Successive governments in New Brunswick have failed to ensure residents have access to abortion services, even though all provinces, including New Brunswick, consider it to be a medically necessary procedure, thus making it subject to the conditions and criteria of the Canada Health Act (1985). Not providing access to this service is considered a violation of the Act. From 1994 to 2024, governments in New Brunswick restricted abortion access to hospital settings. As New Brunswick allows more procedures, such as cataract surgery, to be done in private clinics, reproductive justice advocates concerned about equity in health care should be cautious about calling for increased private delivery of health care. More privatization of health care is linked to the erosion of the universal public Medicare system and poorer outcomes for patients, especially marginalized populations. This paper traces the history of the regulatory restrictions that have impeded abortion access in New Brunswick until the present day, a pivotal historical moment when political openness to increase abortion access could be seized by either public or private interests, each holding very different, predictable outcomes for reproductive justice.