, a community-based organization providing a wide-range of health and social services for persons in vulnerable situations, including older persons, immigrants, persons in situations of poverty, indigenous peoples, young people and victims of domestic violence. The centre offers a holistic approach and various programmes in different locations, including health services and referrals, support, advocacy and counselling in areas such as domestic violence, parenting, early learning childcare, housing, pregnancy and nutrition. B. Sexual and reproductive health rights 91. Canada has made significant efforts regarding sexual and reproductive health rights. However, the Special Rapporteur received information about retrogressive measures, such as the elimination by the government of Ontario of the 2015 sexuality education curriculum in favour of reinstating a previous one that had reportedly missed key contents in terms of consent, challenging homophobia, Internet safety and information on a diversity of gender identities and sexual orientations.36 92. The Special Rapporteur observed several good practices, including sexuality education at the Lester B. Pearson High School in Montreal, where school professionals can teach children obligatory topics about sexuality at an age-appropriate progression, from basic concepts to more detail and deeper discussions. The programme covers the biology of sex as well as the cultural, ethical, moral, emotional and interpersonal aspects of sexuality. It provides information to help identify and prevent risky behaviour, and teachers are guided to emphasize the positive role that sexuality plays in individuals’ lives. 93. A remaining challenge is access to abortion. While abortion was decriminalized in 1988, the availability of, access to and information about safe abortion care is inconsistent across provinces and territories. Several provinces maintain discriminatory policies, practices and regulations imposing different types of barriers to gaining access to abortion services. 94. For example, New Brunswick regulation 84-20 denies funding for the provision of abortion care in non-hospital settings, such as clinics. Moreover, while some provinces, like Ontario and Quebec, have a high number of hospitals and clinics that offer abortions, others do not, including the three territories, Prince Edward Island and Nova Scotia. Regional barriers in policies and practices to gaining access to abortion are compounded by barriers of accessibility, availability and quality in remote and isolated Northern and rural communities, making it even more difficult for women in these areas to gain access to the procedure. 95. Moreover, women continue to be refused sexual and reproductive health information and services for conscientious objection or religious grounds. Many have been further denied access to accurate information by administrative gatekeepers, mainly in hospital settings, and in some cases there seems to be an institutional-wide conscientious objection policy. Regrettably, national ethical guidelines by the Canadian Medical Association do not require physicians to provide timely referrals upon conscientious objection for abortion procedures, although they do provide for physicians’ ethical duty to inform women about their objection. While some provincial colleges of physicians and surgeons37 include ethical requirements to provide referrals (Alberta, Ontario and Quebec), the Special Rapporteur stresses that, beyond professional ethical codes, the State has the duty to ensure that 36 37 18 For the allegations, see OL CAN 4/2018, available at https://spcommreports.ohchr.org/ TMResultsBase/DownLoadPublicCommunicationFile?gId=24216; for the Government’s reply see https://spcommreports.ohchr.org/TMResultsBase/DownLoadFile?gId=34661. See www.arcc-cdac.ca/postionpapers/95-appendix-policies-conscientious-objection-healthcare.pdf.