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'Very scary': Expectant parents diverted from Lower Mainland hospitals, lack of resources increase risk

Last Updated Jul 7, 2021 at 6:27 pm PDT

Summary

New parents share stories of lack of hospital space when they were in active labour

Midwife says safety is a major concern when it comes to hospital diversions

Starting July 8, Peace Arch Hospital will divert maternity patients to Langley due to 'gap in pediatrician coverage'

VANCOUVER (NEWS 1130) – When Katrina Kirk went into labour during her second pregnancy, she was terrified her worst nightmare might come to fruition, again.

She went into early labour with her first pregnancy in July 2019. With her water breaking, Kirk went to Surrey Memorial Hospital only to be told they had no beds or nurses available for her to birth safely. Offered to be diverted to Langley, Kirk declined as her attending midwife didn’t have privileges at the Fraser Valley hospital.

She went into labour, and her midwife made calls to nearby hospitals.

“Surrey Memorial said ‘No, we can’t take her.’ And Surrey Memorial is 10 minutes from my house, but I had to go to Peace Arch which was 20 minutes from my house,” Kirk told NEWS 1130.

By the time she and her partner arrived, Kirk was in active labor.

“I had to push. I knew it was coming. So, we got into Peace Arch and within 45 minutes, my son was born,” she said, adding it was a frightening experience.

“[It was] very scary. Especially when it’s your first time in labour, and you’re driving somewhere where you don’t know. They didn’t even have my information at the hospital because I was supposed to go to Surrey Memorial, not Peace Arch.”

Kirk says she was never told about the possibility of being diverted from one hospital to another while she was pregnant. Fast forward to just seven weeks ago when Kirk gave birth to twins, she knew another diversion was possible.

Even with an induction date booked for 38 weeks, Kirk was told there was not an obstetrician available at Surrey Memorial Hospital, nor were there enough nurses for her to safely be induced.

“So they said, ‘We need to be fully staffed to do that. And we don’t have the staff to do that tonight.’ So it was like, ‘Well, what was the point of you bringing me here if you can’t even induce me? Because that’s what was supposed to happen,'” she said.

She says a nurse eventually advocated for her stay, and she was able to deliver at that hospital.

Katrina Kirk
Left: Katrina Kirk with her husband Wes and son Arthur after Arthur was born at Peace Arch Hospital in July 2019. Right: The couple’s twins George and John, after they were born at Surrey Memorial Hospital in May, 2021. (Photos courtesy Katrina Kirk)

As of July 8, Peace Arch Hospital in White Rock will be diverting maternity patients to Langley Memorial Hospital. Announced on Friday by Fraser Health, the diversion will take place until July 19 due to “a temporary gap in pediatrician coverage.”

“Fraser Health made the decision to implement this temporary diversion to ensure a high level of care for expecting individuals. During the diversion period, impacted patients will be notified directly by their physicians or midwives to discuss their birth plan and ensure their needs are met,” the statement reads.

In an email to NEWS 1130, Dr. Michael Smith, Dr. Jason Burrows, and Dr. Darren Lazare, program medical directors at Fraser Health, say their priority is ensuring babies, children, and their parents have access to emergency and urgent care when they need it.

“We are committed to providing ongoing and sustainable maternity services to the White Rock-South Surrey community,” it reads, adding “We made the decision to implement this temporary diversion to ensure a high level of care for expecting individuals.”

The email suggests recruiting pediatricians to work in smaller hospitals — many without a Neonatal Intensive Care Unit — including Peace Arch, “can be a challenge since some pediatricians prefer to work in larger acute settings. ”

However, Jennie Lucow, a B.C. Midwives Association member and Semiahmoo Midwives team member, says the real issue with hospital diversions is safety.

“We focus a lot on Peace Arch, because that’s our primary site, but it is actually a Fraser Health-wide issue with Peace Arch and Surrey being the two biggest issue areas,” she said.

Asking labouring clients to change delivery hospitals can be very scary, Lucow says.

“When we’re talking about maternity care, things can happen very, very quickly. And so it does bring up a few safety issues for us … It’s certainly been an issue with some of our clients that deliver precipitously. When they have a really fast baby that’s coming, driving the extra 25 minutes is actually quite an issue.”

For Lucow, knowing about a diversion ahead of time can help plan for her clients. However, even with Langley as the designated next hospital, it is not guaranteed a birther will be admitted.

“So for our clients, they phone us when they’re in labour. We phone Langley, and then we all go into Langley. However, now they’re taking on extra births. So, if they were to be on diversion, then we actually start trying to phone around hospitals, going by closest to farthest out,” she explained.

“I remember saying, ‘I’m not going to make it. I need a hospital right now.'”

Rebecca Whatley welcomed her daughter, Mia, back in February. She wasn’t due until March 4, but early labour began on Feb. 16.

“This was my first baby and my birthing plan was to deliver at Peace Arch Hospital,” she said.

But she says when her midwife called Peace Arch to let them know Whatley would be coming in to deliver later that day, the hospital said they couldn’t take her.

“What I remember [is] it was due to a pediatrician shortage and bed shortage,” she said. “She then called Langley and Surrey to try and get me in to one of those hospitals, but again unfortunately they were both diverting as well.”

Whatley says they planned to wait a few hours and call all three hospitals to see if any spaces opened up.

“Contractions were getting very intense, water still hadn’t broken, and again no hospital could take me,” she said.

Since no hospital had space for her, Whatley decided to have a home delivery.

“After my water broke, things progressed very fast. I was in so much pain from the contractions and was feeling so sick and light-headed and was worrying I was going to pass out and not be able to deliver my baby vaginally. I just remember looking up at my husband and midwife and saying, ‘I’m not going to make it. I need a hospital right now.'”

Whatley says she was eventually admitted as an emergency patient to Surrey Memorial Hospital, where her daughter was born that evening. She feels lucky that everything turned out okay.

“When I tell people about being diverted at three different hospitals, they almost don’t believe me. This is such a terrible problem. I consider myself very fortunate that I had a healthy baby and my birthing went relatively really well. I couldn’t imagine having a complication and being on diversion like that.”

The Ministry of Health has told NEWS 1130 serious complications from hospital diversions are uncommon.

Rebecca Whatley
Rebecca Whatley, pictured with her husband and baby shortly after giving birth, says three hospitals all said they didn’t have space when she was in labour. (Photo courtesy: Rebecca Whatley)

It’s not uncommon for midwives and maternity providers to be having conversations about possible diversion, Lucow said.

“It’s not that unusual for us to have a problem where we’re talking about whether or not we’re going to divert to Squamish. That’s definitely come up.”

The drive from Surrey Memorial Hospital to Squamish General Hospital is 95 km, often taking more than an hour and a half.

When she was in active labor herself around 10 months ago, Lucow was almost diverted to Langley Hospital from her local hospital of Peace Arch.

“So if Peace Arch was on full closure, that would’ve been a pretty scary car ride for myself, and especially for my partner who does not deliver babies for a living,” she said.

But Lucow says her story is not unique, and whilst Fraser Health and care providers do put in place policies and procedures to mitigate risk, “there’s nothing you can do” about physical distance.

“People need to have access to the closest hospital.”

The unknowns that come with the possibility of a hospital diversion are a big issue.

“There’s an expectation that they will be provided care in a fully functional hospital. So the fact that it’s closed for two weeks, it’s having a mental strain on our clients. It’s very scary for them to be going to a new site where they physically don’t even know where the parking lot is, let alone know what the procedures are,” Lucow said.

Jennie Lucow
Jennie Lucow, pictured with her two children, is a midwife who was nearly diverted to Langley from her local hospital of Peace Arch. (Photo courtesy: Jennie Lucow)

She told NEWS 1130 of a recent complication in which she describes as a “near miss.”

“[We had a] a client almost deliver in the vehicle and then proceeded to have a hemorrhage. So she was able to make it to the hospital that we needed her to go to, which was not the hospital closest to her. But the risk to her with bleeding, had that happened in a car, would be significant,” she recalled.

So far, in most instances, Lucow says she has been able to follow her clients to other hospitals as she has secondary privileges at Surrey Memorial and Langley Memorial, however she is expecting these privileges to be removed in the coming year. That would greatly affect her ability to support her birthing clients.

“That’s a pretty big safety issue when you have a lack of communication with your care providers. And when the procedures are different from site to site, not having someone to explain what’s happening to you, in context,” she said.

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In an emails sent to NEWS 1130, the B.C. Ministry of Health says it knows it’s challenging for parents when hospitals are put on diversion, adding “People want to give birth as close to their home as possible.”

The ministry says temporary diversions are a “regular operating procedure that occur periodically in all health authorities when there is a gap in service” that can be filled at a different hospital.

“Diversions are intended to provide the best and safest care for patients and can occur in many departments, not just labour and delivery. When a hospital is under diversion, health authorities assess and divert patients to available sites within the region. Every effort is made to divert a patient to the closest hospital,” an email reads.

“Diversions of patients to other hospitals occur due to capacity issues or reasons related to higher level of care requirements.”

It adds people who are pregnant and their babies are foremost in their planning. However, the ministry says there are times when hospitals must go on maternity diversion.

“The ministry is specifically working with Fraser Health and Peace Arch Hospital Pediatrics department to stabilize services with a physician contract that will support a full pediatric service,” the ministry said

It says maternity units are unique because “cases fluctuate depending on demand.”

“Our government is working to address the needs of patients and care providers through our new primary health-care strategy.”

“I had no idea who the doctor was.”

On February 17, Hanieh Berg’s water broke. Pregnant with her third child, it was the last day of that diversion at Peace Arch Hospital.

“Once we realized I was active, I said to them on the phone, ‘Okay, if you’re on diversion, am I [going to] Langley or to Surrey?’ And that’s when the nurse advised me that they were both full and that my options were Burnaby or Chilliwack.”

It was her husband’s worst fear, Berg explains.

“Logistically, it was a lot. I have two older kids, so I had to get my mom to come and stay at the house,” she said.

“It wasn’t like we were just five minutes down the road, like we would have been with Peace Arch. We were an hour away. Even something as simple as kids’ drop off and pick up, and lunches and stuff … had to fall on my mom.”

Heading into a hospital that she knew nothing about was hard.

“When I walked in, I asked ‘Who was the doctor?’ Like, I had no idea who it was … I wasn’t sure who was the nurse or the doctor was. And so I literally googled the doctor to see who it was going to be because I had no idea who it was,” she said.

After her experience, Berg wrote to the Ministry of Health and Premier John Horgan in March, 2021 outlining what had happened.

“The maternity ward at Peace Arch Hospital saw a $5.3 million major renovation and expansion in 2010, yet the Hospital has been unable to secure Pediatricians despite over 1,000 deliveries
annually, not to mention an Emergency Room with over 5,000 pediatric visits annually,” Berg wrote.

“The need for 24/7 pediatric coverage at Peace Arch Hospital is critical and I urge you to resolve this shortfall immediately.”

Replying more than two months later, the premier’s office instructed Berg to make an official complaint with Fraser Health, as “issues concerning the quality of care provided in health facilities are the jurisdiction of the health authorities.”

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Stephanie Penner, a maternity doula with Wildflower Birth Collective, says it’s well-known that Peace Arch hospital is often on diversion.

“This isn’t the first time that they’ve been on diversion … for this exact reason as well,” she said.

Diversion isn’t a new thing, Penner says. She says she’s had clients diverted from Peace Arch, Surrey Memorial and Royal Columbian Hospital.

“It’s really hard. It’s hard for those families because they they end up losing their care providers a lot of the time. And so they’re showing up at a different hospital with without their care providers and with somebody that they don’t know.”

Penner says although diversion doesn’t really change anything for the way she practices, it’s stressful for both birthers and care providers.

“It’s just always in the back of our mind — thinking about whether or not the hospital that they’re attending is on diversion. And trying to make sure that we don’t go to the hospital too early and get diverted … just trying to make sure that that stays safe for everybody.”