Invermere obstetrics delivers results

Births on slow but steady rise at local hospital

Births are on a slow but steady rise at the Invermere & District Hospital. Officials chalk it up to a strong, dedicated maternity team focused on delivering results in the community.

“We have a really engaged team that is interested in ongoing learning,” confirms Dr. Jane Fleet, a maternity team doctor. “The people doing obstetrics in Invermere at the moment really believe in what we are doing. We believe that practicing low risk deliveries in a setting without operating services is a patient-centred safe practice with solid evidence behind it.”

She says the rising numbers indicates several key changes: a growth in confidence by local moms, a unified team of doctors, midwife, and nurses, and enough on-call medical professionals to make obstetrics care manageable for this small community.

In 2007, the local hospital saw 24 births out of 103 Valley-resident births, or 23.3 per cent of the births. In 2017, they delivered 27 of the 87 births – an increase to 31.4 per cent of overall births, just over eight per cent growth rate.

The delivering practitioners include Dr. Fleet, Dr. Shannon Page, Dr. Edward Schaffer, and midwife Kyra Warren, as well as dedicated nurses at the hospital focused on maternity care.

Several years ago, explains Deborah Austin, health services director at the Invermere hospital, there was talk of maternity services at risk in Invermere because of the low birth volumes. She credits the medical staff in the Valley for taking the initiative to make sure we did not lose obstetrics. The group does continuing obstetrics education, which Ms. Austin says has built confidence and knowledge for the entire team.

Ms. Warren, the Valley’s only midwife, is proud of the work being done here.

“We are on the leading edge of rural, low resource maternity care, and are held up as an example of success and what is possible,” says Ms. Warren. “We are growing the number of safe deliveries here in Invermere.”

In her time working in Invermere, Ms. Warren has seen a shift in attitudes. Five or six years ago, the majority of her births were in Cranbrook, maybe 80 per cent. Now, on average, Ms. Warren estimates it is 50 per cent split between the two communities where she has hospital privileges.

Ms. Warren says it was not a planned, intentional shift in the culture for birthing mothers. It was that the team-based learning led to a stronger, more confident maternity team.

“The care providers are feeling excited,” says Ms. Warren. “The community can feel that.”

Ms. Warren attended a symposium with several other Invermere representatives that focused on rural maternity care this past June. UBC’s Centre for Rural Health Research gathered the five hospitals that offer maternity care without access to local caesarian sections. At the symposium, Invermere’s team was told they are the most likely to succeed moving forward thanks to their obstetrics model.

Jude Kornelson, co-director for the Centre for Rural Health Research, says the research backs up the need to maintain maternity services in rural areas.

“It’s safe to do this, and the outcomes are good,” says Ms. Kornelson. “When there’s no local access to any services, the outcomes for women, regardless of where they deliver, are worse.”

Delivering here versus another centre like Cranbrook has multiple benefits, share the professionals, including the convenience of being close to family and friends, the safety factor from not having to drive a long distance for care, the cost savings of needing to travel and stay in another community, and the research-proven health outcomes for mom and baby delivering closer to home. It also means for mothers delivering locally, they will know the care providers that continue to be involved after baby is born, such as breastfeeding support.

The Invermere & District Hospital will never have 100 per cent of Columbia Valley births, nor do they aim to, reports Dr. Fleet. She says if there is a remote chance of a high risk delivery, they are referred to Cranbrook. And no one who was interviewed suggests there is no risk to the future of obstetrics in Invermere. It will depend on keeping enough trained professionals interested in maintaining service, enough mothers continuing to

choose to give birth here, and, as always, on the will of authorities, to keep up service. But, local health care practitioners are optimistic.

“Any small town obstetrical service is fragile due to potential changes in numbers of practitioners,” says Dr. Fleet. “We are extremely lucky at the moment that we have four people doing deliveries.”

Ms. Warren agrees, saying it helps that all four practitioners have similar philosophies around childbirth, and their personalities match well.

“We have passionate caregivers that work together as a team,” says Ms. Warren. “What we have is special here.”

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