Giving birth 100 km away is the new norm for some pregnant Alberta patients

Catherine Calling Last remembers breathing through her contractions and hoping she would make it as her husband drove down the highway between Pincher Creek and Lethbridge.

“Sometimes your labour can just kick right into full gear … and baby’s ready to come out. I was thinking about the worst-case scenario,” she recalled.

“It was a little bit stressful. I really wanted to have baby closer to home.”

Calling Last gave birth at the Chinook Regional Hospital in Lethbridge, more than one 100 kilometres away from her hometown, earlier this month.

She’s part of a new generation of maternity patients from Pincher Creek who are expected to travel elsewhere to deliver their babies, as the number of local health-care providers dwindles.

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“Rural maternity is at risk both in Alberta and across the country,” said Dr. Jared Van Bussel, one of just four family physicians currently providing maternity care in Pincher Creek. Another doctor is on leave and expected to return next year.

For years he’s been the only physician in town who is trained to perform caesarean sections, leaving him on call around the clock, with the exception of vacations.

The community has lost a number of doctors, including surgeons and anesthetists in recent years, he said.

“For the last two years, every time a delivery came through the door, the response was, ‘Oof, I don’t think we’ve got the staffing for that today,” he said.

“There was a lot of fear and trepidation about not having the people that we needed.”

He wrote an open letter, earlier this year, warning the situation was no longer sustainable and that, as the only surgeon there, he could not support labour and delivery beyond May 31.

With no solution in sight, the doctors stopped providing routine labour and delivery at their local hospital at the end of May, according to Van Bussel.

Maternity patients are being transferred to doctors in Lethbridge for care during the last few weeks of their pregnancy.

Deliveries are still supported in Pincher Creek on an emergency basis, he noted, when it is not considered safe to send them.

“We need to come up with a solution for this because transportation on winter stormy roads is not a great option.”

Ambulance transfers from one hospital to the other can take an hour and a half, he said.

Van Bussel worries this could lead to patients giving birth en route. He is also concerned delays could lead to more babies ending up in the neonatal intensive care unit.

A key first step, Van Bussel said, is recruiting another surgeon who can perform C-sections.

Five deliveries a month

According to Alberta Health Services, there are an average of about five deliveries a month in Pincher Creek, including one ceasarean section.

A spokesperson for the health authority said it has nursing coverage to support labour and delivery at the local hospital, when physicians are available, and it has not reduced staffing or resources.

AHS spokesperson Kerry Williamson said it is standard practice for doctors in rural communities to arrange for maternity patients to be cared for elsewhere if they can’t be cared for in town.

“We want to reassure the community that AHS supports high-quality maternity care throughout the province and seeks to provide services as close to home as is possible,” Williamson said in an emailed statement.

Recruitment is a challenge, particularly in rural areas, he said, and AHS is working to support these efforts in Pincher Creek.

Williamson added the health authority is working with the local doctors to “understand their practice decisions and future intent with respect to the provision of obstetrical care, including both prenatal and delivery services.”

In a recent press release, the United Nurses of Alberta called for the resumption of labour and delivery services in Pincher Creek, suggesting AHS should provide a contingency plan.

“This is not a problem that our members working in the community can resolve, and it must be treated with appropriate seriousness by the authorities who do have the ability to do something,” said Heather Smith, the union’s president, in the release.

“Our concern is the safety of patients.”

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Meanwhile, Calling Last, who ended up needing a C-section, is relieved to be home.

“In the end, that’s all what I wanted, was my baby girl to be healthy and both of us to be OK.”

But she worries about other expectant moms.

“What if they don’t have their own transportation or there’s things that can happen and affect the delivery and your labour,” she said.

“We all just kind of want to have a smooth delivery. That’s all we can hope for.”