Stevenson Memorial Needs Maternity Care

TO:

ADMINISTRATION & THE BOARD OF GOVERNORS, STEVENSON MEMORIAL HOSPITAL
Edward Takacs, President and CEO Stevenson Memorial Hospital
Susan Plewes, Vice President and Chief Nursing Executive Stevenson Memorial
Hospital
Dr. Alex Riddell, Chief of Staff Stevenson Memorial Hospital
Nigel Gripper, Board Chair Stevenson Memorial Hospital
Paul Whiteside, Board Treasurer Stevenson Memorial Hospital

The Honourable George Smitherman, Minister of Health and Long-Term Care

Helena Guergis MP Simcoe Grey

Mike MacEachren, Mayor New Tecumseth


Stevenson Memorial Hospital is planning to close its obstetrical unit before 31 March 2007, an exact date has yet to be announced. The planned closure of the maternity unit is a travesty against informed choice and birthing options for women. Women and their families need to birth in their own communities with friends and family for support. It is not always feasible for women to travel a great distance for prenatal, antenatal and postnatal care. With the shortage of family doctors servicing this community, combined with a cap of how many women can be serviced by midwives, many mother's will go without adequate care. Worldwide studies suggest the need for birthing within ones own community for the health and well-being of both mother and child. SMH should remain an available choice for birthing women.

The birth of a child is a special time in most womens life. It is a time fraught with joys and sorrows, triumphs and defeat. It is a time that is never forgotten. Women have great recall of the events surrounding their childs birth. Birth can be a spiritual and emotional journey for many women and their partners. It is a complete sensory experience they recall a kind word, a certain smell, what music was playing, what they were looking at. Most importantly, they remember how they were cared for was it with respect and dignity, or was she part of an assembly line of birthing women with no personal or emotional contact. Birth is a key life experience; it is sacred and time honoured.

In North America, the tides are changing. Women have had freedom of choice in many provinces and states. Birth can happen at home, in a hospital or a birth centre. Women can be attended by midwives, obstetricians or family doctors. Some women choose no assistance at all while others will have the support of family members and doulas. In some areas, there are no choices. New Tecumseth is about to become one of those places with no choices.

Community consultation on this planned closure has been noticeably absent. Many, many lives have been positively touched by a wonderful birth experience at SMH. Many lives have, sadly, also been negatively touched by situations where this choice was not available.

In recent years, numbers of births in this small, community hospital, have dropped. The obstetrical unit has had its fair share of highly publicized challenges. From retaining and maintaining quality obstetrical services to gaps in anesthesia coverage, from lawsuits to intermittent closures, Stevenson has been challenged by what many other rural and remote communities are experiencing across the Province. Rural communities need the safety net that small hospitals can provide for maternity care.

According to the Integrated Maternity Care for Rural and Remote Communities (IMCRRC), there is a Provincial-wide crisis in maternity care providers. One of the most alarming trends is the well documented, dramatic decline in family physicians providing care combined with the the shortage of nurses with obstetrical training. While the number of obstetricians in Ontario has remained stable, many of them work in larger cities and attracting them even one hour from Toronto has been difficult. The demand for midwives, is quite obviously increasing, but the demand exceeds the supply and quite often there are lengthy waiting lists for women seeking midwifery care.

This past May, the IMCRRC hosted a symposium on the looming crisis in maternity care, particularly for rural and remote communities in Ontario. Presenters included the Ontario Maternity Care Expert Panel (OMCEP), Babies Cant Wait and the federally funded Multidisciplinary Collaborative Primary Maternity Care Project (MCP2). Representatives from partner organizations include: the Association of Women's Health, Obstetric and Neonatal Nurses Canada (AWHONN Canada), the Canadian Association of Midwives (CAM), the College of Family Physicians of Canada (CFPC), the Society of Obstetricians and Gynaecologists of Canada (SOGC), and the Society of Rural Physicians of Canada (SRPC). The Canadian Nurses Association (CNA) has also joined MCP2 to support the issues and interests of nurses and nurse practitioners across the country. All groups are united in their concerns for maternity care; however, practical and sustainable solutions for Ontario were addressed and action plans put into place.

The IMCRRC hosted a local working group in six communities. Alliston was one of the chosen communities that was required to deliver a sustainable model presentation. With the help of consumers in the area, the local working group was able to prepare this presentation. Representatives from Stevenson Memorial Hospital and our surrounding communities attended these sessions. Unfortunately, to date, no action has been taken by administration of Stevenson Memorial Hospital or the Ministry of Health on suggested solutions to the challenges faced within this community. An emerging model of care has been working well at the South Vancouver Birth Centre and generates another working role model for integrated care, doulas for all women, informed consent and education for women and their families. This, too, has not been regarded.

The unannounced closure of the maternity ward will have a ripple effect for our already overburdened surrounding communities. We need a local birthing facility. Our community is vast and the needs are great. We need to build confidence in the services we have and expand on the quality services that are already offered. We have a large population of teen mothers who would find great difficulty in birthing outside their community. This, combined with a gap in continuous community resources, puts a new generation at risk for living and surviving in and under serviced area. Think also about mothers with rapid labours or mothers with problems in their pregnancy with time-related solutions. Homebirth will no longer be offered, another choice gone. While other communities are trying to step up services for women, our hospital is stepping out of providing much needed services. There are solutions at hand; unfortunately, they are not part of the bigger, financial picture for SMH and the push is on for that facility to make money or risk full closure.

Its a true shame that the sacred part of birth that honours families may no longer be seen in this community. If it were you, your sister, your friend or your wife would you be fighting to retain these unique services? Birth is a key life experience to be remembered forever the uncertainty of a birth environment, the challenges of getting there and the politics and the finances of the hospital and the Ministry of Health need not be placed at the centre of this sacred time in each of our lives.

We, the undersigned, would like to see SMH implement a maternity care network, comprised equally of consumers and maternity professionals to guide an integrated model and a baby friendly initiative plan into place.

Solutions are at hand.

Please make maternity care a priority in this region. We care!