Doctors worry Lethbridge patients without proper care as obstetrics shortage drags on

Doctors are, once again, raising the alarm about a lack of obstetrical care in Lethbridge, Alta., as worries about patient safety persist.

Since late last year, there has been just one permanent obstetrician-gynecologist (OBGYN) for the city of 100,000 and surrounding areas. There's funding for eight specialists.

"This is still a crisis for women in southern Alberta," said Dr. Jonathan Cluett, a Calgary-based obstetrician-gynecologist who heads to Lethbridge every week to cover labour and delivery shifts at Chinook Regional Hospital.

He's one of a number of locum physicians rotating through, temporarily, in an effort to fill the gaps.

"In pregnancy … you're supposed to have some consistency in your care, and that is entirely absent here and is really making for what could be dangerous care for women," said Cluett, noting local teams are working flat out to care for patients.

"It's shocking to me that this has been going on for six months."

Safety worries

Dr. Marguerite Heyns, a B.C. obstetrician, is also helping out at the Lethbridge hospital on a temporary basis. 

"I'm very concerned," she said. "I strongly believe it's just a matter of time before we have something avoidable and catastrophic happen."

Heyns said she's is seeing a lot patients with high-risk pregnancies who are not getting adequate prenatal care.

"There's a reason we have these guidelines and there's a reason we provide prenatal care the way that we do. And we are not meeting that standard here," she said.

"Things will be missed and patients are going to present too late. And that may result in bad morbidity and even mortality for our patients. It's scary. It's very scary."

Last fall, Alberta Health Services (AHS) opened a prenatal clinic at the hospital to address the shortage.

But, according to Heyns, the on-call obstetrician juggles clinic and hospital patients at the same time, and that can lead to long waits and cancelled appointments when C-sections or other emergencies arise.

• Women's health at risk as Lethbridge battles severe obstetrician shortage, doctors warn

Pregnant patients aren't the only ones at risk, according to doctors. People with gynecological concerns are also affected.

"I'm seeing way more people than I have in other similarly sized centres presenting with acute vaginal bleeding, with undiagnosed cancers," said Heyns.

According to Cluett, women in need of gynecological care for issues such as infertility and ovarian masses are being sent to Calgary for care.

"It is, again, a reflection of the overall importance that our government, our leadership, places on women's health," he said.

Smith's response

Dr. Sharon Rowan, a Lethbridge family physician who specializes in providing low-risk obstetrical care, is so worried, she asked Premier Danielle Smith about the situation during an event with Lethbridge business leaders on Monday. 

"We need help," said Rowan during a question-and-answer session.

Smith attributed the problem to a shortage of anesthesiologists in rural hospitals and suggested sending patients elsewhere and using more midwives could help.

"It seems to me there's got to be a better way of identifying at-risk moms and then maybe having them go to a major hospital," said Smith.

"But we have midwives who are able to have home births. And if you can have midwives doing home births, surely we would be able to support more maternity in all of our rural hospitals."

Rowan explained Chinook Regional Hospital is not a rural facility but a regional referral centre in southwestern Alberta which is responsible for 2,200 deliveries a year.  And, she said, it has a dedicated anesthesia department.

Smith added she believes there are problems with decision-making at the zone level and she welcomes Rowan's input on solutions.

In an interview with CBC News, Rowan said she believes the government should prioritize keeping health services as close to home as possible.

"The way to do that is to stabilize the workforce and to ensure that there is appropriate recruitment and retention of obstetrician-gynecologists to work in our regional centres, as well as low-risk obstetrics and midwives, to all work within our regional system," she said.

"For the safety of our pregnant patients, for the safety of their newborns, we have to do what we can to keep this obstetrical ward open locally."

Meanwhile, AHS said it's continuing its efforts to recruit more physicians.

Two OBGYNs who are on leave are expected to return later this year, and the health authority said it will continue to bring in locum obstetricians.

AHS said it's also bringing in more family physicians. A total of 17 have been recruited, 12 of whom have begun practising and the rest are expected through the year.