Medical school study find maternity care services disappearing in northern Ontario

Northern Ontario is becoming a maternity care desert, according to a recent study by the Northern Ontario School of Medicine.

In 2020, three NOSM physicians surveyed five urban and 35 rural hospitals to gauge their level of birthing services. Compared with the last study done in 1999, officials say things are getting worse.

“It's gone from 20 hospitals out of the 35 down to 11 hospitals that are providing (maternity) services in northern Ontario," said Dr. Eliseo Orrantia, one of the authors of the study.

"Not only (did) the number of hospitals providing those services decrease, but in the places that were still providing rural obstetrical services, the number of physicians had gone down. It had gone down from an average of seven now down to three."

Researchers also found women affected by the disappearing services now have to travel an average of 90 minutes to access services elsewhere. Finding a place that offers C-sections requires an average of 2 ½ hours of travel time.

“There’s a real concerning story here and it boils down to a health equity issue for northern rural women," said Orrantia.

"They're just not able to access services closest to home.”

Buffy Fulton-Breathat, a midwife in Sudbury, said midwives are filling the gaps in service in rural communities. She said the Society of Obstetricians and Gynaecologists of Canada published a paper a while back that said midwifery services should expand into rural and remote areas.

"So now we have midwives in Elliot Lake, we have midwives in New Liskeard," Fulton-Breathat said.

"So those smaller centres are getting served.”

Orrantia said while midwives provide key birthing services, adding more midwives doesn’t solve the problem.

“For midwives to practise, the general model that they have is that they’re anchored in a hospital that has physicians to provide obstetrical services,” he said.

He said ways to solve the problem include government intervention to support not only physicians, but nursing services, too. Specific funding for obstetric care would also help, since right now those services come out of the hospital's general budget.

Orrantia said there should be a focus on birthing education for both physicians and nurses while they are in school so they feel qualified once they are working in the field.

“Northern women need support in this and we really have to change the tide and it can be done," he said.

Currently, the physicians are working on a second study that will look at the nine hospitals in the north that closed obstetrics care in the last 20 years. They hope to find out why the closures happened. The study should be complete in the next six to 12 months.