More babies are being born in the valley; hospitals can’t keep up

By Joti Grewal, Tyler Olsen, and Grace Kennedy

Births in the Fraser Valley are increasing and health facilities can’t keep up. Fraser Health’s struggle to staff a maternity ward is the latest challenge to issues that have affected moms from White Rock to Boston Bar in recent years.

Last Friday, expectant mothers who had expected to deliver their baby at Peace Arch Hospital were told that after Jan. 28, they would have instead needed to travel an extra 20km to Langley. But during an impromptu press conference yesterday afternoon, scheduled half an hour before its start time, Fraser Health’s president and CEO Dr. Victoria Lee announced that “significant new scheduling commitments” means the diversion is largely off. The changes followed protests in White Rock and media coverage across the region.

This week’s controversy came two years after residents in the eastern Fraser Valley were diverted to Abbotsford for several weeks. Rerouting patients is common across the swollen Fraser Health region, according to Dr. Stephanie Balog, a physician at Peace Arch Maternity Clinic who specializes in maternity care. (Balog spoke to The Current on Wednesday, before Fraser Health had cancelled the diversion.) She and her colleagues care for the majority of the patients that deliver at Peace Arch Hospital. While located in White Rock, the majority of moms who give birth in the hospital live in neighbouring cities

“We’ve unfortunately been struggling with intermittent diversions due to temporary gaps in pediatric coverage for several years now,” she said. “And usually it’s set up that [patients] are supposed to go directly to Langley, but often we find that Langley is full. And we’re struggling to see where else we can divert.”

More babies, more challenges

With more families and would-be families moving east from Vancouver, the number of babies born in Fraser Health hospitals was on pace last October to hit heights not seen in at least a decade, according to numbers obtained by The Current through a freedom of information request.

Despite the hospital’s continued staffing challenges, around 900 babies were born in Peace Arch Hospital last year. Balog estimates that around 150 patients were told to go elsewhere. As of last October, Langley Memorial Hospital was on pace for about 1,600 births in 2021. That would have been the highest such figure in at least a decade. And Surrey Memorial Hospital, the next-closest hospital to Peace Arch, was on pace to host around 4,900 births, more than 700 than a decade ago.

Physicians are worried that there isn’t enough capacity in the region to be able to handle more babies with fewer maternity wards.

“Some of our colleagues did reach out to Langley, and they’re concerned about their ability to handle the volume,” Balog said before the Peace Arch diversion was largely cancelled.

The arrangement between the two hospitals is not new. Last July, Peace Arch Hospital’s maternity patients were diverted to Langley Memorial Hospital twice for a combined three weeks. At the time, some midwives expressed concerns about the impact it would have on their patients who would need to travel the extra distance to Langley. Those who might travel from the Crescent Beach area in South Surrey to Langley, for example, would find themselves covering a distance of nearly 30km, which is about a 40 minute drive, according to Google.

More people were affected by diversions in 2019, when Chilliwack General Hospital’s maternity unit closed and patients were sent to Abbotsford for more than two weeks. (Fraser Health had originally expected the diversion to last nearly four months.) Chilliwack is Fraser Health’s most easterly hospital with a maternity unit, and the closure forced parents in Fraser Canyon and Hope to drive more than an hour to give birth.

Typically, Chilliwack has three obstetricians alternating their on-call schedule to provide 24/7 care for the hospital. During the 2019 diversion, only one was available.

When The Current began to look into maternity ward capacity last year, Fraser Health said in an email that their priority during the 2019 diversion was “ensuring babies, children, and their parents have access to emergency and urgent care when they need it.”

The numbers obtained by The Current suggest that at least 100 expectant mothers who would normally have given birth in Chilliwack instead had their child elsewhere.

Fraser Health said they sent “extra resources” to Abbotsford in 2019 to accommodate the additional births. “Temporary diversions are part of our regular operating procedure and are used when there is a gap in service coverage,” the email read. They said more obstetricians had been hired between 2019 and 2021, including one at Chilliwack General Hospital.

The Current contacted the Faculty of Medicine at the University of British Columbia about the trends in medical students entering those specialties, but they declined to comment.

In Langley, the health authority had planned to support the maternity unit by redeploying staff from Peace Arch, a move that Balog said staff hadn’t been consulted on and just wasn’t feasible.

“We do [on-call support] and clinic at the same time,” she explained. “We can’t be in clinic in White Rock and on call in Langley, and giving us two weeks to sort that out is not realistic.”

Closing the maternity unit could also have left the emergency department at Peace Arch with limited resources and without a pediatrician to consult if a child needs to be admitted. Balog said she also heard from nurses there who were considering shifting into different roles to stay at the hospital.

When it announced the diversion last week, Fraser Health said the diversion would be temporary and last until they recruited pediatricians to fill gaps in the service at Peace Arch. According to Balog, the health authority had known about the issue for several years and there was a “lack of leadership in really working to recruit.”

On Thursday, Fraser Health and the Ministry of Health found a solution. It would change the way doctors are compensated at smaller volume hospitals.

But when she spoke to The Current earlier in the week, Balog warned that money alone can’t solve recruitment challenges.

“If you’re trying to recruit a new pediatrician to a site that doesn’t have the services that they’re used to working in… they’re gonna lose all those skills, and they won’t be hireable anywhere else.”

It remains to be seen whether future diversions can be avoided. In its press release Thursday, Fraser Health carefully promised to ensure patients with “pre-existing plans” will be able to deliver at White Rock. But it cautioned that there would be “sporadic single-day diversions” when necessary.

Earlier this week, Balog was blunt in her assessment: “The region is full.”