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Doctor helping out with emergency C sections at SGH

Only two women transported to Lions Gate Hospital during doctor shortage
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Squamish General Hospital (SGH) has been able to perform emergency Cesarean Sections (C-sections) after all, thanks to a doctor who stepped up to cover weeks in July and August when the only two doctors at the hospital trained in the procedure are not available.

A third Squamish doctor should be trained in the procedure by September, allowing things to go back to normal when it comes to providing around-the-clock coverage.

As a result of the extra doctor, only two women have had to be transported to Lions Gate Hospital for emergency C-sections — both during the first week in June when no trained doctor was available.

"The doctor who has helped us out is a physician who lives in Squamish with the appropriate credentialing/experience, and has been given locum privileges at SGH to help cover some of the on-call gaps," wrote Anna Marie D'Angelo, the senior media relations officer for Vancouver Coastal Health.

The doctor covered one week in July and another in August, while one of the other on-call doctors covered the second week in July to provide full coverage through the summer.

Vancouver Coastal Health (VCH) informed pregnant women in June about the staff shortage. According to VCH, there were only two doctors on call that were certified to perform emergency C-sections at SGH and they had been filling that role for roughly 10 years — and seldom a week goes by when they are not called in. The tired doctors reduced their availability to every third week, leaving one week uncovered until SGH could train an additional doctor.

As a result, high-risk women were counseled to adjust their plans to give birth at Lions Gate Hospital in North Vancouver, or another Lower Mainland hospital.

Low risk women were warned that there was a chance they could be sent to Lions Gate Hospital if the attending doctors thought there was a risk — and that decisions on whether that would be required would be made as early as possible to ensure the safety of the mother and unborn child.

If required, BC Ambulance Service would take the women to Lions Gate Hospital, a trip of roughly 45 minutes — approximately the same time, according to VCH, that's required to bring in an on-call doctor in Squamish to perform the procedure.

The first week not covered in Squamish was June 11 to 17, followed by July 2 to 9, July 23 to 30 and Aug. 13 to 19. It's unknown at this point whether any future weeks could be added in September, but VCH believes that a third doctor would be available by then.

"I can't give the exact date as to when the doctor in training will assume coverage," said D'Angelo.

"We anticipate sometime in September. We will know more near the end of August."

According to statistics, some 50 to 80 per cent of women giving birth at SGH do so through vaginal birth.

Roughly 20 to 50 per cent of women will develop a labour concern, with roughly half requiring an emergency C-section. Most of those are not life-and-death emergencies, which represent between two and three of every 1,000 live births.

In 2011, 230 babies were delivered at SGH, roughly 25 per cent of which were emergency C-sections. On average, that's just over one child per week. From 2007 through 2012, the average is between 25 and 30 per cent.