A baby born on the side of Highway 16 between Russell and Yorkton, Sask., late last year has reignited a debate about the quality of health care provided in rural Manitoba.
In the early morning hours of Dec. 13, Rachel Driedger was awakened by an intense contraction while she slept at her family home in Russell. Driedger, who had previously given birth to three children, immediately knew she was in labour and needed to get to the hospital as soon as possible due to her history of quick child births.
After making two phone calls — one to the Russell hospital to make sure a doctor could see her and one to her mother-in-law to come and stay with her children — Driedger and her husband Eric arrived at the hospital at about 3 a.m.
After being admitted, Driedger said the doctor checked her over and assessed her. It was then that the couple were told to head west to Yorkton, the closest hospital with obstetric services.
It’s not uncommon for pregnant women in the area to choose Yorkton as their hospital as it is closer than the next available centre in Brandon.
"The doctor checked me and my contractions were strong and he decided we should go, he basically looked at us and said ‘Go!’" Driedger said.
In labour with contractions so strong she couldn’t even walk to the front door of the hospital, Driedger said her husband asked if the doctor meant they drive the hour-long trip down Highway 16 to Yorkton.
And minutes later the couple were in their vehicle travelling at high rates of speed toward the Saskatchewan border.
"We were about 35 minutes out of Russell when my water broke and I told Eric, ‘We’re not going to make it, you’re going to have to pull over,’" Driedger said.
Part way through passing a semi about 10 minutes out of Yorkton, Driedger said the baby’s head started to pop out.
Locating the next approach, Eric pulled over and played the role of doctor — something he had joked about with nurses at routine checkups during the pregnancy.
"I pulled my one leg out and (Eric) leaned down and caught her," Driedger said. "He pulled her up on his lap and she didn’t let out a cry right away, which was scary, but we hung her upside down by her foot — that’s also the moment we realized we were having a girl, we thought we were having a boy so that was a big surprise — and gave her bottom a little swat and she let out a big yell so we knew she was okay."
Eric quickly wrapped the new-born in his jacket to ensure she was warm and used his boot lace to tie off the umbilical cord, something he learned during his conversations with nurses.
Driedger, still in the front seat of her mother-in-law’s car, phoned 911 to inform the Yorkton hospital that they had just given birth on the side of the road and that both she and the baby would need medical attention on arrival.
Fast-forward to today and the couple are the proud parents of their fourth child, Maisie Elizabeth, but they also know things could have turned out dramatically different.
While she holds no ill feelings toward the Russell hospital or the doctor who sent her to Yorkton, Driedger said it’s important to shine a light on some of the challenges that people face in rural Manitoba when it comes to the health-care system.
"We don’t want to see this happen to other people," she said. "I have easy babies and I’ve never had complications during birth and it wasn’t that bad for us, but other people might have complications and if you run into trouble who knows what would have happened.
"I don’t know what we would have done if there would have been problems."
Road conditions and the weather, which was below
-20 C the night Maisie was born, already create cause for concern for rural residents, according to Driedger, but she’s even more worried about a large-scale review of the province’s emergency medial services system that recommends closing some paramedic stations in the province.
"That’s a very frightening thought," Driedger said, referencing the review that recommended the "reduction of 18 stations."
"We deserve the same medical care and treatment that people in the cities get and we’re already having to drive more than an hour to deliver babies. If we also have to start waiting longer for ambulances or wondering if the ambulance care is going to be there when we need it — I think that’s why we’ve decided to share our story."
And at just six months, Maisie has already proven to be an effective agent for change.
Health Minister Theresa Oswald said a new policy in the Prairie Mountain Health Authority will ensure all women admitted to hospital in labour will be provided ambulance service to a centre with obstetrics.
"It’s out of this situation that there has been some learning, not only for an individual physician but for the regional health authority that has implemented this policy," said Oswald.
She also addressed the province’s EMS system review and Dredger’s concerns.
"The report does say that we need to ensure that we are locating our ambulance services more efficiently as it relates to where the population is," Oswald said, adding that the goal is to provide higher-trained paramedics that will be staffed 24/7 to reduce chute times and provide quicker and more reliable service.
"There won’t be less access to EMS, but it might look different," she said.
Oswald only learned of the roadside birth last week when Riding Mountain Progressive Conservative MLA Leanne Rowat questioned her about it on the legislature floor.
The minister didn’t have a direct answer for why the situation wasn’t passed up the chain of command.
The whole situation raises a number of questions, Rowat said.
"Was it a staffing issue, a bed issue, why wasn’t she admitted to the Russell hospital?" she asked. "It concerns me that they might be running at such tight numbers and what if something more concerning would have happened? What would have been their protocol to deal with it?"
She can’t believe a woman in labour with a history of quick pregnancies was sent to a hospital an hour away in another province. It’s not the first time Rowat has heard of families in rural Manitoba delivering on the way to the hospital.
She’s also concerned if the province does reduce EMS supports that we could see more critical situations turn out negatively.
"They are trying to fall back on the air ambulance and it’s not sufficient," Rowat said. "I know some rural facilities have requested the air ambulance and have been denied because it’s elsewhere."
She is happy to see changes being made to the way pregnant women are cared for at hospitals, but was surprised that women in active labour were not already transported to hospital via an ambulance.
Prairie Mountain Health CEO Penny Gilson said the policy change should curb instances like this in the future.
"You can’t predict how quickly or not quickly women are going to deliver," she explained. "We’re telling all
our sites to transfer with ambulances if they have an active labour."
Gilson said most obstetrics in rural areas have been eliminated because it was tough to find staff to maintain critical skills and competencies. However, emergency rooms and ambulance staff are prepared for emergency deliveries.