LAC LA BICHE - What was supposed to be a joyous experience for Chrissy Rae, a soon to be mother from Lac La Biche, welcoming her baby into the world became a time of concern.
The expectant mother says learning about the closure of the Obstetrics Unit at the W.J. Cadzow Hospital last week has dulled some of her glow.
Last week, an internal document from Alberta Health Services was released into the community stating the unit would be closed for 10 days ending on Feb. 14, due to a lack of surgical staff. Additionally, the unit that delivers babies, provides cesarean sections and wrap-around services for pregnant women, only provided urgent delivery care in the Emergency Department at the facility, until the obstetric unit opened up this week.
The emergency deliveries were provided by a single physician and two midwives, and any patient follow-ups were provided through an on-call service, the statement read.
Less than a month away from being full-term, Rae says she could give birth any day now, and with the compounding stress from the news about staffing shortages, there is always a possibility of another mother requiring care at the same time. Considering if any complications happen that affect her or her baby’s health or another expecting mother’s health, one doctor and two midwives just aren’t enough for everyone, she said.
“There can be so many complications that happen when you're in labour too. With my first I hemorrhaged, and if I didn’t have all those doctors and nurses in there to be swift, who knows what could have happened. It’s definitely worrisome especially when you’re a higher risk.”
Midwives are ready
One of the hospital's contracted midwives Chantal Gauthier-Vaillancourt agrees that the situation is very difficult, and is doing her best to offer concerned residents some words of comfort when it came to the temporary closures. Gauthier-Vaillencourt operates the Tree De La Vie Midwifery in Plamondon with her business partner, Marianne King. The pair of trained and skilled midwives who have more than two decades of experience between them have been assisting at the hospital for years.
“The hospital called us because we’re actually a part of the Mom Care Team. Right now there is only one doctor who actually does deliveries and the two other people who are on-call for all births are myself and Marianne,” said Gauthier-Vaillancourt. “We’ve been doing this for three years now and people don’t realize we’re a part of that team. If we weren’t there, there would probably be no Obstetrics at all in the community because we’ve been helping out with the mom care calls for the last three years now.”
While the midwives say they are always doing their best to comfort any expecting mothers, Gauthier-Vaillencourt says the reality is that the recent situation is stressful for all involved.
Staffing shortages on top of the pandemic challenges have created situations that the healthcare system is trying to manage as best as it can.
“It’s stressful seeing the departments trying to manage all those changes…If I was a pregnant woman, no that wouldn’t be enough for me, but the thing is with the reality of our situation and how it seems to be changing all the time, I think it’s really hard for any leadership roles within the hospital and AHS to be dealing with all these changes.”
The best response during such uncertain times, she said, is to continue to do the very best they can, and for everyone involved to be prepared for any situation.
“It’s tricky when there’s no OR and it adds a whole other layer of concern, worry and anxiety to those moms who are likely already stressed, excited, and partly worried. It’s a big deal having a baby so facing that along with having to make these possibly last-minute decisions or changes, it adds to the uncertainty that’s already there.”
Some of those last-minute decisions during the recent closure included transfers to neighbouring communities where obstetrics and surgical units were operating. Those transfers saw potential patients moved to Cold Lake, St. Paul or St. Albert.
Gauthier-Vaillencourt understands the recent uncertainties in the community’s healthcare facilities and realizes that there are efforts being done to prepare for any emergency alternatives when need be — but she doesn’t want the recent closure to become a reoccurrence.
“With birth, it’s important to have no expectations; but be prepared for everything. Being prepared for everything means having an OR,” she said, acknowledging that while dedicated OB wards aren’t available in many remote communities across the country, to see similar services lost permanently in the Lac La Biche would be devastating.
“Women do get used to that concept if things are going straight-forward they're going to give birth in their community; if they’re not they’re being flown out. I never want our community to get to that point but it is a reality of certain Canadian communities that the services are just not there. I would be crushed if it got to that point where it was like that all year round here.”
Alternative plans
While Rae, like other local women expecting babies in the coming weeks, waited for more information about the Obstetrics Unit's operations, she did prepare for alternative options if the unit continued to stay closed.
“I have a backup plan to go to my mom's and deliver in St. Albert if I have to. That's pretty much going to be based on if the shortages aren't bad on Feb. 14. If they are, well, I’m probably going to go to my mom’s because it’s not worth the risk for me to sit around and wait.”
Not only is the potential complications, limited services and extra planning stressful, Rae says she has to also consider her three and four-year-old sons, while her partner has to find time off work to support her—especially since it’s his first child.
“Obviously he’s not going to want to miss the birth—it’s his first but my third, but I’m thankful my boyfriends’ mother will watch my other two children. But if I’m all the way in St. Albert, I’m uncomfortable having them all the way here in Lac La Biche while I’m there.”
The thought of potential complications and the proximity to emergency help are the main factors in her planning.
During Rae's last pregnancy, her son was born premature and required the Neonatal Intensive Care Unit (NICU), and the fear that comes with not having enough staff or sufficient obstetric services for her third child is troubling and makes the decision to travel easier.
“My last son was born at 29 weeks and I didn’t have contractions or anything, he just came. It’s very worrisome for me because my baby could come at any time,” she said. “If the baby will need the NICU, they're not equipped for that here, so if anything were to happen you’d be getting rushed to Edmonton anyway.”
More services needed
The temporary closure of the OB and surgical areas in several Lakeland hospitals due to staffing and pandemic issues over the last year are highlighting a need for a regional maternity care facility, says Gauthier-Vaillancourt.
As a midwife and vital health care member, she hopes to see a centre dedicated to obstetrics in the future flourish in the community by supporting, educating and providing tools to the community that is always facing staffing shortages.
“My ultimate dream for this community is a Family Centre Maternity Care unit that would serve all of the pregnant population for the county and surrounding areas. It would be collaborative care between midwives, nurse practitioners, nursing staff and doctors,” she said
Although it is only an idea, she feels it would address the worries, travel concerns, emergency responsiveness and reoccurring issues that are once again playing out in the community.
Area health officials say families who may have required obstetrics services while the Lac La Biche hospital’s ward was closed were contacted with up-to-date plans and options for their continuing healthcare well-being.
