It only took the sudden departure of a general practitioner to destabilize the only obstetrics program present in the 800 kilometers of northern Ontario, between Timmins and Thunder Bay.

Sensenbrenner Hospital in Kapuskasing says without emergency funding, its obstetrics unit will soon close, forcing hundreds of pregnant women to travel long distances to give birth.

General surgeon and chief of staff Dr. Jessica Kwapis says the hospital only has two general practitioners trained in obstetrics and they do not work in that unit full-time because they have other practices such as l anesthesia and emergency medicine.

“We can’t maintain coverage 365 days a year with two providers,” she said.

Kwapis adds that there are other doctors willing to come and help, but the hospital has no mechanism or compensation agreement in place to pay them.

“They would essentially be donating their time to help with deliveries unless the government gave us the money we need to support this medical service,” she said.

Kwapis says she prefers not to get into specific numbers, but says the funding proposal recently submitted to the Department of Health is just a “drop in the ocean” in the grand scheme of things .

She says she has heard from several patients who tell her that uncertainty about the future of the obstetrics program in Kapuskasing, combined with a lack of places to safely give birth outside of Timmins and Thunder Bay, is causing some residents to of the Highway 11 corridor to reconsider if they want to go through another pregnancy.

She says not everyone has the resources to arrange child care, travel hundreds of miles to another community and pay for housing there while they wait to give birth.

“A lot of women will choose not to move and just hope for the best when the time comes,” she said, adding that being transported by helicopter out of the community is not an option for a person in work.

“This is a health equity issue…Imagine thinking ‘I don’t know if I want another baby because I don’t have a safe option for where to give birth.’

“That would be unacceptable in southern Ontario,” she said.

Fewer doctors providing obstetric care in Northern Ontario

A recent study in the Canadian Journal of Rural Medicine found that the number of rural and urban hospitals in Northern Ontario not offering obstetrics increased from 35 per cent in 1999 to 60 per cent in 2020.

Hearst, a small town of 5,000 located a two-hour drive from Kapuskasing, had to close its obstetrics program in 2023 due to staffing and funding issues.

Mélanie Goulet, recruitment coordinator for the Hearst Medical Recruitment Alliance, says it’s unfortunate because the city has seen a particularly high number of births this year.

Pregnant women are advised to leave the community once they reach 37 weeks and travel three hours to Timmins or six hours to Thunder Bay.

Sensenbrenner Hospital in Kapuskasing is only used in cases of absolute emergency, she said.

But not all of them reach an obstetrics unit on time.

At least seven people have given birth while trying to get to an obstetrics ward in the past year, according to Kwapis.

“There have been deliveries in taxis, ambulances and even emergency room toilets,” she said.

“If nothing is done, something serious will happen,” adds Goulet.

Hospitals in Hearst and Kapuskasing say additional funding for obstetric training and midwives is welcome, but ultimately won’t be enough to prevent obstetric units from closing.

They are asking Ontario to give the green light to a funding model for obstetrics that already exists in other specialties.

Kwapis says the Department of Health supports the concept, but negotiating these models can take years.

“We don’t have any years,” she said. “We need them to move faster in this area.”

Asked about this situation during question period at Queen’s Park, Anthony Leardi, Parliamentary Assistant to the Minister of Health, responded by saying that the government had made significant investments in health, including increasing the number of obstetricians and gynecologists.