Canada is the only country with complete decriminalization of abortion: no gestational duration limitations, no parental consent obligations, and no waiting periods. In recent years, other countries (New Zealand, Colombia, Uruguay, Mexico) have made strides toward this, while the United States has notoriously lost ground. Amidst the tumult, nurse and scholar Martha Paynter uses historical context and contemporary issues to explain why experts advocate against laws governing abortion. Despite decriminalization, Canadian federal and provincial legislation and regulations about health funding, delivery, and human rights all shape how abortion care is delivered. Barriers persist in uneven access, unclear information, and belief-based denial of care. In accessible plain language from the expansive perspective of a clinician, researcher and activist, Paynter describes abortion policy, practice and experience and discusses how to resolve challenges that continue more than three decades after Canada became the world's most legally progressive jurisdiction for abortion.