Expecting parents have to relocate to give birth due to midwife shortage on Salt Spring Island

This story is part of Situation Critical, a series from CBC British Columbia reporting on the barriers people in this province face in accessing timely and appropriate health care.

Robyn Millerd wanted to give birth to her baby on Salt Spring Island, where she was raised and still lives. 

But instead, due to staffing shortages at the only hospital in the Southern Gulf Islands, she had to uproot her life and move to Vancouver Island at 38 weeks pregnant. 

Millerd is one of several expecting parents in the Southern Gulf Islands who have been affected by the loss of a midwife at Salt Spring's Lady Minto Hospital, which has prompted Island Health to ask them to relocate weeks before their due date to be closer to an interim care provider.

That means moving close to facilities in either Cowichan, Sidney, Victoria or the Lower Mainland, where short-term housing can be expensive and difficult to find.

Millerd said she was fortunate, as she and her husband were able to stay at a friend's place in Saanich to be near Victoria General Hospital, and her husband was able to find work in Victoria.

But although Millerd was well supported by loved ones, she said moving to a new environment and starting over with different health-care professionals was stressful and caused her to lose sleep. 

"The last period of pregnancy is really intense and really emotional ... it was definitely an adjustment," said Millerd. 

"You want to be home, you want to be where your friends and family are and feel safe," she added. 

Her baby was born in late June, 13 days after the due date. The couple and their dog stayed in Saanich for a total of four weeks before the birth. 

"If we had to pay for an Airbnb for four weeks, that would be impossible," said Millerd. 

Island Health says the relocation applies until mid-August to patients between 37 and 42 weeks pregnant. It says it expects the shortage to affect eight families, all of whom have been contacted.

"Health-care workforce challenges are having an impact across the country, including the Gulf Islands. Providing patients with safe, high-quality care is our top priority," a spokesperson said.

Midwife shortage

Angela Flegel, a doula and pre-natal educator on Salt Spring Island, said Lady Minto Hospital had two midwives until last month, when one of them moved away.

Since then, the hospital has not been able to deliver babies. A second midwife or other eligible birth attendant must be present at all births, according to B.C. College of Nurses and Midwives' policy. 

Flegel said even before the midwife's departure in June, pregnant patients would have to relocate to give birth whenever one of the midwives was ill or on vacation. 

Having two birth attendants working on the island isn't sufficient, she says.

"Both midwives were working full on, providing on-call support, 24-hour support, and that's just not sustainable," said Flegel, who added that offering a higher wage and assisting with housing could help attract and keep midwives on the island. 

"The last midwife who left was living in an RV with her family," she said.

Flegel said due to the financial and logistical barriers of moving away temporarily, some patients wait until they go into labour to leave the island, or choose to have an unattended birth at home, which can come with risks. 

'It was really stressful'

When Nisha Moodley gave birth in September 2021, one of the midwives was off work. 

She said her pregnancy was deemed risky, so she would have had to relocate anyway as Lady Minto does not have resources for certain procedures. 

She and her partner stayed at three different Airbnbs in Victoria over two weeks around the birth, spending approximately $3,000 for accommodation. 

"At 40 weeks pregnant the last thing you want to do is be packing up and relocating ... it was really stressful," said Moodley. 

"I just don't know what people do when they're low income. I'm just imagining a mother or a pregnant person having to couch surf." 

Moodley's five-year-old son stayed at home with his grandmother as he was starting kindergarten at the time.

She said being away from her son as he started school was sad and frustrating. 

"The thing that is hard to wrap my heart and head around is that we don't have sufficient care for something as simple as a baby to be born here," said Moodley.  

Island Health said families who need financial assistance may be able to access the province's travel assistance program, which covers some of the transportation costs for residents who need to travel to access medical services, including ferry transportation. Assistance for accommodation costs is not available.

The health authority expects Lady Minto to have additional midwife coverage starting in mid-August.