There's a place in North America where women have to wait for weeks to get an abortion because of lack of funding for nurses, doctors and operating rooms.
This place is not some conservative U.S. state or a remote corner of Canada's far north.
It's Ottawa.
Wait times for abortions in Ottawa stretched to six weeks this summer and are expected to do so again this winter.
Right now, a woman who wants an abortion in the city must wait about 3½ weeks, a delay that's unheard of elsewhere in North America, according to abortion-rights advocates and providers.
"They just wait and wait," says Joan Wright, who runs the Morgentaler abortion clinic in Ottawa. "This reminds me of the old days ... it's getting scarier."
The consequences of long wait times for abortion are problematic, advocates and doctors say, because the window of opportunity is so narrow: The cutoff for an elective abortion in many parts of Canada, including Ottawa, is 20 weeks.
Forcing women to wait weeks for an abortion, advocates say, puts their health at risk.
The longer a woman is pregnant, the more risky and complicated her abortion will be.
"I've had people wait six or eight weeks. By that time they were really far along. It's definitely more dangerous to the patient," says an Ottawa abortion provider who asked that she not be named to protect her privacy and safety.
Waiting weeks for an abortion also means women may suffer morning sickness and other symptoms, as well as the psychological burden of waiting to terminate the pregnancy.
"I was definitely shocked to find out what the wait times were - it made the process that much more traumatic," said Holly, a 20-year-old single mother who was told she'd have to wait five weeks for an abortion in Ottawa. She decided to drive to Montreal to terminate her pregnancy.
The long wait for abortion services in Ottawa is one symptom, advocates say, of how the pro-choice movement in Canada has lost steam since the decriminalization of abortion in 1988.
Although other nations often hail Canada's system as a model for safe, legal abortion, the reality is more complicated.
Nationally, only about one in six hospitals does abortions, according to a 2007 survey of all 791 public hospitals in Canada: That's 15.9 per cent, down from 17.8 per cent in 2003.
"While I wish that a woman was never in a position where she felt abortion was necessary, I do hope that the wait times shorten," Holly, who asked that her last name be withheld, wrote in an e-mail to The Globe and Mail.
"From my experience, women punish themselves emotionally after an abortion and forcing women to wait over a month is salt in the wound."
"We've probably sat on our laurels. Absolutely, access has decreased," says Patricia LaRue, executive director of Canadians for Choice. "It's only when you need it that you realize there are barriers."
Women in Montreal, Toronto, Vancouver and most other Canadian cities can usually access abortion services within a few days.
But no hospitals in Prince Edward Island perform abortions, and in New Brunswick women are required to get referrals from two doctors before having a publicly funded abortion, a practice that's the target of an ongoing lawsuit.
Perhaps the most desperate situation exists in the nation's capital, where wait times have been a problem for years, with no solution on the horizon.
Dawn Fowler, Canadian director of the Washington-based National Abortion Federation, says Ottawa's six-week wait time is the worst she's encountered.
The main problem in Ottawa is money and time - specifically, operating room time. Doctors are willing to perform abortions, but the OR schedule is packed and there aren't enough nurses and anesthetists to go around.
The push to reduce wait times overall has actually made things worse, experts say, because the province's priority areas, such as joint replacement and eye surgery, take operating room time away from everything else, including abortion.
"The Ontario government has begun extra funding [for those priorities]but there aren't any more nurses or anesthetists, so that means other things have to be decreased," says the Ottawa abortion provider.
For example, she says, the hospital has cancelled six abortion clinic days per year - which adds up to about 120 abortions - to give more operating room time to orthopedics.
"It's insane that no more funds are given by the provincial government for abortion services," Ms. LaRue says.
The provincial government pointed the finger at local health authorities, noting that overall funding has increased for both the Ottawa Hospital and the Morgentaler clinic in recent years.
The abortion wait time is a local problem, a health ministry spokesman said.
"We do not track wait times for abortions," said A.G. Klei, a spokesman for the Ontario Ministry of Health.
Ottawa Hospital officials, meanwhile, say they try not to let the new priorities bump other surgeries, but they don't always succeed.
"It is very complex," says hospital spokeswoman Peggy Taillon. "We've tried to minimize the impact. That's not to say there's not going to be some displacement."
The hospital has recently started negotiating to transfer its abortion services to the Morgentaler clinic, which currently operates two days a week. But there's no guarantee that would solve the problem, as the clinic is already overtaxed.
In the meantime, women say the wait wears on them physically and mentally.
"That was the hardest part, my hormones were all over the place," one Ottawa woman wrote to Canadians for Choice, thanking them for their support after she waited two weeks for an abortion. "...I was bloated and so sleepy all the time."
Ms. Wright says she doesn't know how many women simply give up when confronted with the long wait time, but says women who lack the resources to travel may end up carrying their unwanted pregnancy to term.
Anti-abortion activists hope that's exactly what happens.
"A wait time is a good thing in the sense that it gives the woman in a crisis pregnancy more time to think about whether she really wants the abortion," says Stephanie Gray, executive director of the Canadian Centre for Bio-Ethical Reform.
"The unborn are human, so to us whether it happens late or early, still it's killing a human being."
One rare thing activists on both side of the issue agree on: The Canadian public doesn't think much about abortion any more.
Anti-abortion activists decry the lack of attention to their issues. "Why aren't we looking for a way to support these women and help them in their pregnancies?" asks Joanne Byfield, president of LifeCanada.
Pro-choice supporters, meanwhile, say they're struggling to lessen the stigma of abortion and bring access issues to light. "I have not figured out how to say this so people grasp what is happening and how unfair it is," Ms. Wright says.
For now, abortion wait time is an issue that's confined to the shadows.
Women who need abortions are reluctant to speak out publicly, and few people are willing to stand up for a silent, stigmatized constituency.
"They know women will never complain," Ms. Wright says. "Not about this."