Bay Centre: Sexual Health

Image of two people holding hands on a desk while at a doctor’s appointment

The Bay Centre offers comprehensive and inclusive sexual healthcare services.

Established in 1973, we offer patients from across Ontario access to a multi-disciplinary healthcare team and a variety of confidential services, including physical examination, counselling, information and referrals. Our healthcare services include contraception counseling, preventive sexual health testing such as Pap smears and STI testing, pregnancy options counseling and abortion care. Driven by a commitment to inclusive and equitable healthcare for all, our clinic is proud to serve a diverse patient community.

We provide information, counselling and assessment for all methods of pregnancy prevention. Preventing a pregnancy involves using “birth control” and can include hormonal, non-hormonal, and barrier methods

 

Birth control options:

  • Birth control pills
  • Barrier method (e.g. condoms, diaphragm)
  • Birth control patch (e.g. Evra)
  • Contraceptive ring (e.g. Nuvaring)
  • Intrauterine device IUD (e.g. Copper, Mirena, Kyleena)
  • Injectable (e.g. Depo provera)
  • Single-rod implant (e.g. Nexplanon)
  • Emergency contraception (e.g. the morning after pill, post-coital IUD)

To learn more about the different methods of contraception, visit:

Think you might need emergency contraception? Visit WhatsNextForMe.ca, a website developed by Women’s College Hospital to help you choose and access emergency contraception.

Miss taking a pill, or forget to take your contraceptive dose on time? Use the S.O.S. tool created by Sexualityandu.ca, and see what measures you can take to reduce the risk of an unwanted or unplanned pregnancy.

The Bay Centre also offers other sexual health services including:

  • Pap tests (including our Drop-in Pap Program)
  • Testing and treatment for sexually transmitted infections (STIs)
  • Safer sex counselling and information
  • Cryotherapy

To speak with a nurse regarding your test results please call 416-351-3800 ext. 2828

Special Treatment Clinic

We also offer sexual healthcare services to patients of all genders through our Special Treatment Clinic. The clinic provides sexually transmitted infection (STI) testing and treatment.

NOTE: The Special Treatment Clinic is temporarily closed. Please contact the Bay Centre for more information.

We offer the following services related to reproductive healthcare:

  • Assistance with pregnancy decision-making
  • Counselling on pregnancy options

We provide information on, and access to, a range of abortion options, including medical and surgical abortion. We work with each patient to make an informed decision about which abortion option is right for them. To learn more about our abortion care services please see click here.

 

Bay Centre 

76 Grenville St.
Floor 3
Toronto, ON M5S 1B2

Phone: 416-351-3700
Fax: 416-351-3727

Email: bcbc@wchospital.ca

Hours of Service

Monday – Friday 8:00 a.m. – 4:00 p.m.

Note: Phone lines are open Monday – Friday 9:00 a.m. – 5:00 p.m.

Drop-in Pap Clinic: Temporarily closed
Special Treatment Clinic: Temporarily Closed

Special Treatment Clinic

NOTE: The evening clinic (5 – 8 p.m.) is temporarily closed. Please contact the Bay Centre for more information.

The clinic will be providing same day booked appointments; patients will no longer be able to drop-in to be seen.

To book an appointment call 416-351-3800 ext. 2208 Tuesday to Thursday from 9:00am to 11:00am and speak with a nurse who will schedule your appointment for the same-day evening clinic (4:00-7:00pm).  It is best to phone first thing in the morning as these appointments fill up quickly.

Please arrive 15 minutes prior to your scheduled appointment time to ensure sufficient time for registration and completion of any required forms and/or documentation for your visit. Should you arrive late, your appointment may have to be cancelled.

Please notify our receptionist at check in of any changes to your contact information such as your address or phone number.  It is essential that we keep the correct information on file for any follow-up. Always bring your Health Card, Insurance, Interim Federal Health paperwork or photo identification to your appointment.

Please contact the Bay Centre for more information.

The Special Treatment Clinic provides care to patients of all genders.

Services provided include:

  • STI testing
  • STI treatment
  • Syphilis treatment (including for immigration purposes)
  • Treatment of genital warts/molluscum

To speak with a nurse regarding your test results or for any other STI related concerns please call 416-351-3800 ext. 2207.

Drop-In Pap Program

NOTE: The drop-in Pap program (Wednesdays 4 – 7 p.m.) is temporarily closed. Patients can book an appointment for a Pap through the Bay Centre.

We have developed a weekly drop-in program available to anyone in need of a Pap test. The program runs on Wednesday evenings from 4 – 7 p.m. If you have a health card you must bring it. If you do not have a health card please bring insurance, interim federal health paperwork or photo identification with you.

The program is run by nurses. As a result, patients are asked to visit the drop-in program only when they are not experiencing symptoms that would require the immediate attention of a physician.

Anyone with a cervix or internal genitals that has ever been sexually active and is between the ages of 25 to 70 should have a regular Pap test every three years, to be screened for cervical cancer. This includes all people with a cervix or internal genitals regardless of their gender identity or sexual orientation. After the age of 70, people who have had three normal Pap tests in the past 10 years can stop screening.

For more information on the drop-in Pap program, please contact us at 416-351-3700 or BCBC@wchospital.ca.

Abortion Care

The Bay Centre at Women’s College Hospital provides an inclusive and holistic approach to abortion care services. We offer a broad range of abortion options in addition to comprehensive counseling, assessment and follow up. We strive to make the Bay Centre a safe space for all our patients. What matters to us is that you make a fully informed choice that is right for you. These services are for anyone who is experiencing an unplanned or unexpected pregnancy.

To confirm your gestational age or the number of weeks that you are into the pregnancy – estimate using the first day of your last menstrual period. You can also use an online pregnancy calculator.

  • During your initial appointment you will see a nurse, doctor, and possibly a social worker.
  • You may be asked to have an ultrasound and/or blood work. An ultrasound is an imaging test that uses high frequency waves to capture images from the inside of your body.
  • You will then be advised on your options for abortion care. We understand that this is a complex decision and provide counselling services to support you.
  • We provide interpretation services in a wide variety of languages for patients who need it. Family members and friends are not permitted to interpret for the patient. This is done to protect patient privacy and helps to ensure that your medical information is correctly interpreted and understood.

  • A medication abortion is done using pills only.
  • It can be done up to 70 days (10 weeks) after the first day of your last menstrual period, or 56 days (8 weeks) since conception.
  • First, you will have a visit with a nurse. At that visit, we may order bloodwork and ultrasounds.
  • Next, you will meet with a physician who will discuss how and when to take the medication, as well as what to expect.
  • Following the medication abortion, we will arrange a follow up call with you to check how you are doing.

 

  • A “no-touch” abortion is a medication abortion that may be helpful for those patients  who face barriers to visiting us onsite.
  • You will be required to complete a 10-minute questionnaire via myHealthRecord prior to your first appointment.
  • You will be booked for a video visit with a physician
  • The doctor will fax a prescription to the pharmacy for the medicine you will need to take. They will then book follow up virtual visits, usually at 1 week and 4 weeks after you complete the medication abortion.

Please note that a virtual abortion may not be the best course of care for some patients – a clinician will work with patients to ensure they receive the type of abortion care that meets their healthcare needs.

For further information on low/no touch abortions, visit this page.

  • A surgical abortion is a procedure during which a pregnancy or pregnancy tissue is removed from the uterus.
  • It can be done for any pregnancy starting at 42 days (6 weeks) after the first day of your last menstrual period, through to 25 weeks.
  • If you contact the Bay Centre for a surgical abortion, you will be booked for a pre-operative assessment at the Bay Centre. During this appointment you will see a nurse and a physician. You will also have an ultrasound to confirm the gestational age (i.e. number of weeks), and bloodwork. Once this appointment is complete you will be booked for a surgical abortion. You will be welcome to ask any questions.
  • We will offer an appointment with our social worker for additional counseling or to assist with additional concerns related to your abortion or pregnancy options care.
  • Our surgical abortions are currently offered 1-2 times per week. We work with a team of gynecologists and family doctors who provide the procedure. You will meet them the morning of your procedure and have a chance to ask any additional questions.
  • In general, for surgical abortions at WCH, patients are fully asleep for the procedure. The anesthetist will discuss with you the options on the day of your procedure.

Manual Vacuum Aspiration

This type of surgical abortion can be done up to 8 weeks of pregnancy. The procedure takes up to 10 minutes, and you are awake for it. We provide you with mild medications to help with pain, and a local anesthetic is used to freeze the cervix (the opening to the womb). This procedure is very safe; two visits are required (one for counseling and consent, one for the procedure itself).


Suction Dilatation and Curettage

This is a type of surgical abortion that can be done up to 14 weeks and 3 days of pregnancy.  It is done in the operating room, and in general for surgical abortions at WCH, patients are fully asleep for the procedure. However, you can request to have no anesthesia, mild anesthesia, or to be fully asleep for the procedure. The anesthetist will discuss with you the options on the day of your procedure. A machine applies suction to help empty the uterus; this procedure can take up to 10 minutes. The procedure is very safe; at least two visits are required.

If the pregnancy is beyond 10 weeks, you may need an extra appointment to insert a laminaria. A laminaria is a small firm rod that is placed inside the cervix several hours before your procedure. It swells and helps to open, or dilate, the cervix. It is also often referred to as a cervical tent, or cervical dilator.


Dilatation and Evacuation

This is a type of surgical abortion that can be done between 14 weeks and 4 days, and 25 completed weeks of pregnancy. This procedure is very safe. It usually involves 2 to 3 appointments. If you are coming from out of town, please be mindful that you might need to find a place to stay for two or three nights. Bloodwork and an ultrasound will need to be completed during your first or second visit. Cervical preparation using cervical dilators such as laminaria and Dilapan-S is required to help open the cervix.

The day before your procedure you will be required to meet the doctor doing your procedure and have cervical preparation. Local anesthetic is used around the cervix to help with any mild pain. For abortions between 20 and 25 weeks there are a few additional steps. In addition to the cervical preparation, you will be required to take medication in advance of the procedure.

At Women’s College Hospital, this procedure is currently available up to 24 weeks and 6 days gestational age and is done in an operating room. You are put to sleep using an anesthetic. An oxygen mask, an airway called a “laryngeal mask airway” or full intubation “endotracheal airway” may be required. You will meet with an anesthetist to discuss your anesthetic plan prior to your procedure.

Other clinics offering this procedure in Toronto include:

If you do not live in Toronto, or want to learn about other clinics, please visit www.choiceconnect.ca.

If you are over 24 weeks and 6 days gestational age please contact the National Abortion Federation (NAF) to discuss options (NAF Canada Home – National Abortion Federation Canada)

To learn more about the different abortion options available, see our chart.

Abortion Care Questions and Concerns

When a pregnancy is unplanned or unwanted, people sometimes feel overwhelmed by their emotions and alone. They may fear judgement from their family members, partner and peers.  Some people are certain they want an abortion. Others struggle to make this decision in a short time frame. This can be hard when some people need time to process emotions, think through decisions, and seek support from others.  It is important to seek support in making an informed choice that’s right for you. At the Bay Centre we offer pregnancy options counseling and psychological counseling. You can book an appointment at the Bay Centre without knowing if you want to proceed with an abortion. For more information or to get support contact 416-351-3700.

 


What are the risks of surgical abortion?

Some period-like bleeding and pain is common after a surgical abortion. The risks of surgical abortion include infection, hemorrhage/heavy bleeding, retained tissue, and incomplete procedure (i.e. you remain pregnant). The likelihood of any of these risks are less than 1 per cent. Rarer risks include hematometra (trapped blood in the uterus), cervical trauma, and uterine perforation (a complication during the surgery itself where a hole is accidentally pierced through the wall of the uterus or womb).

Known side effects of the medications include nausea, vomiting, diarrhea, and fevers. You will be counseled on these and how to manage them. A medication abortion will lead to a few hours of heavy bleeding and pain. Ongoing heavy bleeding or hemorrhage is a risk and may require a visit to the emergency department. There is a risk of failure (2 to 5% of cases) or of retained tissue requiring further intervention with a procedure or more medications

If you are having a manual vacuum aspiration (MVA) you will be awake with some mild pain medication. Pain is often described as mild to severe cramps. Bringing earbuds to listen to music can sometimes help. The pain does not last long as the procedure only takes a few minutes; ongoing cramps afterwards are common and can be treated with mild pain medications. If you are having a dilatation and curettage (D+C) you will be given anesthetic that puts you to sleep. You will wake up when the procedure is done.
People having a medication abortion will experience cramps that can be quite strong when the abortion is happening. Your doctor will prescribe you some pain medications to take to help with this. Warm compresses like a hot water bottle, or gentle back massage, can help as well. The pain improves immediately after the abortion is complete.

A medication abortion, when using the regimen Mifegymiso (mifepristone plus misoprostol) is up to 99 per cent effective if less than or equal to 63 days pregnant and up to 95 per cent effective if up to 70 days pregnant.

Surgical abortions in the 1st trimester (up to 14 weeks) are 98 per cent successful. This means that up to 2 per cent of the time you might need a repeat procedure or to take medications like misoprostol.

Yes, it is called an induction of labour. It requires admission to a hospital and can take 24 hours to 4 days to be completed. In Canada it is currently much harder to access. In general, it is considered safer to have a surgical abortion, as it is quicker, does not require a hospital stay, has a lower rate of retained tissue or retained placenta, and a lower risk of infection. People who need the products of the pregnancy examined with an autopsy or do genetic tests may be counseled for an induction of labour as there is less damage to the tissue.

Abortion is the medical term used to describe emptying the uterus of a pregnancy. It applies to therapeutic abortions, when an abortion is done intentionally, and to spontaneous abortions, often called miscarriage.

In general, an assessment at the Bay Centre is roughly 3 hours long. That’s because we review your pregnancy options, your health history, do a physical exam, and ensure there is time to discuss your feelings about your decision, and answer any questions you have. This also includes the time required for bloodwork and an ultrasound, which are done to ensure your abortion is as safe for you as possible.

When you have your abortion at Women’s College Hospital, you need to arrive 2 hours before your procedure, and stay up to 2 hours after for monitoring. Although the actual procedure is short (10-15min), the total time you will spend at the hospital is generally around 5 hours.  Sometimes you may be asked to arrive even more than 2 hours before the procedure, depending on whether you need to have any extra preparation.

During the COVID-19 pandemic, we are not allowing support people to accompany patients in the hospital, even for abortion care. However, you can use your mobile device to connect with them remotely during the counselling portion of your care and while you are in the waiting area for your procedure.

Please do not bring any unnecessary valuables. If your phone battery drains quickly it can be helpful to bring a phone charger. Warm/cozy socks usually help keep you more comfortable. You might want to bring a book, headphones, or something else you can do to keep busy while waiting. If you are planning to start an IUD or contraceptive implant at the time of your procedure, please remember to fill the prescription and bring the device with you. Finally, you need your health card or proof of insurance and proof of ID if not covered by OHIP.

At Women’s College Hospital, our abortion care is provided in the operating room. The anesthetic medication we provide can sometimes mean a patient needs an endotracheal tube placed, which is an “aerosol-generating medical procedure”. This is known to increase the risk of COVID-19 transmission. It is our protocol for ALL procedures and surgeries happening in operating rooms to have a COVID-19 test within 48 hours of the procedure. In the event of a positive test, you will be contacted and counseled on your options.

It is possible to still get an abortion after testing positive for COVID-19. Depending on your individual circumstance, your procedure may be delayed until you are considered recovered, or our team will discuss other abortion care options with you.

Bleeding is common and will continue for up to 3-4 weeks afterwards. This can vary especially if you are starting a new contraception. Cramps are also common and get better with time. Acetaminophen and ibuprofen, hot water bottles, are often used to help reduce the pain. People with pregnancies over 18 weeks may get breast discharge, which is normal and will also get better with time.

After an abortion many individuals feel a sense of relief, but it is also normal to experience guilt, shame, isolation, regret and sadness – all emotions encompassed by grief and loss, and due to a shift in hormones from the pregnancy.
It is important to give yourself permission and the space to grieve. One struggle with abortion is that it is a disenfranchised loss, meaning it is a loss that society doesn’t always validate.  This means people don’t feel they have the same right to grieve the loss because it was their choice or because of the judgment and stigma around abortion.  It is important to remember that, though this loss is not identical to other losses, that does not mean it is not a valid loss.  It is an experience that you have the right to grieve.  It is part of you and your story, and you can feel, process, and integrate the complicated emotions that come with that.
The sadness of any type of grief can become overwhelming at times, despite being normal and a natural part of the process. However, if after several weeks you find that your emotions are overwhelming, you are not able to stop thinking about the pregnancy or abortion and you are unable to return to your routine, it may be a good idea to seek professional support. Part of your care at the Bay Center is access to counselling post-abortion. For more information or to speak with the social worker on staff contact 416-351-3700. You may also choose to speak to a therapist or counsellor of your choice in the community.

It is very unlikely for a surgical abortion to affect your future fertility. Some people worry about a condition called Asherman’s Syndrome, which is when scar tissue forms in the uterus leading to menstrual issues and fertility problems. This condition is rare but is more likely to occur when there are complications after a vaginal delivery, miscarriage, medication abortion or surgical abortion, such as an infection. Most individuals who have an abortion go on to have normal pregnancies later in life (if they want to).
It is important to remember there are many factors that affect fertility. The most important one can be age. Infertility is defined as the inability to conceive after 1 year of trying. If someone is experiencing difficulties in conceiving after 1 year, or after 6 months if they are over the age of 35, we recommend they seek the opinion of a gynecologist and/or fertility specialist.

National agencies such as the National Abortion Federation of Canada and Action Canada for Sexual Health and Rights have 24 hour Canada-wide toll-free access hotlines that can help direct you in terms of where your closest options are for abortion care. They also have small emergency funds that can help individuals address the challenges they may face in accessing care. Action Canada can often help navigate other barriers to accessing care, such as when people do not have passports and may need to travel to the US or have legal challenges that impact their ability to travel outside their region. For more information please visit their websites.

The Bay Centre for Birth Control offers Surgical Abortions up to 24 weeks and 6 days gestational age.

Second Trimester Abortion Referral Form

Prepare for Your Appointment at The Bay Centre

In Person Appointments

Please arrive 15 minutes prior to your scheduled appointment time to ensure sufficient time for registration and completion of any required forms and/or documentation for your visit. Should you arrive late, your appointment may have to be cancelled or rescheduled.

Please ensure that our receptionist at check in has your most up to date contact information such as your address or phone number.  It is essential that we keep the correct information on file for any follow-up. Always bring your health card, insurance, interim federal health paperwork or photo identification to your appointment.

Virtual Appointments

In-response to COVID-19, we have accelerated our virtual care services to ensure that we are able to care for patients safely. In addition to our in-person services, we also offer telephone visits and video visits for our patients. Our team will work with you to select the right virtual choice for your health needs. To learn how to prepare for your virtual visit and what to expect during, please visit our Virtual Visits page.

Online Patient Portal

To view your medical information online, stay up to date on your appointment details and view your lab results*, sign up for our online patient portal, myHealthRecord. Patients taking part in video visits and other virtual care services will need a myHealthRecord account. To learn more, please visit our myHealthRecord page.

*Note: Not all results are viewable through myHealthRecord.

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