The only obstetrics unit within 800-km stretch of northern Ontario could soon close, raising safety fears

It took just one general practitioner's sudden departure to destabilize the only obstetrics program in the 800-kilometre stretch of northern Ontario between Timmins and Thunder Bay. 

Kapuskasing's Sensenbrenner Hospital says that without emergency funding, its obstetrics unit will soon close, leaving hundreds of pregnant people travelling long distances to deliver.

General surgeon and chief of staff Dr. Jessica Kwapis said the hospital only has two general practitioners trained in obstetrics, and they don't work in that unit full time as they have other practices such as anesthesia and emergency medicine. 

"We can't sustain 365 days a year of coverage with two providers," she said. 

Kwapis added there are other physicians willing to come in and help, but the hospital has no mechanism or compensation agreement in place to pay them. 

"They would essentially volunteer their time to help with deliveries unless the government gives us the money we need to support that physician service," she said.

Kwapis said she'd rather not go into specific numbers, but the funding proposal recently submitted to the Ministry of Health is "a drop in the bucket" in the grand scheme of things. 

In an email to CBC News, Minister of Health spokesperson Hannah Jensen writes that it is a new proposal and it "requires review and work in collaboration with the Ontario Medical Association to analyze the submission."

Meanwhile, Kwapis said she's heard from several patients that the uncertainty over the future of the obstetrics program in Kapuskasing, combined with the lack of places to deliver safely outside of Timmins and Thunder Bay, has some Highway 11 corridor residents reconsidering whether they want to go through another pregnancy. 

She said not everyone has the resources to arrange child care, travel hundreds of kilometres to another community and pay accommodations there while waiting to deliver a baby.

"There are many women who will opt to not relocate and just hope for the best when the time comes," she said, adding that helicopter transport outside of the community is not an option for someone in labour.

"This is a health equity issue… Imagine thinking, 'I don't know if I want another baby because I don't have a safe option for where to deliver the baby.' 

"That would be unacceptable in southern Ontario," she said.

Fewer doctors provide obstetrical care in north

A recent study in the Canadian Journal of Rural Medicine found the number of rural and urban northern Ontario hospitals not offering obstetrics had risen from 35 per cent in 1999 to 60 per cent in 2020.

Hearst, a small town of 5,000 residents located an hour drive away from Kapuskasing, had to shut down its obstetrics program in 2023 because of staffing and funding issues. 

Mélanie Goulet, a recruitment co-ordinator for Hearst medical recruitment alliance, said it's unfortunate because the town has had a particularly high number of births this year. 

The people who are expecting are advised to leave the community once they reach 37 weeks and travel three hours to Timmins or six hours to Thunder Bay. 

Kapuskasing's Sensenbrenner Hospital is only used in case of absolute emergencies, she said. 

But not all make it to an obstetrics unit on time. 

At least seven people have given birth while trying to reach an obstetrics service in the past year, according to Kwapis. 

"There's been deliveries in taxis, ambulances and even in the bathroom of an emergency room," she said. 

"If nothing is done, something serious will happen." 

The hospitals in Hearst and Kapuskasing say extra funding for obstetrics training and midwives are welcome, but ultimately won't be enough to prevent the closures in the obstetrics unit.

They're asking Ontario to green light a funding model for obstetrics that already exists in other specialties. 

Kwapis said the Ministry of Health is supportive of the concept, but these models can take years to negotiate. 

"We don't have years," she said. "We need them to move faster on this."

When asked about this situation during question period at Queen's Park, Anthony Leardi, parliamentary assistant to the minister of health, responded by saying the government has made significant investments in health, including increasing the number of obstetricians and gynecologists.

Ministry of Health spokesperson Hannah Jensen adds that from 2018 to 2021, "the number of obstetrics and gynecology specialists in Ontario increased by 6.3 per cent." 

She also points out that the Ford government has launched "the largest medical school expansion in over 15 years" and that 44 undergraduate and residency positions were added to NOSM programs.