Prince George residents Christine and Lauren Kennedy are excited to welcome their first child together, but are now one of the many couples from across British Columbia facing uncertainty as the province grapples with a shortage of obstetrical specialists.
Lauren, who is 39 weeks pregnant with her first child, said she was frightened to learn that gaps in maternity department physician scheduling at the University Hospital of Northern B.C. (UHNBC) in Prince George could potentially force her to be sent hundreds of kilometres away for care.
Prince George is the largest service centre in northern B.C. and often provides health-care services for the entire region.
“You don’t think in a community of this size that this is something that you would have to be dealing with, and on top of all the other things that come with being a new parent,” said Lauren.
“It is really challenging not being able to know what to expect.”
On July 21, Northern Health said that starting in August, it would be experiencing a shortage of obstetrical specialists and warned that gaps in coverage could lead to “high-risk” patients being transferred to other hospitals in the province.
Prince George, Kamloops, Kelowna and Dawson Creek are among the many communities in the B.C. Interior facing maternity service disruptions.
Despite recent efforts by the province to train and recruit more workers, Health Minister Josie Osborne says challenges to fill staff shortages remain.
“I think there is a possibility that we will see that kind of strain on services elsewhere,” Osborne said at a July 21 news conference.
Christine and Lauren said they aren’t sure exactly what to do and have been taking the situation day by day.
“We don’t want to lose sight that we are quite privileged and we can, you know, figure it out when it comes to this, but there will be a lot of families that wouldn’t be able to as well,” said Christina.
“We both grew up here. This is our community. We want our daughter to be born here, and it’s pretty sad to think that she might need to go elsewhere.”
Local doctors scrambling to find coverage
It’s not just parents who are worried about gaps in coverage, but the people who provide maternity care as well.
Dr. Kasandra Joss, the acting practitioner-obstetric lead at UHNBC, says her colleagues have been panic-stricken, and she’s been in emergency meetings with obstetrical providers to find coverage for the month of August.
“It’s a whole lot of confusion, and it’s really bogged all of us down in our offices trying to explain to patients what this means,” she said.
Joss says one physician rearranged her holidays, and two physicians from other communities agreed to come and help provide coverage.
While health authorities have issued assurances that everyone who needs care will receive it, Joss calls he situation “terrifying.”
She said these doctors have stepped in because they can’t risk the health and safety of the communities they serve, but warned the existing medical workforce is being spread too thin.
“It is absolutely the most stressful thing that any of us has been through,” she said.
“The wording of these things is like, only if you’re ‘a high-risk patient’ [will you be sent away], and it just gives these false reassurances to patients. We can’t guarantee that we’re going to be able to deliver them safely in the current circumstances.”
She says high-risk pregnancies can include anyone who’s never had a baby before, people with larger body sizes, women who are over the age of 35 or 40, people who’ve had a previous C-section, or if an ultrasound shows the baby being too big or too small.
“The thing is, so-called low-risk women become high risk at the drop of a dime.”
Joss says the services affected by the lack of obstetricians are extensive and include epidurals, induction of labour, vacuums for stuck babies, severe tearing and placental removal.
She says she’s also extremely anxious about transferring women to other hospitals in emergency situations.
“Anybody that’s ever worked in the hospital and had to deal with the patient transfer network knows the system is also pretty overloaded, and it’s hard to get people out in a timely fashion,” she said. “And sometimes it’s not safe to transfer a woman. If she’s too far along in her labour, you can’t risk putting that woman in the air because in the air makes everything worse medically.”
Recruitment challenges
Health Minister Josie Osborne acknowledged the anxiety the disruptions and threat of disruptions are causing families, and said that no one in need of care would be turned away when a birth is imminent.
“The health authorities are working very hard trying to find locums and assistance, helping to fill those gaps where that exists and ensure the services are there for people that we will continue to do that work,” she said on July 21.
Dr. Ronald Chapman, vice president of medicine for Northern Health, said they have been working on recruiting additional obstetricians at UHNBC while trying to cover gaps in services.
“With any service interruption we do have, we are continually recruiting and looking at creative ways and means to fill any service gaps we do have, and that is fluid and that can change,” he said.
“I’m very pleased to say at least we’ve got some obstetricians in the pipeline, especially for Prince George, so we are actively working with some of those physicians to see if we can successfully recruit them to Prince George.”
Joss says her department is currently staffed by three full-time equivalent obstetricians, but they were only given approval by Northern Health to recruit up to eight positions after a 12-hour service disruption in May.
“‘I’ve been dying to, you know, inform the public about what’s happening with our system just so that it gives patients time to kind of think about what it is they want to do.”
She says they’ve already been interviewing candidates, but have run into administrative challenges and delays with licensing international medical graduates through the College of Physicians and Surgeons of BC.
Joss says she’s worried about coverage in September if they are not able to expedite licensing.
Expectant parents Christine and Lauren say they are trying to handle the situation as best they can, but feel like they are navigating a system failure.
“In pregnancy, I’ve been lucky. We’ve been lucky that it’s been pretty uncomplicated, but it is really frustrating that this is something that we even have to deal with,” said Lauren. “It’s placing a lot of stress on a situation that is already so unknown and unpredictable.”
