Flin Flon hospital was 'greatly' distressed by risks to babies, mothers before delivery ward closure

Staff and mothers were seriously concerned by close calls at Flin FlonGeneral Hospital after the departure of its obstetrician in February until the delivery ward closed in November, CBC has learned.

Internal briefing notes obtained by CBC through an access to information request show "near misses" at the obstetrical department were "greatly distressing" for staff.

While the Northern Regional Health Authority declined to provide examples of the near misses, citing patient confidentiality, mothers in the town of 4,800 say they include situations where women went into labour outside their expected due date window and had to be rushed to The Pas or deliver in the Flin Flon emergency room.

Flin Flon's full-time obstetrician left the hospital Feb. 14. For the following nine months, the town relied on locumsor fill-ins to staff the hospital'sobstetrical department. On Nov. 18, the Northern Regional Health Authority suspended obstetrical delivery services for the indefinite future.

Jo-Val Klasson, 21, saidshe knows three women who gavebirth with the assistance of an emergency room doctor in Flin Flon, rather than with an obstetrician who specializes in birth and pregnancy medicine, because they went into labour early in recent months.

Earlier this year,Klasson herself was supposed to give birth in Flin Flonwith a fill-in obstetrician set to arrive a day after her due date. She ended up going into labour five days early but had time to drive to The Pas to safely deliver her son. He is now five months old.

The Northern Regional Health Authority said it suspended baby deliveries in Flin Flonin November to "ensure patient safety for expecting mothers and their newborns is upheld."

The internal briefing notes expand on that reasoning. Theysay the"near misses"had "near critical incident impact" on mothers and babies.

A summary position written by Helga Bryant, chief executive officer of the Northern Regional Health Authority, said a negative outcome for a mother, newborn or bothwas becoming "more an issue of when, than if."

In November, the NRHA reported an obstetrician was only available about half the time at theFlinFlonhospital.

Internal documents showthere was not a single month in 2018 where the hospital had consistent coverage.

In April2018 the hospital was not able to provide obstetrical care for 26 days out of 30, in June it was unable to provide care for 25 days.

Are we getting the best care?

The internal briefing notes also mention "inconsistent" messaging to patients that caused confusion.

For the duration of her pregnancy, Klasson said she heard different interpretations from thefill-in family doctors about whether her iron levels were low or not. Two doctorstold her they were low, the third laughed at the diagnosis, she said, and told her the levels were fine.

"It seems you see one doctor and they diagnose you with something or they tell you something and then you see the next one and you get a completely different answer from them," said Klasson.

"It's very concerning and alarming. It scares us because are our babies getting the best care they can get? Are we?"

For Logan Oulette, 25, her doctors couldn't agree on a due date for her now newborn son.

She was first scheduled for a caesarian the Friday before Thanksgiving when a family doctor in Flin Flon believed her due date was Nov. 4. Other family doctors later changed her date to either late-November or early-December.

Oulette gave birth to her second child on Dec. 1 at a hospital in Dauphin, Man.

"Because they had my dates wrong I had testing done at the wrong times leading them to believe things were wrong when they were fine," she said. "It put a lot of stress on me."

Both Oulette and Klasson don't believedeliveries or prenatal care have improved now that the obstetrics department in Flin Flon is closed.

"I don't feel like they made a solution to the problem. I definitely feel like they just made it worse," Oulette said.

Klassonwonders whether the lack of birthing support will turn young families away from the town.

"I want to leave. It very much scares me. I know I just had my baby, he's just six months old, but I would like to have a child in the future," Klassonsaid.

Prenatal care improvements

Kirsten Fritsch is a committee member with We Want Birth, a Flin Flon-based group calling for better women's health care.

"What we'd like to see is continuing coverage. The reason we had 'near misses' is due to gaps in coverage there was no consistent pattern to who was [staffing the obstetrics ward] and why and when and for how long," she said.

We Want Birth was formed to advocatefor permanent staff at the obstetrical ward so low-risk births could continue at the Flin Flon hospital. For now that goal is on hold, Fritsch said, because they have littlehope the ward will ever reopen.

They are calling for more consistent prenatal care and better supports for mothers who must now leave for The Pas or elsewhere weeks before their due dates to deliver their babies.

"We're finding that moms are deciding between paying rent and paying to leave town," Fritsch said.

Northern Regional Health Authority spokespersonTwyla Storey said expectant mothers will receive prenatal care from their primary care provider in Flin Flon and an obstetrician from The Pas will travel to Flin Flon twice a month for prenatal visits.

"The Northern Patient Transportation Program will subsidize medical transportation costs for eligible insured services not available in the patient's home community,"Storey said on the issue of out-of-town costs.

"Patients can apply to have their transportation costs reimbursed under the program. All applications are considered on their own merits consistent with the NPTP policy."

The Northern Regional Health Authority said the obstetricalward will remain closed in Flin Flonuntil the development of a provincial women's health clinical services plan at which time the closure will be "revisited."