(From Connexion Newsletter Fall/Winter 2024)
An unprecedented, physician-led, and in-person maternity care event drew 21 physicians and two midwives from ten communities throughout the BC Interior to share experiences across their sites. Participants discussed the roles of providers, Divisions and other organizations in human resource planning, and explored how a regional network of maternity care could improve patient care.
“When we began to explore the concept, we discovered the interest to participate was palpable and the decision to proceed with a maternity care event was obvious,” said Melanie Todd, Senior Project Manager at the Thompson Region Division of Family Practice.
The group came together for an evening meet-and-greet and a full day of facilitated conversation in Kamloops where they shared information about their sites, challenges, successes, opportunities, and what motivates them to do the work they do.
“An event like this has never been done before,” said Dr. Shaun Davis, a family physician who works at Thompson Region Family Obstetrics and was the physician lead for the event. “There has been little opportunity for family physicians and midwives providing intrapartum care across the region to build relationships, share experiences, and learn from each other. This event gave us a valuable opportunity to put names to faces and empathize with our colleagues from other communities in the region who are facing similar situations.”
Key learnings included:
- The need for clear risk assessment guidelines for obstetrician transfer and consult.
- Enhancement of collaborative compensation models (FP/midwife).
- Allowing providers more transparency with patients.
- Increasing the number of maternity care providers.
- Experiences of residents and learners in current environments.
- Nursing shortages and training to support nursing staff.
- Differences in how obstetricians practice across the region (primary care vs. consult-only) require navigation support.
“Family physicians and midwives are a critical part of the system. They are the foundation of maternity care in BC, but they can only function when the whole system is working,” Dr. Davis said. “These conversations around maternity care are deeply impactful and let providers express their frustrations, build relationships and work towards a better future. We are not alone in this struggle of feeling pushed over-capacity. All parts of the system are feeling this pressure and the moral distress of having to turn away pregnant patients is difficult to manage.”
The group worked on a list of recommendations to break down barriers and enhance cohesiveness, including the creation of a regional maternity network to support information sharing, education, and the opportunity to amplify regional needs.
Regional strategies to improve patient care could include regional rounds to support collective decision-making concerning patient care and transport; the creation of a funded regional position for maternity care access and flow between referring and accepting sites; and the creation of a central list for maternity care locums.
“Maternity care providers across the BC Interior are struggling and require targeted ongoing funding and infrastructure to support a network that could help identify pain points and inform provincial stakeholders and eventually policy making.” said Katherine Brown, Executive Director, Thompson Region Division of Family Practice. “The challenges are multi-faceted and require ongoing quality improvement funding to support sustained maternity care improvements.”
Next steps include escalating key learnings and regional strategies to appropriate regional and provincial stakeholders, and bringing the group of providers together again.
