Maternity wards around Montreal have had to close temporarily because of nursing shortages

Forced overtime during the pandemic and a recent spike in births have exacerbated a shortage of labour and delivery nurses in Quebec, leading several Montreal-area maternity wards to curtail services and even, in some cases, temporarily close.

Patients have been transferred to other hospitals, sometimes as far away as a couple of hours drive, in order to deliver their babies.

Doctors worry the measures announced last week — bonuses of between $12,000 and $15,000 to attract nurses who have left the public system — won't be enough to fix the shortage of specialized nurses.

"We want to be sure that pregnant women will have a delivery with all the nurses they need, who will take care of them and their baby," said Dr. Diane Francoeur, an obstetrician and gynecologist at the Sainte-Justine mother and child hospital in Montreal.

"And with this big shortage, it's a threat."

Francoeur says she hopes the bonuses will convince labour and delivery nurses to come back to work, but notes it's a specialized field that comes with difficult shifts, working nights and weekends — one of the reasons many nurses left the public system to join private agencies, health officials say.

"You have to be really convinced that it's the best place to work to stay," she said.

The consequences of the shortage in maternity wards are wide-ranging, from causing stress to patients to leading nurses to work-related burnout, says Francoeur, who is the former president of the Quebec Federation of Medical Specialists.

Last week, maternity ward nurses at Longueuil's Pierre-Boucher Hospital staged a sit-in to protest forced overtime.

Quebec's labour tribunal deemed the sit-in illegal before the ward could close completely, but other hospitals have had to interrupt labour and delivery services in recent weeks and months, including the Lakeshore General Hospital in the West Island and Cité-de-la-Santé hospital in Laval.

Dr. Dario Garcia, the president of Quebec's association of obstetricians and gynecologists, says hospitals in regions outside Montreal with smaller maternity teams have experienced those issues for the past couple of years.

But Garcia says the fact Montreal-area hospitals are now faced with acute shortages is a sign the problem is getting worse.

Health Minister Christian Dubé made no commitment to ending forced overtime when he announced the nursing incentives last week, which unions said was a major disappointment.

Patients transferred to other hospitals

Francoeur has seen patients having to travel from Montreal to Sherbrooke to deliver because of shortages at their local hospital.

She says having to change hospitals can be a major stressor for expecting patients. The physician-patient relationship in labour and delivery is particularly important because of the number of complications that can arise, she added.

"If you only speak English for example and everybody speaks French [at the other hospital], and you're already worried about your baby, it's not the way we wish to provide care, even though that care may be perfect," said Francoeur.

"Patients need to trust us and they need to understand, and participate in this special moment in their life."

Francoeur says physicians, nurses and orderlies are working hard to provide a high standard of care, "but at the end of the day when your shift is done you go home and you are dead tired."

Katalina Tennent believes her near-death experience in labour last winter could have been avoided if there hadn't been staff shortages at the Montreal General Hospital where she was a patient.

Tennent, who is 24, landed in the intensive care unit after experiencing a stillbirth due to a health issue.

"They didn't have the time to realize something was happening before it actually happened," said Tennent, who is 22 weeks pregnant now and seeing a doctor specialized in high-risk pregnancies at Sainte-Justine.

She says she feels more support from the care providers there, but that it's harder to get to from her home in Montreal's Saint-Léonard neighbourhood since she doesn't have a car and tries to avoid public transit because of the fragile health of her and her baby.

"This time, I'm hoping and I'm praying that everything will be more organized, that I'll have a lot more support from the doctors or the nurses, and that we'll both come out healthy," Tennent said.

'Crazy busy' but care is still good, doctor says

The Health Ministry says it's following the situation closely and is also concerned by the recent interruptions in services.

In a statement to CBC, it said a number of measures to help with the shortages in maternity departments are taking effect in the coming weeks.

They include creating a network of obstetric emergency nurses and providing mentoring from more experienced nurses.

"The [ministry] wants quality and safe obstetrics services at all times in all establishments. We also want to support the nurses in the network.… Everyone agrees to recognize that overtime is not desirable," said the statement emailed by ministry spokesperson Marjorie Larouche.

According to Quebec's statistics institute, there were 600 more births this year between April and June, compared to 2020. Francoeur says those months, as well as the summer months, are typically the busiest because many parents plan to have their baby in the warmer seasons in Quebec.

But Francoeur says she wants to send a message to expecting parents that no matter how busy the health-care system is, physicians and nurses will go to great lengths to make sure they get the care they need.

"It's important to tell women that, for now, it is still safe to have your baby at hospital. People run all over the place and they are crazy busy, but I think the good care is there," Francoeur said.