YARMOUTH, N.S. — Pregnant women are being warned that due to a shortage of anesthesiologists at the Yarmouth Regional Hospital, when the time comes to give birth to their babies there may be times after the end of May that they will have to drive to hospitals that are two or three hours away from Yarmouth to give birth.
The Nova Scotia Health Authority says babies are still being delivered at the Yarmouth hospital, and it is working to do what it can to rectify the situation caused by a shortage of anesthesiologists. But in a letter the health authority is giving to pregnant women it says it wants prenatal patients and their families to know “what to expect over the next few months at the Yarmouth hospital.”
“Due to a shortage of anesthesiologists, there may be times over the next few months when it will not be possible to deliver babies, or perform some surgeries at Yarmouth Regional Hospital,” the letter reads.
The health authority says to ensure the safety of both mother and baby, the hospital must be ready to perform an emergency C-section or surgery if needed. To do this safely, an anesthesiologist must be available. But as things stand, this isn’t something that can be guaranteed.
Three anesthesiologists have left the hospital since the fall, leaving the hospital down to one.
A media release the health authority issued the morning of April 25 says anesthesiologist coverage at the Yarmouth hospital is secured to the end of May. This differs from the letter given to pregnant women earlier in the week that had stated the coverage was only in place until mid-May.
“When we started to distribute the letters on Tuesday, it was still mid-May. The work to secure coverage is non-stop, so we have been able to get additional coverage until the end of next month. We are hopeful this will continue to improve,” says health authority spokesperson Fraser Mooney.
The health authority says work is ongoing to secure coverage for the upcoming months, but there may be times when anesthesiologist support is temporarily not available. “If this happens, it may not be possible to deliver babies, or perform some surgeries at Yarmouth Regional Hospital," it says.
THE BACK-UP PLAN
In that circumstance the health authority has laid out this plan. Pregnant women who feel they need care are being asked to call the Women and Children’s Health Unit before coming to the hospital. The number is 902-742-3542, ext. 1130.
After speaking with staff, a woman may be directed to go to another hospital for care or to deliver her baby. Options include the Valley Regional Hospital in Kentville or the South Shore Regional Hospital in Bridgewater, both of which are 200 kilometres from Yarmouth. Or they may have to go to the IWK Health Centre in Halifax, which is 300 kilometres and a three-hour drive away.
“Obstetricians and prenatal clinic physicians will be available to assess patients who must come to the Women and Children’s Health Unit, however, babies will not be delivered here without anesthesia present, except in cases where transfer to another hospital is unsafe or unfeasible,” the letter reads.
The health authority stresses this plan is only for times when anesthesia support may not be available.
“It is important for pregnant women and their families to understand that babies are still being delivered at Yarmouth Regional Hospital,” the health authority states in an April 25 release.
Dr. Cheryl Pugh, Western Zone Head for the Women & Children’s Health Program with the Nova Scotia Health Authority, says they are working to reduce the possibility of babies not being able to be delivered in Yarmouth.
“We hope it will not happen," she says about having to send mothers to other hospitals do deliver their babies.
“But at the same time,” she says, “it is important for patients to know what services will continue to be offered.”
The Yarmouth Regional Hospital services Yarmouth, Shelburne and Digby counties. Pregnant women can still come to the hospital for prenatal clinic appointments, obstetrical consultations, ultrasounds and labour room assessments.
SITUATION CAUSING CONCERN AND ANXIETY
As expected, the prospect of maybe having to drive two to three hours away to deliver their babies is creating anxiety and concern for pregnant women. On the evening of April 24, Yarmouth resident Caroline King, who is 34 weeks pregnant, posted a letter on her Facebook page addressed to health minister Randy Delorey. King says she is by no means critical of the prenatal program at the Yarmouth Regional Hospital.
“I really think the staff are in an impossible situation and doing everything they can,” she says, saying after receiving the letter the staff did their best to reassure her of the situation. “But I came home and thought about it more and this just seems like it shouldn’t be a reality. There must be something the province can do. Speed up the credential process to get new doctors, or larger incentives during this crisis...something. The best solution shouldn’t be rerouting women in labour to other hospitals.”
In her letter to the health minister, King tells him about being pregnant for the first time a little over two years ago. At her 16-week scan she says “an incredible ultrasound technician” picked up the fact there was something wrong with her baby. Their unborn child, Millie, was diagnosed with Hypo-Plastic Left Heart Syndrome at the IWK.
“Unfortunately, our daughter, despite all the opportunities given to her, our constant love and the impeccable care we received at the Hospital for Sick Children, IWK, Yarmouth Regional, and from VON, passed away at 16 months of age due to surgical complications,” she writes.
It was last fall that she and her husband Derek found out she was pregnant again. “We felt many emotions but the most prominent was that I just wanted this pregnancy to be normal, healthy. I wanted to have my baby in Yarmouth hospital, with the doctors I knew and my family present. I wanted to be able to go home with my baby and not worry. I wanted this time to be like I’d originally planned, a worry-free pregnancy,” she says. Her baby’s due date is June 2.
She says the news being given to pregnant mothers is troubling and the back-up plan of maybe having to travel to another hospital hours away while in labour is “terrifying and unacceptable.” On top of this, she and her husband are also losing their family doctor, leaving her scared her family will fall through the cracks.
“I know you’re aware of these issues, I know you’re working on it, how could you not be?” King writes to Delorey. “I know we are not the only family being severely affected by the lack of doctors in our rural health care system. However, I hope my personal experiences and fear will give fuel to your fight.”
The province’s opposition, meanwhile, says the provincial government must be held accountable for the current health care situation.
Argyle-Barrington PC MLA Chris d’Entremont says when expectant families can no longer count on the Yarmouth Regional Hospital to deliver their babies, the health system is truly in crisis. He calls it a broken system. D’Entremont adds the prospect of having to go elsewhere for delivers also heaps unnecessary stress on families.
“Telling pregnant women who need care to drive for two hours or more is a risky policy,” adds PC leader Tim Houston said. “Access to basic care is being eroded every day. It’s time for this government to take immediate action.”
The health authority continues to say it is doing all it can to turn the situation around at the Yarmouth Regional Hospital where some other surgeries might also not be able to be performed without anesthesiologist support.
“Many people are working very hard to recruit more anesthesiologists and to get back to full surgical services as soon as possible,” says Dr. Pugh. “The stability of services for Yarmouth Regional Hospital is a high priority for Nova Scotia Health Authority.”
