Staffing Shortages Leave Expectant Parents in the Lurch

Jen Mio was 38 weeks pregnant when she realized she’d have to throw her entire birth plan out the window.

Her plan had been to wait until she naturally went into labour with her third child and deliver at her local hospital, the Bulkley Valley District Hospital in Smithers, which is a five-minute drive from her house.

Two weeks before she was due, however, Mio was told the hospital’s maternity ward would likely be closed when she needed it due to staffing shortages.

What followed was a scramble to figure out where she would be able to access care.

Mio was told if she went into labour she may have to get her husband to drive her to the next closest hospital with a maternity ward in Terrace, a two-and-a-half-hour drive away, or to Prince Rupert, a four-hour drive away.

These roads are largely without cell service. Mio describes the possibility of making the drive while in labour as “super scary” and worries about what could happen to her or her child in an emergency.

So Mio adjusted her birth plan and scheduled an induction in Smithers — only to have it cancelled due to staffing shortages. Mio was then told staffing shortages were causing service interruptions, closures and cancellations in Terrace and Prince Rupert’s maternity wards too.

In a pinch Mio was told she could deliver in the emergency room in Smithers and be transferred to a different city afterwards for postnatal care. But she worries the small hospital’s ER could be overwhelmed if there was another emergency, like a car accident or overdose, while she was in labour.

The Tyee called the hospital and confirmed staffing was uncertain for the period of time Mio anticipated giving birth.

In a statement offered after press time, Northern Health acknowledged staffing challenges had led to interruptions of maternity services over the Labour Day weekend, and following that weekend, but said services had “returned to normal” as of Sept. 11.

The Tyee called maternity services at the hospital to ask about scheduling, but reached a nurse who was filling in and couldn’t confirm if the schedule had been solidified. The Tyee has followed up with a hospital scheduler to confirm.

“Smithers and area maternity providers have reached out to their patients, particularly those at higher risk, to help them plan based on their care needs and expected delivery dates,” the statement continued.

“I shouldn’t have to worry about there not being enough staff and staff will have to choose between saving me or my baby,” she says. “I never considered Smithers to be an unsafe place to give birth.”

It’s also an option to get a hotel in Terrace or Prince Rupert and wait for labour to start. But Mio says she could be away from home for weeks because it’s not possible to book an induction. She has two young kids in school, a dog and a business she runs with her husband. The Tyee spoke with other expectant parents who said the cost of having to stay in a different city would be “outrageous” due to the high cost of accommodation, food and fuel. Families weren’t given time to budget and plan for this, they added.

Mio says doctors encouraged her to make a plan she was most “comfortable” with.

“I’m saying none of this is comfortable,” Mio told The Tyee. “You can’t tell me when the BVDH’s maternity ward will be open. Midwives are booked up and I have absolutely no other options.”

She adds flying to the Lower Mainland to stay with her mom, who is a nurse, also isn’t possible because you’re not allowed to fly when pregnant past 37 weeks.

“We’re in a crisis where multiple hospitals can’t care for a mother and child,” she says.

Mio isn’t the only expectant parent going through this.

The Tyee heard from several other people who are due within the next couple weeks and who weren’t sure where, or how they would be giving birth.

Kiera Super is 22-years-old and lives in Houston, an hour outside of Smithers. She’s a first-time parent with a due date that just passed, on Sept. 11. When she spoke to The Tyee over email, she wasn’t sure if she’d be able to stay in Smithers to give birth, or if she’d be sent to Terrace or Prince George. She told The Tyee that the uncertainty was making her “super anxious,” because she doesn’t have family in either city, her husband would have to take extra time off to travel with her and the drive back to Houston with a newborn would be “difficult.”

Hannah Camus says she heard in August that maternity services would be understaffed for September and October.

“I didn’t know it was going to be as bad as this though,” she told The Tyee in an email. “We had to plan around staffing instead of the needs of mom and baby. That’s the most scary part, that the care can’t be provided depending on the patient’s needs.”

Camus was scheduled to have a C-section Sept. 11. She says it took a bit of work to book the surgery, which kept getting bumped back, but once she had the date it was “easy” to access pre-surgery care. She says this suggests doctors are available — but without nurses to help them, a hospital can’t run.

Nursing staffing shortages have been in the works for decades, says Adriane Gear, president of the BC Nurses' Union.

She says thanks to historic and current lack of investment in health care, nurses have been overworked and underpaid for years. This pushes them to leave the industry or leave for private health care, which adds more workload on the nurses left in public health. This is creating unsafe working conditions where nurses are burnt out and unable to properly care for all of their patients, she says.

Gear says B.C. needs at least an additional 26,000 nurses to properly fill existing health-care demands, but that number will increase now that the province has said it will introduce nurse-to-patient ratios which will reduce the number of patients a single nurse works with.

Gear says the government needs to hire more internationally trained nurses, train more domestic nurses, better support nurses by hiring ancillary workers like cleaners, address workplace violence and be more flexible with scheduling to allow nurses to request time off.

Solving maternity staffing shortages in northern and remote communities is a bit trickier, she says. Maternity nurses have specialized training and education, so it’s not possible to fill the staffing shortages with just anyone.

She recommends the health authorities ask maternity nurses to volunteer to be redeployed rather than telling local nurses they’ve been redeployed for the week to a hospital several hours away. Agency nurses could also be brought in for temporary staffing relief, she adds.

In B.C. the provincial Medical Services Plan covers the cost of a midwife. The Midwives Association of British Columbia said anyone looking to work with a midwife should contact them as soon as they know they are pregnant. Midwives then care for the pregnant person and baby through each trimester and until six to 12 weeks postpartum.

The statement from Northern Health said that patients would still be able to deliver in a hospital ER, or be attended to at an ER and offered safe transport, if needed.

“We recognize that having expectant or pregnant mothers travel to give birth can be disruptive but patient safety must come first,” the statement said.