Letters and Comments

Dear Minister:
I am writing regarding the closure of obstetrical services in Banff. Obstetrics is a vital service to a small community. The closure of maternity services will mean 100 women per year will have to make the drive to Canmore monthly, then biweekly after 28 weeks, then weekly for 4-6 weeks during their pregnancy. Given motor vehicle accidents are a leading cause of fetal death this puts mother and child at unnecessary risk.
Furthermore, local providers of Obstetrical care need to be providing ongoing care to remain proficient in their obstetrical skills. By removing these patients these providers will lose their proficiency in this skill. In such a transient and tourist comminity like Banff it is extremely likely that women from out of town will present to the emergency dept in active labour and will be faced with a staff that is out of practice and potentially unskilled. Unnecessary risk for mom and baby.
Lastly, having a community where children are born and raised creates a connection to the community itself. The more people are driven from their community unnecessarily for tests, procedures, or even something as natural as childbirth, the more people lose faith in their community to fulfill their needs. And the exodus begins.
Banff is a beautiful town set in the stunning backdrop of the Rocky Mountains , it would be a shame if no one could claim to be “from” there. I sincerely hope that you will not make the same mistake in Banff that has been made in countless other towns in Alberta. Please do not close Obstetrical care in Banff.
Sincerely,
Dr. Shelley Mott
Hello sir/madam,I would like to join my voice to those who are protesting the closure of the Banff labour and birth unit. The unit is providing a valuable service with a great track record. Across Canada there is a move to increase the number of smaller birth units closer to home for Canadian women. Please do your research…. there are many health benefits for women and for families when woman birth closer to home with a care provider that they know and trust. You have this kind of situation occurring in Banff right now, to close the center would be a step backwards.Marie Berwald, Childbirth Educator
Sir: It is my opinion that there is nothing sound, medically, socially or morally, to support your decision to close maternity care at the Banff Hospital
Mary Ellen McColl MD CCFP CIME Cascadia Medical Service High River AB Dear Health Minister,

I am writing to express grave concern over the potential closure of the maternity services in Banff’s local hospital. I am a maternity care provider in a rural town in British Columbia, and know the value of having quality maternity care close to home. It would be an incredible loss to the childbearing community not to be able to access intrapartum care in their community. Having to travel to Canmore to access care would displace families and put labouring multiparous moms and babes at risk of delivering on route. Furthermore, it is my understanding that Banff hospital has an admirably low caesarean section rate of 8%, while Canmore’s rate is among the highest in Canada at 38%! Should the maternity unit close, there would potentially be up to 100 labouring women diverted to Canmore, and this would result in 30 more C-sections a year. This would be costly for the healthcare system and an incredible burden for families.
Also, in my experience when maternity services are not available where women live, and women feel strongly about having their babies close to home, I have seen the number of unassisted births (not attended by any qualified provider) and births attended by lay birth attendants increasem, as women feel have no other choice to birth close to home. Not having access to a skilled care provider for emergencies that can occur during labour or postpartum puts moms and babes at risk.
I must also admit that I am appalled to hear that the impetus behind wanting to close this unit is to be able to promote mostly private pay destination plastic surgery. How can you in good conscience trade off a needed community service for an unneeded luxury service for rich Canadians, Americans and others?
I implore you to reconsider the closure of maternity services in Banff. If fact, I challenge you to take this a step further, and acknowledge the incredible care that the nurses and doctors provide in being able to achieve such a low C-section rate. Why not use this as an opportunity to examine how care is provided within the unit in order to achieve such a low C-section rate, and then use this as a model to decrease caesarean sections in other facilities in the province. Consider this a way to cut healthcare costs instead of increasing revenue through plastic surgery. There is much to learn and gain from this gem of a unit and the staff that work there. You will be losing an incredible resource and putting childbearing families at risk if you close the maternity unit in Banff’s hospital.

Respectfully, Lydia Szymanski, RM Squamish, BC

Dear Sir,
I am a family physician practising obstetrics in Duncan, British Columbia.
In my training and first years of practice I worked in the following BC communities that are smaller than Banff and provide similarly excellent obstetric care to women who want to deliver in their own community: Hazelton, Fort St James, Masset, Bella Coola, Port McNeill.
Access to safe maternity care in a women’s home community is a right. Obviously it is not safe for women who need a higher level of care. Where a woman delivers, in my opinion is the decision of the woman and her care providers, and this should be based on evidence and experience. Currently, the evidence and experience support women to deliver in communities even smaller and more remote than Banff.
So please sir, protect maternity care in Banff.
Yours sincerely,
Graham Blackburn

— Graham Blackburn graham.anton@gmail.com Duncan, BC

Mr. Fred Horne Health Minister Alberta Mr Horne I am a Canadian childbirth researcher. Since 1994, in Quebec we have birthing centers where a maximum of 250 births can happen annually. The outcomes have been quite good, there is a waiting list to get in, and more have been set up by our ministry of health in recent years. And there are also small hospitals where women give birth. In several countries, including ours, the trend is increasingly towards keeping as much as possible birth as a normal, physiological and multidimensional event. Although humanizing birth is possible to achieve in a big maternity, with lots of efforts though, it is way easier in small units, without compromising the mother and baby’s health. Since families and caregivers know each other, continuity of care is easier, and since the number of births is small, the environment necessary for facilitating labour and birth can be more easily set up there. Another preoccupation linked to birth is cesarean rates. More and more research reveals the risks of being born by cesarean, or having a cesarean, risks that can have a lifetime impact. Maternity units that have low cesarean rates should not be closed, they lead the way for others regarding how to lower the rates of unnecessary cesareans, thus the risks to women and babies. I urge you as Minister to reconsider the closure of the Banff maternity, so that women, babies and families in the area can continue to receive high quality maternity care close to home. Best regards, Hélène Vadeboncoeur, Ph.D. Childbirth researcher Author of Une autre césarienne ou un AVAC ? S’informer pour mieux décider (3rd edition, FIDES, 2012) and of Birthing Normally After A Cesarean or Two – A Guide for Pregnant Women (Fresh Heart Publishing, 2011) www.helenevadeboncoeur.com Administrator, International MotherBaby Childbirth Organization (IMBCO)

Dear Minister Horne:
 
RE: Maintaining obstetrics services at the Banff Mineral Springs Hospital
 
Maintaining obstetrics services at the Banff Mineral Springs Hospital (MSH) is critically important to numerous women and families throughout the Bow Valley, given this facility’s long-standing record for safe, natural childbirth.
 
As a resident of the Bow Valley, I am very opposed to the closure of the Obstetrics Department at Banff Mineral Springs Hospital given the vast differences between birthing outcomes at Banff and Canmore hospitals. The Banff Hospital has a remarkably lower CSection rate than the Canmore Hospital. In conjunction, the Banff Hospital has an excellent track record for minimizing vaginal trauma during birth while the Canmore Hospital does not.
 
In 2011, I gave birth at Banff Springs Mineral Hospital. We chose this hospital because of its commendable practices in natural childbirth. The support offered by Dr. Fowke and the nursing staff at the MSH was exceptional. At no time did I ever feel concerned about my safety or the safe delivery of my baby. In fact, I felt extremely fortunate to have had the support of the obstetrics doctor and nurses at MSH given the strenuousness of my delivery and our goal to deliver naturally.
 
I am also very opposed to the closure of obstetric services at MSH as no input was sought from Banff’s obstetrician, Dr. Fowke, before decisions were made.
 

Dr. Fowke should have been consulted extensively about any changes to obstetric services at MSH. A Banff physician for almost 25 years, Dr. Fowke has earned a reputation in the Bow Valley as a leading obstetrician in support of natural childbirth. Last year she delivered over 50 babies at the Banff Hospital, and she did so with an exceedingly low CSection rate and with an exceedingly low vaginal trauma rate. Clearly the closure of the obstetrics department at MSH will affect Dr. Fowke’s birthing practices and the care she can provide for her patients.

 
In response to Alberta Healthcare Services’ report COMMUNITY AND RURAL HEALTH PLANNING, if the Government truly endorses “building on the unique strengths inherent in each rural community” then Alberta Health Services should be maintaining obstetric services at the Banff Hospital as it provides the safest care for mothers and babies given its outstanding success rates for natural birthing in the Bow Valley. Further, Alberta Health Services should seek the guidance of doctors who are affected by the changes long before any decisions are reached.
 
The highly disputable manner in which change was brought to the obstetric services at MSH suggests that Alberta Health Services is not concerned about the security of our community’s doctors or nurses, nor are they implementing change that will truly enhance the safety of childbearing women and their babies in our community.
 
As a resident of the Bow Valley, I believe it is important to maintain the obstetrics services at the Banff Mineral Springs Hospital given this facility’s long-standing record for safe, natural childbirth. Women in the Bow Valley need choice and they deserve to have this option for many years to come, otherwise more woman and families will end up driving to Calgary to birth naturally. Please do not shut down the obstetric services at Banff Mineral Springs Hospital.
 
 
Regards,

Tricia B

The relatively negative views of birth held by FPs providing only APC need to be addressed in family practice education and in continuing education. This explains the doctors response in their letter to the Crag Wednesday March 20th.

FP Attitudes Can Fam Physe139.full

PREGNANT WOMEN NEED A VOICE. YOU ARE THAT VOICE.

Pregnant

Alberta Health Services and Covenant Health:

PLEASE Reverse  the removal of obstetrical services from Banff

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watch this space for more events.

Emergency Birthing Place being set up on the way to Canmore. Starting March 25th. Volunteers

needed

No support : No maternity care:  Loss of community.

Write letters to the Alberta Health Minister

Ron Casey, MLA Banff-CochraneLegislature Office 630 Legislature Annex 9718 107 Street Edmonton, AB T5K 1E4 Phone: (780) 415-8429 Fax: (780) 415-0951Constituency Office Unit 109, 1205 Bow Valley Trail Canmore, AB T1W 1P5 Phone: (403) 609-4509 Toll-Free: 1-866-760-8281 Fax: (403) 609-4513 banff.cochrane@assembly.ab.ca Hon. Fred Horne, Minister of HealthOffice of the MinisterHealth 208 Legislature Building 10800 – 97 Avenue Edmonton, AB T5K 2B6 Phone: 780 427-3665 Fax: 780 415-0961 E-mail:health.minister@gov.ab.ca

FOR SALE  –> HATCH PATCH DISPATCH T-SHIRTS  BRIGHT ORANGE  ALL SIZES. AVAILABLE AT ALPINE MEDICAL CLINIC. Procceds to go to Honorarium for Guest Speaker.

Dear Sir, I find the decision to cut maternity services at Banff to be utterly unbelievable! The service provided by the maternity care providers is something that should be shouted far and wide rather than thrown aside like a bad weed.
You may have heard of Haida Gwai (formerly the Queen Charlotte Islands) in B.C.. At times they are totally isolated from the BC mainland by sea and by air, and, of course, by road. Their maternity service has a world-wide reputation in the literature for its practice and results. They are able to triage their patients into high and low risk and end up delivering only 20 mothers in their home community per year. This service is provided by midwives, physicians and nurses and other team members.
The Banff team would appear to be providing just such an excellent service. Any maternity service with a C. section rate of <10% has to be highly regarded, and to think that you would suggest sending these patients down the road to a centre with a section rate of close to 40% is indeed puzzling. Oh. I am very sorry to have mentioned that word – PATIENT, a word that has little if any effect on government positions and decisions. Imagine how the women of Banff feel now; they will have to travel away from home to a hospital that has such a record. They have to arrange babysitters, house sitters, etc., etc., often at short notice.
Mr. Minister, I would humbly ask you to reconsider your decision to close the Banff maternity service. You have a great opportunity to showcase this site as an Albertan model of the provision of safe rural perinatal practice.
,
Yours very truly
Brian W. Galliford, MD., FRCS©
9460 Mountainview Rd.
Prince George, B.C.
V2L 2L5
250-552-306

Dear Minister:

I am writing to request that you, as Minister of Health for Alberta, direct the appropriate officials to reconsider the proposal to closure maternity care services in Banff. The reconsideration should be based on solid medical, social and economic evidence, with a view to the long-term impacts.
This issue has particular significance for me as a family physician who began practice in the small northern Ontario town of Sioux Lookout. I was one of 4 GP’s who worked with nurses and nurse practitioners to provide care, including maternity care, for both the local community and the native communities scattered across the northwestern part of the province all the way up to Hudson’s Bay. It might have made short term economic sense to consolidate maternity care in Winnipeg or Thunder Bay or Dryden. But providing culturally-appropriate care as close to home as possible was (and continues to be) recognized as both socially and economically the greater value over the long term.
I urge you as Minister to consider the longterm welfare of the citizens of Banff and Alberta in directing a review of this proposal. Respectfully — David White

David White, MD CCFP FCFP Associate Professor, Family & Community Medicine, University of Toronto
Interim Director, UTOPIAN, the University of Toronto Practice Based Research Network
Community Teacher, North York General Hospital

 Dear Minister of Health,

I am writing in support of the group lobbying to maintain maternity services in Banff. As a full service rural physician in BC I do understand the difficulties faced with providing maternity services in a small town but cost saving has never been part of this. Transporting patients in labour, unnecessary caesarean sections, transporting unnecessarily to a tertiary care centre as well as the risks associated with a site losing their obstetrical skills are significant costs to the system. We are currently trying to convince physicians in small hospitals to continue obstetrics as studies tell us that this is better for patients. Taking away an obstetrical service that is functioning seems counter productive. I appreciate that there are always competing pressures for various budgets. I think you will find however, that costs in other areas will increase significantly and far outweigh any short term savings. Thank you for your attention to this matter. Sincerely, Nicole Ebert MD CCFP

 Banff Hospital is now a glorified Day surgery unit.

AHS/COVENANT HEALTH DOES NOT UNDERSTAND PATIENT SAFETY. THEY WANT TO CLOSE OBSTETRICS IN BANFF AND MOVE IT TO CANMORE. Patient safety is about protecting patients from real and unnecessary risk. It emphasizes the reporting, analysis, and prevention of medical error that often leads to adverse healthcare events. HOSPITALS WITH HIGH CAESARIAN RATES PUT PATIENTS AT RISK. BANFF`S  8% Caesarian section rate in 2012 puts it as one of the safest places to deliver in Canada Canmore had a 38% Caesarian section rate in 2011. . unknown.jpeg What causes medical error? Unnecessary medical interventions. Unnecessarily high Caesarian rates. WHICH PLACE IS SAFER NOW? SMALL IS BEAUTIFUL.

 

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LET US LOOK AT SAFETY.

1. Banff maternity unit has one of the lowest C-Section rates in the province. 8% in 2012. Canmore`s data not available yet but in 2011 Csection rate  in Canmore was 37%. Provincial rate in 2011 was 27%.

2. Canmore Hospital has the highest 3/4th degree vaginal tear rates in the Province 17% in 2011. Banff was 2%. Provincial rate in 2011 was 3.5%.

3. No such thing as a critical mass.

4. 50 deliveries a year is not low volume.

5. On site training which occurs in Banff maintains the level of competance for nurses.

6. Read Posts from patients that have delivered in Banff.

7. Increasing the number of deliveries in Canmore will only increase the risks to labouring mothers as there is already a bed shortage. Nurses in Canmore are concerned.

 

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