The only obstetrician in Antigonish is leaving, and families are worried

Rebecca Silver Slayter says whether she and her husband decide to have a third child rests partly on whether obstetricians return to the regional hospital in Antigonish, N.S.

Silver Slayter lives in St. Joseph du Moine, about two hours from St. Martha's Regional Hospital. The facility serves patients in western Cape Breton as well as the area around Antigonish, and both her children were born there.

Silver Slayter said she was "devastated" to learn the only obstetrician currently working at St. Martha's is leaving at the end of the summer. It has made her and her husband think twice about adding to their family.

"We're so much on the fence that I sincerely think it could be a deciding factor for us, if we know there aren't services like that available when the time comes," she said. 

One of three obstetrics positions at St. Martha's is vacant, one of the specialists is on leave and the third has given notice she'll be finished at the end of August. The hospital is located in the riding of Health Minister Randy Delorey. 

The Nova Scotia Health Authority says birthing services will continue despite the staffing crunch.

Efforts are underway to fill the empty positions and the health authority plans to rely on locum doctors until that happens, it said in a statement.

Silver Slayter hopes efforts to support physicians continue even after the recruitment process is complete to ensure doctors aren't stretched too thin. 

"It's very difficult to recruit new doctors or midwives for a position where they're the only one on call. Obviously this has to be a pretty broad effort," she said.

Antigonish 'worth fighting for'

Dr. Amanda Worden-Rogers, one of the handful of family doctors who delivers babies at St. Martha's, is also moving to New Brunswick to be closer to family at the end of July. She has worked in the town since 2014.

She said the current staffing situation calls for a "renewed recruitment and retention strategy" with a focus on specialists in rural areas and physicians' needs for a work-life balance.

"Antigonish is worth fighting for. It's such a beautiful amazing, medical community and I think it is a place where a sustainable obstetrical program can be built. It just needs to have the right people and the right support behind it," she said.

The lack of obstetricians comes just a month after expectant mothers in Yarmouth were informed they might have to travel to Kentville or Bridgewater to deliver due to a shortage of anesthesiologists.

Across the province, babies are only delivered in regional hospitals and neonatal care is based in Halifax. Places such as the community hospital in Inverness, which is closer to Silver Slayter's home, no longer offer maternity services.

Doula Jennifer Drummond, who is based in Chéticamp, works with women across Cape Breton and northern Nova Scotia. Doulas offer prenatal and postnatal support but they don't provide any medical advice.

She said she's received calls from women "almost in a state of panic" who are looking into care options after losing the option of having a midwife when the Antigonish program was suspended. She said people in her part of the province are concerned about what will happen if they're forced to change hospitals or drive even farther while they're in labour.

"So much of having a baby is the inability to plan for things. There is so much security in being able to choose your doctor, to choose your midwife, your [obstetrician], choosing the place where you're going to have your birth, because you don't get to choose how that birth is going to go."

In the meantime, the uncertainty about staffing in the Antigonish area is weighing on some expectant mothers' minds.

"Pregnancy and an upcoming labour and delivery is something that is unpredictable and worrisome on a good day, especially for a first baby, which is our case,"  said Antigonish resident Tara Crowley.

"And then to add in this extra element of unknown and stress, it's a lot to take in."

Crowley is due in late July and though her family doctor performs deliveries, Crowley worries about the pressure the remaining staff will face. Even in cases where family doctors handle low-risk pregnancies, obstetricians must be available in the event of an emergency C-section. 

"When we first got pregnant I believe there were eight [people including the midwives] who could deliver our baby for us. And by the time of our due date, my understanding is there will only be three … and that's if nothing changes in the next two months" Crowley said.

"How long can you keep that up? It just seems like a heavy, heavy load for the remaining doctors."

Hospitals 'ensure the long-term viability'

Crowley's friend Louise Brennan, who is due around the same time, said transparency and information about the recruitment process will go a long way in reducing anxieties among expectant mothers in the weeks and months ahead.

Brennan, who reached out to Delorey about her concerns, said the regional hospital factored into her decision to move back to her hometown.

"Young couples and young families do make decisions about where to locate based on the availability of health services," she said.

"Regional hospitals, rural doctors, they're not only major employers in the region but the services they provide ensure the long-term viability and, I guess, prosperity of more rural areas."

Silver Slayter echoed that.

"If that really vital service isn't in place, it's a shattering blow to a place that is really trying to attract and retain young families," she said. 

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