Vancouver hospital should 'never' be diverting pregnant patients, says trauma surgeon

Pregnant patients requiring exigency or medical specialist give care ar face of the earth diverted from Vancouver General Hospital (VGH) due to a lack of on-call obstetricians.

Dr. Philip Dawe, a trauma surgeon and medical director of VGH Trauma Services, says he and others have been told not to treat patients who are 20 or more weeks pregnant, and they're not happy about it.

“In trauma, seconds matter … we should never be talking about diversion because VGH is the trauma centre for Vancouver acute [care],” he says.

“There's a horrific distress among clinicians about this,” he says.

While babies are normally delivered at other designated hospitals in the Lower Mainland — such as B.C. Women’s Hospital — Dawe explains that in certain emergency situations, a pregnant person undergoing treatment at VGH may need a caesarean section.

The hospital has normally had obstetricians on call for that, but it is no longer the case, he says.

“It's a very rare event that somehow, this patient getting treatment for something else, goes into labour,” Dawe adds.

Dawe gave an example of how the new restriction could play out in his work as a trauma surgeon.

If a woman who’s 20 weeks pregnant is stabbed in the chest, she will no longer be brought to VGH for care, he says.

“She's gonna go to Saint Paul's or Richmond or Lionsgate. And with all due respect to my colleagues at those centres … they don't have trauma surgeons on call and so they may not resuscitate mom as well,” he says.

The effect is that pregnant people are not going to get the best trauma care possible within Vancouver, he says.

Dawe, along with Dr. Gordon Finlayson, medical director of VGH Intensive Care, sent a letter to the ministry of health and several MLAs over the weekend, warning about the dangers of the diversion and seeking a commitment to resolve it.

A spokesperson for Vancouver Coastal Health said in a statement that a group of specialist obstetricians from B.C. Women's Hospital had been providing on-call emergency coverage at VGH.

But in December 2024, the group gave notice that they would be ending their agreement, and the health authority says it has been unable to find alternative coverage.

The spokesperson added that pregnant people experiencing an emergency should dial 911, and if they show up at VGH, they would be stabilized and may be transferred to other hospitals if they need further obstetrical care.

"There is a very low volume of pregnant patients who attend VGH for emergency care," the spokesperson wrote.

"From end of 2023 to date, approximately one pregnant patient over 20 weeks gestation visited VGH for emergency care per month that required a transfer to another hospital for obstetrical care," they added.

Green Party MLA Jeremy Valeriote pointed out that a shortage of obstetrician-gynecologists in both Kamloops and the Fraser Health region was straining health care for pregnant people throughout the province.

"Bringing in new doctors from the U.S. Or other countries is fine, but we need to retain the ones that we have," he said.

"And that goes down to working conditions. And it obviously is affecting obstetric care."

B.C. Health Minister Josie Osborne was asked about the diversions in a scrum on Tuesday with reporters.

She said that occasionally a pregnant person who’s experienced severe trauma will arrive at the emergency department on their own, but the hospital is not designated for maternity care like other nearby hospitals.

"Vancouver General Hospital has not delivered babies as a matter of routine care for years and years," the minister said.

According to Osborne, about three to six patients arrived under these circumstances at VGH over the past 20 months.

But Dawe says the issue is more complex because VGH is uniquely positioned. For example, advanced burn care and certain cases of spinal cord injuries can only be treated at VGH, he says.

Even one case of a pregnant patient dying because they can’t access the care they need is a failure, he adds.

“This is a significant equity issue, right?” he says.

“It's a marker of social justice that we take care of women and children.”

Reporter

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