Report calls for action on shortage of labour and birthing care in northern Ontario

Less than a month after Sensenbrenner Hospital in Kapuskasing made the alarming announcement that its obstetrics program is in immediate danger of shutting down, a recent report from the Northern Policy Institute has urged for urgent action to address the scarcity of labor and birthing care in rural northern regions.

The report, titled “Delivering Solutions: An Action Plan for Sustaining Rural Birthing in Northern Ontario,” reveals that only nine rural hospital sites are currently offering labor and delivery services to approximately 50,000 rural northern Ontarians of childbearing age. This number has significantly decreased from 20 hospital sites that were operational around two decades ago. If Sensenbrenner Hospital’s program ceases to exist, the count could further drop to eight.

According to the report, every year, about 1,200 individuals from northern Ontario have to travel an average distance of over 1.5 hours to access basic labor and delivery services. Shockingly, during the 2021-2022 fiscal year, more than 200 individuals had to endure journeys of over four hours, posing significant risks to maternal and infant health.

Dr. Eliseo Orrantia, the author of the report, emphasized the critical issue of distance when it comes to accessing necessary healthcare services. Studies have indicated that prolonged travel times for medical care are associated with higher risks of stillbirths and preterm births. Even infants born to parents who travel between one to two hours for delivery often require extended stays in neonatal intensive care units compared to those residing closer to labor and delivery facilities.

Moreover, rural residents face a twofold increase in life-threatening conditions during childbirth, such as eclampsia and amniotic embolism, compared to their urban counterparts. This stark reality contradicts the province’s goals of providing swift access to healthcare and delivering appropriate care in the appropriate locations.

In response to the closures of obstetrics programs in northern regions, the report outlines several recommendations to prevent further shutdowns. Firstly, enhancing education and training in obstetrics for rural family physicians is crucial. Dr. Orrantia proposed altering the curriculum to prioritize obstetrical rotations and providing funding for continuing medical education to upgrade obstetrics skills among rural physicians.

Secondly, recruiting healthcare professionals skilled in labor and delivery care is essential. Although attracting healthcare professionals to rural areas, especially those with specialized skills like obstetrics, has been challenging, a shift in provincial funding for midwives could offer a solution. The revised funding model for midwives, which is no longer based on delivery numbers, encourages them to broaden their scope of practice and work in smaller communities.

The report emphasizes the need to bolster support for obstetric care, advocating for systems that enable quick access to experienced doctors or specialists in critical cases. Dr. Orrantia highlighted the existing challenges faced by healthcare providers in rural areas when seeking assistance for complex obstetric cases.

In conclusion, the report calls upon the province to appoint an organization to devise a strategic plan to address the shortage of obstetric care in northern Ontario. Dr. Orrantia estimates that this endeavor would cost approximately $350,000 and urges the province to allocate the necessary funds to support this initiative.

While the Minister of Health’s office did not provide a direct response regarding funding for the proposed plan, they emphasized the government’s efforts to increase the healthcare workforce, including the addition of new nurses and doctors and the expansion of medical school programs in Northern Ontario.

Dr. Jessica Kwapis, the chief of staff at Sensenbrenner Hospital, expressed support for the report’s recommendations, particularly in enhancing residency training and continuing education funding. She highlighted the importance of a collaborative approach in addressing the obstetric care shortage, emphasizing the need for a central organization to coordinate responses.

As discussions regarding a funding proposal to sustain Kapuskasing’s obstetrics program continue, Dr. Kwapis assured that the program remains operational. She emphasized the significance of working collectively to find sustainable solutions to the obstetric care crisis in rural northern Ontario.