A well-known abortion rights activist is raising concerns about access and the future of the debate here in Canada after Alabama’s Republican governor stoked controversy south of the border by signing strict legislation that would make abortions illegal in nearly all cases, including rape and incest.

On Wednesday, Alabama Gov. Kay Ivey signed a bill that would make performing an abortion at any stage of pregnancy a felony punishable by 10 to 99 years or life in prison, with the only exception being for cases when a woman’s life is in danger. The ban would go into effect in six months if it’s not legally challenged – something abortion rights advocates have already vowed to do.

As women across the U.S. took to the streets and social media to voice their opposition to the legislation this week, Carolyn Egan of the Ontario Coalition of Abortion Clinics, says the debate is far from over in Canada.

Although abortion has been legally unrestricted in Canada since 1988, Egan said there are many women who still don’t have adequate access to the procedure because of a shortage of hospitals and clinics offering the service.

“I think it’s most difficult in rural areas, areas outside of the major cities,” she told CTV’s Your Morning on Thursday. “If you’re in Vancouver, Toronto, or Montreal you have reasonable access, but if you go beyond that, it’s a real problem.”

For example, in the entire province of New Brunswick, Egan said there is only one abortion clinic located in Fredericton and it isn’t funded through a provincial healthcare plan, which means women have to pay for the procedure out of pocket.

“These areas are really, really underserved,” she said.

In terms of the debate itself, Egan said she’s concerned that support for banning abortion in the U.S. will embolden those with the same views in Canada.

“We hope not, but we’re always very fearful,” she said. “Comments like that and what just did happen in Alabama, unfortunately, give confidence to those who want to deny women access to abortion.”

Just last week, Ontario MPP Sam Oosterhoff pledged to make abortion “unthinkable” during an anti-abortion rally in Toronto.

Even though conservative politicians including Ontario Premier Doug Ford and federal Conservative Leader Andrew Scheer have vowed not to re-open the debate, Egan said it’s important to remain vigilant. She said even the Ford government’s plans to cut funding for hospitals and public-health units in Ontario will have a negative effect on women’s health.

“[It will] deny women access to sexual health clinics, for poor women or women who really aren’t well acquainted with the healthcare system, immigrant women, racialized women, young women… where do they get access and birth control?” she said.

On Thursday, federal Minister for Women and Gender Equality Maryam Monsef called on Scheer to “reaffirm Canadian women’s right to choose.”

Egan said legislators can’t ignore the potential health risks to women who are denied access to safe abortions in Canada. She cited examples of women who died because they were forced to have illegal abortions or because they attempted the procedure themselves.

Egan said that approximately 47,000 women die every year around the world from illegal abortions, including in Canada.

“Women have shown, sadly, and many of them have lost their lives showing they will access abortion if they think it’s the right choice for them,” she said.

With files from The Associated Press