Women haven’t been able to give birth in Fort Nelson for five years, but that could be changing thanks to a renewed effort to explore less conventional delivery options.
The Northern Rockies Regional Municipality, along with Northern Health, have been researching the possibility of establishing low-risk, non-surgical maternity services at the Fort Nelson General Hospital.
They’re interested in emulating a maternity model that exists in Haida Gwaii, where low-risk mothers-to-be are given the option of giving birth on the island, knowing that there is no C-section capability should something go wrong.
Their program has been successful for over 10 years.
On Oct. 28, Northern Health, the Northern Rockies, and members of the Haida Gwaii medical team met via videoconference to discuss the possibilities.
Fort Nelson currently has no maternity services. Women who become pregnant are advised to leave three weeks before their due date go have their baby delivered elsewhere, according to Jaylene MacIver, acting director of community development with the municipality.
“Under the traditional model, you have to have that critical team of physicians and a GP (general practitioner) surgeon, and a GP anesthetist, and the nursing staff, and everything to ensure that C-Section capability is there,” she explained.
“When that combination of folks were no longer in Fort Nelson, that’s when we stopped having maternity (services).”
The district and Northern Health have tried for years to recruit the staff required, but have not been
While bringing back maternity services has always been on council’s radar, it’s become a priority as of late to look at options that don’t necessarily follow the traditional model, MacIver said.
Delivering a program like Haida Gwaii's, however, would require education and training for staff, and risk assessments for the mother.
“Basically from conception to delivery they’re assessed, physically and psychologically, for their suitability to stay on island,” explained MacIver.
She was part of the videoconference, as were six councillors, three Fort Nelson physicians, and two representatives from Northern Health, including chief operating officer Angela De Smit and Dr. Becky Temple. From Haida Gwaii, Dr. Gordon Horner and site manager and nurse Kerry Laidlaw
“(We) had a really good discussion about what are the things that we would need to put in place before we consider offering low-risk maternity, and the first one that Dr. Horner said is we need to have a really solid community consultation with childbearing women,” said De Smit.
The Haida Gwaii members also spoke of the importance of having at least three physicians who are prepared to offer maternity services so there is adequate coverage.
Additionally, there must be a detailed risk assessment, De Smit said.
“That’s where you look and see, is this their first baby? Did they have complications with a previous pregnancy or baby? What will be their risk in terms of having complications?”
After those assessments are complete, the pros and cons of delivering in the community would be relayed to the patient, so she can be fully informed before making a decision.
Another factor has to do with training and education, and making sure the medical team is diligent in terms of arranging vacations so there are always people on staff should a woman go into labour, and checking blood bank levels.
One major challenge that could not be overlooked, however, is the fact that Haida Gwaii has 24-hour, seven-day-a-week access to a medical helicopter should an emergency occur.
“That’s the challenge,” De Smit said, explaining that co-ordinating an air ambulance out of Prince George could take several hours.
Similarly, there could be a lengthy wait for an air ambulance to first fly to Fort Nelson, and then transfer the patient to Fort St. John, the nearest hospital with maternity services.