The BC Maternity Care Rant

I'm a bit livid right now. I'm livid with the anesthesiologists. I'm livid with the BC Medical Association. I'm livid with the BC Ministry of Health. The situation right now is an all out cluster f**k - the game playing has reached an obscene level, and in the middle of it are the patients. The mothers and the babies.

Yesterday the BC Government, announced funding for dedicated obstetric anesthesiology at Surrey Memorial, Royal Columbian and Victoria General Hospital. But don't break out the cigars just yet...this is not the birth of DOBA, at least not yet - I'm not sure if this will be yet another miscarriage or actually result in DOBA being a resource for pregnant mothers to rely on that will actually result in women having access to timely care (epidurals and c-sections) during labour and delivery.

So what is the cause of my cynicism? DOBA in BC has a long history - a history of being 'supported', but not actually realized. There has been a series of miscarriages. You see, the announcement yesterday is about 3 years too late. Why? Because, the government actually did try to get DOBA at these hospitals in 2009. What happend? Well not a single anesthesiologist applied to the positions. So as much as DOBA was then recognized to be a good thing that should be at all level 3 hospitals in BC, it did not come to be.

As a result - when I had my baby in July 2010, DOBA was not there. When Mrs. Frith had her baby in December 2010, DOBA was not there. When the baby in August was stillborn and sparked an external review, DOBA was not there.

So now, given the outright hostility between the BCMA, the Ministry of Health and the Anesthesiologists - I am in no way certain that DOBA will be in place anytime soon. I'll believe it when I see it, and in the interim - what about all the women who have been harmed between the time the government first realized that DOBA should be in all tertiary hospitals in BC and the time it actually becomes a reality?

There needs to be some accountability for the harm that has been caused - and right now there isn't...there needs to be some recognition of the pain and suffering that didn't need to happen, shouldn't have happend. If you've been harmed by the lack of DOBA in level 3 hospitals in BC, speak up - your voice deserves to be heard above the petty bickering!

Measuring Access Delayed and Denied

I have anecdotal evidence that timely access to medical care during labour and delivery is sometimes delayed and sometimes denied in BC. I have news articles about these cases and I have the conversations that I have had with other moms. I have some evidence that access to some services is significantly lower in BC than in other parts of the country (for example, the use of epidurals in BC is 30 percent compared to 60 percent in the rest of the country).

I know a problem exists, what I have no real way of knowing is how big of a problem exists. Statistics on how long a person waits for a requested service are not kept. Statistics on requests for services that ultimately didn't happen are not kept. Statistics on services that are bumped by more urgent cases are not kept. As such, I don't know how many other moms in BC are like me - I know that I'm not alone in my experience, but I don't know exactly how not alone I am.

I fear that I am less alone than I should be - I fear that cases like mine, that should be a very rare exception, actually aren't. I fear that quality care is missing for many women. If access delayed and denied was measured, it might be a first step to recognizing that a problem exists, the magnitude of it and moving towards changing it so that patients have a better experience of care.