Hoping to deliver

Labour and delivery in Labrador West is at a risk of being discontinued.

Dr. Thomas Costello, local family physician and Labrador West medical examiner, said without the services of a full-time obstetrician-gynecologist ObGyn), there is the real fear that physicians will not want to provide labour and delivery.

"It has to be all or none," said Dr. Costello. "If you have physicians who decide not to do labour and delivery, the system's going to fall apart."

"It's the lack of backup that's the problem," he stated. "We need the services of a full-time obstetrician-gynecologist. It would improve obstetrical delivery in Labrador West."

There are six doctors working at Captain William Jackman Memorial Hospital, and Costello explained that they are looking for an obstetrician to provide ongoing consultation, to look after high-risk pregnancies delivered in Labrador West, to better educate the doctors on staff, and to promote the recruitment and retention of newly graduated doctors.

As it stands, he informed, on-call doctors are responsible for delivering babies and assisting surgeons in case of caesarian sections.

However, the business of delivering babies runs 24/7, he explained, and it is difficult for doctors to take a respite when they need to cover each other.

He added that there's a high rate of burnout in obstetrics which is time consuming, poorly reimbursed, and stressful.

What is more, he stated, Labrador West is the only community in Newfoundland and Labrador delivering babies without a full-time obstetrician on site.

"What we would deliver theoretically is low-risk prenatals, but if you're familiar with obstetrical care, low-risk can become high risk very, very quickly," he said.

He recalled an instance of a baby prematurely delivered and dying because an air ambulance didn't come in time, and mothers developing HELLP syndrome that's potentially lethal to them and their babies.

"It happens often enough to justify having adequate back up," he stated.

Costello also pointed out that problems arise when the on-call doctor is called to look after both the baby and woman in labour, and when they need to look for a surgeon with the capability to do a cesarean section if the hospital's surgeon takes some downtime.

In the 29 years he's been a doctor in Labrador West, he recalled women giving birth four times while visiting consultant were present, and found their expertise comforting.

However, without a full-time obstetrician on staff, he fears that women might have to be referred out of Labrador West at 36 weeks of their pregnancies.

He believes that there is no obstetrician in Labrador West because the government requires justification for specialists based on population and number of pregnancies.

Costello thinks that with the growing population the area and the surge in first pregnancies, they have the justification needed.

He explained that CWJMH doctors met with Health Minister Jerome Kennedy on his last visit to Labrador West where they expressed the need for specialists, and although there have been no formal talks with the government on the issue, the doctors plan to meet soon and make a presentation on the issue to the government.

"It won't be an easy task to accomplish," exclaimed Costello. "We have to justify the need, justify the numbers, which I think we could do. We need a receptive ear at the political level, which I believe we have. And then there's the logistics of trying to find someone."

Spearheaded by Dr. Willie Arsenault, Costello is encouraged that the process of getting an obstetrician-gynecologist in Labrador West has been set in motion.