A study into maternity care services in northern Ontario has found that the number of hospitals not offering obstetrical care has risen in the last two decades.
The researchers, who surveyed 35 rural and five urban hospitals, said this number went from 37.5 per cent in 1999 to 60 per cent in 2020, with all the closures having been rural sites.
This amounts to only 11 northern rural hospitals continuing maternity services presently and an average of less than four physicians providing deliveries per site, which the researchers say puts rural obstetrics at risk.
“The state of maternity care in northern Ontario points to the urgent need to reverse the ongoing trend of service closures,” said the study, which was published by the Canadian Journal of Rural Medicine on March 26.
It added that there have been no openings of obstetrics in hospitals that did not offer them in 1999, while nine communities that offered maternity services in 1999 no longer do in 2020.
Northern Ontario communities with a population of less than 30,000 were considered rural for the purposes of this study.
A person from these communities now need to travel more than one and a half hours on average to access such services, while caesarean surgeries are only available within two and a half hours of travel.
The study cited that the lack of local obstetrical services has been linked to an increase in perinatal mortality, while longer travel times to access maternity care has been linked to higher neonatal mortality.
It also noted that while the number of general physicians is the same as in 1999, those offering intrapartum care have dropped by 65 per cent in urban centres and by 49 per cent in rural ones still providing maternity care.
“The places that stopped (offering them) are ones that could hand off the work to someone else next door, maybe 30 minutes down the road, or at this point in time, their ‘next door’ is becoming longer and longer in terms of travel time for the women who are losing services locally,” said one of the researchers, Dr. Peter Hutten-Czapski of the Northern Ontario School of Medicine.
The physician said more work needs to be done to determine what barriers hospitals are facing.
“Obstetrics is an expensive service to sustain. Certainly, with hospital budgets being what they are, that is a concern,” he said.
Other researchers of the study were Northern Ontario School of Medicine’s Dr. Eliseo Orrantia, Mathieu Mercier in Thunder Bay and Samarth Fageria of Memorial University of Newfoundland.