Days after physicians, parents and politicians spoke out about the 'pediatric care crisis' in Kelowna, the entire Kelowna General Hospital Department of Obstetrics and Gynecology penned a joint letter sounding the alarm on unsafe maternity care conditions.
"We are placed in the ethically unacceptable position of having to choose which patient receives care first, knowing that delay for either could result in permanent harm to a mother or baby. These are real, foreseeable scenarios that no responsible healthcare system should allow to unfold," said Kelowna physicians Dr. Joanna Baxter, Dr. Shelley LaBerge, Dr. Lisa Catt, Dr. T.B. Kate Collins, Dr. Amber Burridge, Dr. Karen Meathrel, Dr. Paula Espino, Dr. Chantalle Brace and Dr. Sumathi McGregor.
The letter from the Department of Obstetrics and Gynecology states that KGH is facing a critical shortage of primary care providers who are able to perform low-risk deliveries, sparking a "collapse of primary maternity care coverage," that the department said had been simmering for more than a year.
"This situation is not new. For more than a year, our department and others have warned hospital administration and health authorities of the escalating risk."
Dr. Sam Azzam, executive medical director of Interior Health South Region, confirmed that KGH is experiencing a prolonged shortage of primary care providers who support maternity care, including family doctors, nurse practitioners and midwives. Dr. Azzam explained that the shortage was exacerbated recently when three family physicians at the Central Okanagan Maternity Clinic, who had been supporting deliveries at Kelowna General Hospital, provided notice of resignation, effective May 31, 2025. The critical shortage and changes will come into effect on June 1.
All remaining primary care providers who are still working at the Central Okanagan Maternity Clinic are focused on efforts to provide pre-natal and post-natal care at the clinic and are not currently able to support deliveries at KGH.
Typically, obstetric and gynecology (OB-GYN) doctors, also called obstetricians, focus solely on providing specialized care and surgical interventions for high-risk pregnancies and urgent gynecological issues.
Conversely, if a patient and their baby are healthy and progressing well, their care during delivery and labour is often provided by a family physician, nurse practitioner or midwife.
To compensate for the lack of staff, KGH OB-GYNs say they have been asked to assume responsibility for the gaps in care and act both as primary maternity care providers and obstetricians in the hospital.
The team of nine are expected to support an additional 20-40 births per month until the Central Okanagan Maternity Clinic is able to resume delivery services. In total there are approximately 1,800 deliveries completed at KGH each year, which is about 150 per month.
Dr. Azzam said the health region is actively working to recruit more family doctors, nurse practitioners and other health care professionals to strengthen primary care in the Central Okanagan.
The obstetricians at KGH worry that because of the shortage, pregnant patients will arrive at the hospital in labour, with no doctor available to provide safe, continuous care during delivery.
"In practice, this means that a single obstetrician may be simultaneously responsible for attending a complicated high-risk delivery while also being the only provider available for a low-risk patient in labour with no assigned maternity care provider," reads the letter.
The letter also notes that being asked to care for all maternity patients without a family physician working in the maternity ward violates the standards of medical practice and hospital policy, as a second qualified provider must be present to assist during cesarean sections, and without a primary provider available, there is no one to fulfill this critical role.
"There is no backup."
The situation becomes tenuous when multiple patients or babies become ill or experience complications simultaneously.
The obstetricians said they are being placed in the ethically unacceptable position of having to choose which patient receives care first.
"Delay for either could result in permanent harm to a mother or baby."
Further, the in-hospital OB-GYNs are also responsible for covering gynecological issues that present to the emergency department such as ectopic pregnancies, ovarian torsion and miscarriages. While consultations for urgent but not life-threatening issues will be diverted to other hospitals during the period of short staffing, the Department of OBS-GYN worries they will be spread too thin in the hospital without support of primary care providers.
"If our team is already operating on such a patient when a low-risk maternity patient suddenly experiences a delivery emergency—such as a baby's shoulders getting stuck during birth with associated oxygen deprivation—we may be physically unable to provide timely care to both situations."
The Department of OBS-GYN recognizes that the maternity care collapse is unfolding in parallel with an equally urgent pediatric care crisis, which has led to the six-week closure of the KGH inpatient pediatric ward. The combined impact of these dual shortages represents a failure of regional healthcare infrastructure to adequately support perinatal care, said the letter.
The Department of Obstetrics and Gynecology is now calling on Interior Health and the BC Ministry of Health to:
- Restore and maintain primary maternity care coverage through proper compensation and active recruitment.
- Create a safe contingency plan that ensures patients are cared for by trained, available professionals.
- Support appropriate diversion or transfer of maternity patients if safe care cannot be provided locally.
Dr. Azzam said IH will continue to meet with the Department of Obstetrics and Gynecology and is working to address concerns raised by KGH medical staff, including their request for increased compensation.
