The emergency entrance of Vancouver General Hospital.JONATHAN HAYWARD/The Canadian Press
Vancouver General Hospital is diverting pregnant patients with complex medical and surgical conditions to other hospitals because of a shortage of obstetricians that doctors say was made known 15 months ago but that the province did not address.
Gordon Finlayson and Phil Dawe, the hospital’s medical directors of intensive care and trauma services, respectively, say they were given 24 hours notice that obstetrical care for patients past 20 weeks gestation would be diverted elsewhere, beginning last Saturday.
Vancouver General Hospital, B.C.’s largest, does not have an obstetrical service and does not typically deliver babies. However, as a Level 1 trauma centre – a formal designation indicating that the most advanced level of care is available – it has until now contracted with maternal-fetal medicine specialists at BC Women’s Hospital to provide care in complex cases, such as if a pregnant person suffers cardiac arrest, requires an organ transplant or has a blood cancer.
Those specialists gave notice as early as November, 2024, that they would be ending this service as their practice pivoted away from labour and delivery to focus on highly specialized areas of care, such as fetal diagnosis.
“This distressing news is magnified by knowledge that the B.C. Ministry of Health has not resolved this forecasted interruption of care at Vancouver General Hospital during the last 15 months,” Dr. Finlayson and Dr. Dawe said in an e-mail to local MLAs on Sunday that was provided to The Globe and Mail. “We are now left with the sentiment that caring for this vital population is not a priority.”
OB/GYN shortage in B.C. threatens collapse in local maternity care
The doctors continued that this diversion is not simply a geographic inconvenience for women.
“In trauma and intensive care, we know this will become a matter of life and death,” they said. “As such, this announcement hangs with the weight of moral distress.”
The diversion is part of a larger, provincewide shortage of obstetricians-gynecologists that has resulted in rotating “maternity diversions,” clinic closings and notices of resignation by OB-GYNs.
The Globe reported last September that some women are having to travel great distances to give birth, including a Williams Lake mother who was shuffled through four hospitals in 12 days to deliver her twins. The transfer process from Williams Lake to Kelowna to Prince George and then Kamloops involved three flights for the first-time mother, who called the experience “terrifying.”
Chelsea Elwood, vice-president of the Society of Obstetrics and Gynecology of British Columbia, said a group of about 20 obstetricians worked with Vancouver Coastal Health, the local health authority, on short- and long-term planning options as the maternal-fetal medicine specialists continued to provide care at the hospital in the meantime.
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A tentative plan was formed for continuity of care at the hospital but the Ministry of Health ultimately did not support the plan, doctors told The Globe.
“OB-GYNs in the province of B.C. are drowning in work and we don’t need more of it,” Dr. Elwood said. “The reason that we were interested in providing that coverage, and the reason that we believe that coverage is important, is because women and pregnant people deserve that care. The right people to do that care are high-risk obstetricians.”
The withdrawal of service makes Vancouver General Hospital the only Level 1 trauma centre in Canada without an obstetrician on call.
Jeremy Valeriote, the Green MLA for West Vancouver-Sea to Sky, raised the matter in the legislature on Monday, asking Health Minister Josie Osborne why the province didn’t act sooner given the advance notice.
Ms. Osborne responded that, “in the very, very rare circumstance that a woman who is past 20 weeks gestation experiences a severe trauma and is in requirement of Trauma 1 level services,” there are other hospital options, such as Royal Columbian in New Westminster.
However, obstetricians say Royal Columbian does not provide all the services that Vancouver General Hospital does, and would mean a reduction in services that could put pregnant women at risk.
In a statement to The Globe late Monday, Vancouver Coastal Health said there is a “very low volume of pregnant patients” who attend Vancouver General Hospital for emergency care — currently, about two patients per week.
From the end of 2023 to date, the hospital saw about one pregnant patient per month over 20 weeks gestation that required a transfer to another hospital for obstetrical care, the statement said.
The health authority said pregnant patients who present to the emergency department with life-threatening issues will be stabilized and transferred to St. Paul’s Hospital, Lion’s Gate Hospital, or Royal Columbian, as needed.