The missing of mums and babes: Addressing Canada’s rural maternity care crisis

Sarah de Leeuw

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Rural maternity care
Chris A. Finch

Published on: 21 July 2016

Published on: (21 July 2016)
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Rural maternity care
Chris A. Finch, MD Tutor
I can certainly relate to Dr de Leeuw's article and her colleagues.
My family practice started in Flin Flon in northern Manitoba in 1972. We safely delivered many women with GP obstetricians, anesthetists and surgeons. We had good rapport with our specialist colleagues in Winnipeg.
I moved to Mission in the Fraser Valley in 1976 and continued to provide maternity care with my GP colleagues. We had access...
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I can certainly relate to Dr de Leeuw's article and her colleagues.
My family practice started in Flin Flon in northern Manitoba in 1972. We safely delivered many women with GP obstetricians, anesthetists and surgeons. We had good rapport with our specialist colleagues in Winnipeg.
I moved to Mission in the Fraser Valley in 1976 and continued to provide maternity care with my GP colleagues. We had access to specialty care in Abbotsford, but we essentially ran a GP maternity unit. Then the regionalization mentioned in the article occurred. We lost our maternity unit, ICU and paediatric ward and with this loss came the dilution and eventual loss of our GP anesthetists and surgeons. I also discontinued obstetrical care. These were significant losses to our community and women had to go elsewhere to deliver.
However in 2005 I started providing locums in the NWT, particularly Fort Smith, Hay River and Fort Simpson. Even at that time there was a tendency to electively transfer women to Yellowknife for delivery. The importance of community celebrations around birth mentioned in this article can not be underestimated. A Yellowknife birth denied this important cultural event. Fortunately with the efforts of a group of dedicated midwives supported by traditional midwives there is a robust midwifery programme in Fort Smith and another developing in Hay River. Hopefully more programmes will be initiated.
Is there a message for the training programmes in support of rural obstetrical care? It comes down to effective training and mentoring of students and residents. It means giving the opportunity for GP anesthetics, surgery and obstetrics to provide appropriate and safe care in rural settings. It means support for the referral centres and their connections to the rural communities. And perhaps most importantly it means support of midwifery and nurse practitioner programmes and integration of medical training with their programmes. Our rural communities deserve better.
Conflict of Interest:
None declared
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Competing Interests: None declared.