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Outrage builds after birth services cut

Obstetric shutdown in Flin Flon is being done to reduce risk to patients: NHR
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Obstetrical delivery service in Flin Flon has been shut down for the foreseeable future, leaving some mothers scrambling for alternatives.

On Nov. 6, the Northern Health Region (NHR) announced it would be suspending obstetric delivery services at Flin Flon General Hospital. The suspension will take effect at 8 am on Nov. 18.

The measure comes after an external review, ordered after concerns about service gaps were raised with the Flin Flon obstetrics department.

Prenatal and postpartum services will continue at the hospital, but almost all births will be moved to other facilities, including St. Anthony’s Hospital in The Pas. “This is all about patient safety for expectant moms and their newborns,” said NHR CEO Helga Bryant in a conference call on Nov. 6.

“We’ve had a number of clinical experts, within Flin Flon and from Winnipeg, that have advised us that we really need to suspend the service and we must take steps to ensure the safety of moms and babies.”

Flin Flonner Logan Oulette had plans to give birth to her second child in the community later this month. Oulette is now scrambling to find another place to deliver her baby, which is due on Nov. 28 – 10 days after the suspension begins.

“I was especially shocked. I’ve been seeing a doctor every week at this point, and the week before, I was told a completely different story than what we’ve now heard. Originally, I was told that I would either give birth in Flin Flon or they would take me by ambulance to The Pas, bring me right back and my doctor would be in Flin Flon,” she said.

“That’s a little shocking and a little scary. I could end up giving birth on the highway.”

Oulette said she was stunned when she was told the news. “I didn’t even have time to think about it or ask proper questions. I got home and when I saw the news, I just bawled. I just cried. There’s nothing else I feel like I can do at this point, except cry. It just sucks. It’s scary and it’s stressful, it’s overwhelming.”

At the time of the announcement, Bryant said the NHR decision was not made easily and was done with the input of NHR staff. “This was a really difficult decision, but a necessary one, because there have been a few very, very tense clinical situations. Our clinicians were making those untenable situations known to us and this was a decision we had to make, in the interest of the patients that we serve. We’ll continue to work with our patients and physicians.”

St. Anthony’s Hospital will be the hospital nearest to Flin Flon that offers a full obstetrics department. Staff includes one permanent obstetrician, one locum obstetrician and an anesthesiologist.

While the hospital would be the most convenient option for some Flin Flon families, Bryant said some expectant Flin Flon mothers have gone elsewhere for births.

“Based on the number of deliveries The Pas is seeing from Flin Flon, women are not all going to The Pas. The numbers aren’t matching. Even during the gaps, women were aware of those gaps and making their own plans, whether it be Winnipeg, Brandon, or perhaps Saskatoon, wherever their social and family connections are.”

Now that Flin Flon is out of the question, Oulette said she plans on delivering her child in Saskatoon, saying any other area will likely be cost-prohibitive and hard for her young family – which includes a young son who will need care.

“We have family in Saskatoon, so I’m just going to try to have everything in line as best as I can before the baby comes, and hope and pray that it goes well,” she said.

“We have a toddler at home now – what the hell do we do with him if we have to go someplace else? If I get stuck somewhere for three weeks, where I don’t have family or friends who can watch him, do I leave him behind for three weeks when we’ve never, ever before been separated? Do I take him and have my almost two-year-old in the room while I’m giving birth and I’m trying to watch him and have a baby at the same time?”

Flin Flon MLA Tom Lindsey questioned provincial health minister Cameron Friesen about the service change in provincial legislature in Winnipeg last week, saying the decision was the result of health budget cuts imposed by the province.

“My initial response was, ‘This is ridiculous,’” Lindsey said.

“It’s a self-fulfilling prophecy with this government. They cut funding, then say ‘We don’t have enough to provide services,’ so they take that service out of next year’s budget, cut the funding again and cut something else… It’s almost like the government has decided to target the Flin Flon General Hospital and somehow degrade it from a hospital to a nursing station.”

Flin Flon has been without a full-time obstetrician since 2017. Since the previous obstetrician left, coverage in Flin Flon has relied on locums, leaving frequent gaps in care. Obstetric services have only been available on occasion – the NHR estimates obstetric care in Flin Flon has been available only 50 per cent of the time.

Currently, Flin Flon General Hospital is considered a Level 1 centre, meaning it is staffed and resourced for low-risk pregnancies.

Oulette said the shift in care has led to several different doctors working with her, at times providing contradictory advice.

“I’ve just gone through a lot of one doctor saying this, another says something different. I feel like I don’t even know what’s going on,” she said.

Oulette said she thought highly of the previous permanent obstetrician.

“He was just amazing. It was heartbreaking when he left, because he was so good at his job and he cared so much. I felt really comfortable with him, whereas I don’t feel comfortable at all this time.”

About 150 deliveries took place in Flin Flon last year. Most of the families reporting to the Flin Flon hospital were from Saskatchewan, of which many were emergency cases from outlying communities such as Pelican Narrows, Sandy Bay and Deschambault Lake, which do not have full hospital facilities.

Lindsey voiced concern for northern Saskatchewan residents using Flin Flon facilities for births, saying the change may have a “potentially dangerous effect.”

“The hospital here isn’t just a Manitoba hospital, it’s a regional hub. Where will those folks go? Do they have to go to Prince Albert? If they show up to the Flin Flon hospital, will they get transported to The Pas? If so, being Saskatchewan residents, who pays those costs? We don’t know any of those answers and I don’t think the government has really thought about that,” he said.

St. Anthony’s Hospital in The Pas saw almost 400 births last year – more than one per day. Several Flin Flon families from among those births, including higher risk births or deliveries at a time when appropriate personnel were not available in Flin Flon.

The change to obstetrical services in Flin Flon may not be permanent, but will be in effect until at least 2019.

The NHR is currently working on a clinical and preventative services plan, expected to be sent to the provincial government for consideration early next year. In it, the suspension of obstetrical services in Flin Flon is described as temporary.

“Our language around ‘temporary suspension’ is very intentional. We want to leave the window open to regain obstetrical services, if that is deemed appropriate,” said Bryant.

In the meantime, people affected by the change are trying to have their voices heard.

Jan Unruh, a Flin Flon woman who works as a doula, or birth companion, said she is compiling a list of affected people and stories to present to the province and health region.

She adds the reaction she has heard is consistent.

“It’s pretty negative. There’s a lot of stress and fear and just concern going forward,” she said.

“Most of the people I’ve spoken to have either just recently delivered or are currently pregnant and due to deliver before April. A lot of them are just panicking. Anyone who’s due before Christmas is 100 per cent panicking, because now they’re being told they have to relocate.”

Oulette said she and other moms will try to start a petition to advocate a full restoration of obstetric care in Flin Flon.

“A few moms and I have discussed what we can do, whether it’s a petition, mass sending emails,” she said.

“I know Flin Flon is a northern community, but a place the size of Flin Flon, there’s no reason why we shouldn’t be able to safely and comfortably deliver our babies. I know that we’ve all talked about how to make our voices heard, because they need to be heard. This is not okay.”

In Winnipeg, Lindsey plans to bring up the service change often in the legislature and hopes anyone affected will share their views with the province.

“This government needs to hear the voices of people from Flin Flon,” said Lindsey. 

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