For Bailey O’Connell, the excitement of having her first baby has been overshadowed by confusion.
A doctor shortage has left the regional hospital in her hometown of Yarmouth, N.S., unable to commit in advance to delivering her newborn.
“You have to call before,” O’Connell explained. “Who wants to do that when you’re in labour — try to call to see if you can go?”
The problem is a shortage of anesthesiologists, the doctors who relieve pain and prepare women for caesarian deliveries.
In recent months, three of Yarmouth Regional Hospital’s four anesthesiologists have left. While the Nova Scotia Health Authority (NSHA) says it has “successfully recruited a new anesthesiologist that has started at Yarmouth Regional Hospital this week,” a shortage of anesthesiologists at the facility remains.
For expectant mothers in the Yarmouth area, the shortage could stretch the drive to a hospital from minutes to hours.
The nearest fallback options, Kentville and Bridgewater, are at least two hours away.
The other option, Halifax, is a three-and-a-half-hour drive.
O’Connell says this shortage adds extra stress and danger to a pregnancy.
“I just think that it’s asking for tragedy, and it’s not acceptable. It’s not something that should be happening,” she said.
The NSHA says it is continuing to recruit for the two anesthesiology positions that remain vacant at the Yarmouth hospital, adding that coverage for emergency circumstances has been confirmed until the end of May.
However, the health authority warns: “Even with the new anesthesiologist, there still may be times over the next few months when it may not be possible to deliver babies or perform some surgeries at Yarmouth Hospital because anesthesiologist support is not available.”
Yarmouth general practitioner Dr. Joe Gillis, who also delivers babies, says the impact of this shortage is already being felt. Gillis says women who need anesthetics during deliveries are less likely to receive them on time. He cites an example from last week.
“A woman wanted an epidural. She was going to have to wait two hours. She did wait two hours, and then, by the time it was ready to get the epidural, she was fully dilated. She was able to push, and we had her baby,” Gillis explained.
Those who work in health care, including birth doula Barb White, say this is an example of existing cracks in the system that are breaking wide open.
“It’s really a crisis,” said White.
“If they have to have a C-section and then, all of a sudden, they have an accelerated labour and then they have to travel at least two or more hours, you could end up with all kinds of complications. You could end up with a birth on the road,” she explained.
WATCH (April 25, 2019): Nova Scotia woman with cancer challenges premier on doctor shortage
The Nova Scotia government resists calling the current state of health care a crisis, even after a string of horror stories, including a viral video from cancer patient Inez Rudderham, who says her cancer went undiagnosed for two years.
However, Health Minister Randy Delorey acknowledged the need for long-term solutions to the lack of anesthesiologists in the province while speaking to reporters on April 25.
“There is a program that had been proposed — that the NSHA and stakeholders … are looking at — a program that’s in some parts of the country, that’s not here in Nova Scotia, around GP anesthetists providing services,” Delorey said. “These are some of the longer-term initiatives being pursued for the medium- and long-term sustainability surrounding anesthesiologist services in the province.”
Some pregnant women in the Yarmouth area are with family doctors, including Nicole Stewart and her family.
Halfway through her third pregnancy, Stewart says there’s additional uncertainty this time around.
“I’ve been lucky thus far, and both of my girls have been healthy, but I did see an anesthesiologist both times, and to tell me that might not be available this time is scary and that adds stress to me, which probably puts stress on the baby as well,” she said.
Stewart and O’Connell both say that unless conditions at the Yarmouth Regional Hospital improve, they’ll consider moving to one of the designated backup communities a week or more before their due dates.
Meanwhile, the NDP is calling for the Nova Scotia government to expand the use of midwives.
The NSHA also says it’s considering giving family doctors additional training to administer sleep-inducing anesthetics.
But many in the system, including Gillis, have their doubts about that proposal.
“I’m strapped,” he said. “First of all, you’d have to either take somebody out of the system to train them or you’ve got to find these (general practitioners) as they go through residency and train them as an anesthetist. I don’t know the ins and outs of that, but you’re tapping into resources that are already strapped to begin with so I don’t think, by any stretch, that they would be the answer.”
Even recruiting replacement doctors is difficult because other parts of Canada offer higher salaries and a lighter workload, forcing women in Yarmouth into a guessing game at a critical time.