Trauma surgeon says Vancouver hospital should never turn away pregnant patients

Pregnant patients needing emergency or specialist care are being turned away from Vancouver General Hospital (VGH) due to a shortage 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 20 or more weeks pregnant, and they’re not happy about it.

“In trauma, seconds matter… We should never talk about diversion because VGH Vancouver is the trauma center for acute[care],” he says.

“There is a huge crisis about this among doctors,” he says.

While babies are typically delivered at other designated hospitals in the Lower Mainland – such as BC Women’s Hospital – Dawe explains that in some emergency situations, a pregnant person being treated at VGH may need to cesarean section.

He says that generally gynecologists were called in the hospital for this, but now it is not so.

“It’s a very rare occurrence that this patient being treated for something else goes into labor,” says Dowe.

how does it work

Dawe gave an example of how the new restrictions might apply to his work as a trauma surgeon.

He says if a 20-week pregnant woman was stabbed in the chest, she would not be brought to VGH for care.

“She’s going to go to St. Paul’s or Richmond or Lionsgate. And with all due respect to my colleagues at those centers… they don’t have trauma surgeons on call and so they can’t even resuscitate Mom,” he says.

The impact, he says, is that pregnant people won’t be able to get the best stroke care in Vancouver.

Dau, along with Dr. Gordon Finlayson, medical director of intensive care at VGH, sent a letter to the Ministry of Health and several MLAs over the weekend, warning about the dangers of diversion and asking for a commitment to resolve it.

A spokesperson for Vancouver Coastal Health said in a statement that a group of specialist obstetricians from BC Women’s Hospital are providing on-call emergency coverage at VGH.

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

The spokesperson said pregnant people experiencing emergencies should dial 911, and if they show up at VGH, they will be stabilized and can be transferred to other hospitals if they need further obstetric care.

“The number of pregnant patients coming to VGH for emergency care is very low,” the spokesperson wrote.

He added, “From the end of 2023 to today, approximately one pregnant patient more than 20 weeks gestation per month came to VGH for emergency care, requiring transfer to another hospital for maternity care.”

Politicians debate issue

Green Party MLA Jeremy Valeriote said a shortage of obstetrician-gynecologists in both Kamloops and the Fraser Health region is putting a strain on health care for pregnant people across the province.

“It’s OK to bring in new doctors from the US or other countries, but we have to retain the doctors we have,” he said.

“And that impacts working conditions. And it’s clearly impacting maternity care.”

BC Health Minister Josie Osborne was asked about the changes during a call with reporters Tuesday.

Sometimes a pregnant person who has suffered a severe trauma will drive herself to the emergency department, she said, but the hospital is not designated for maternity care like other nearby hospitals.

“Vancouver General Hospital has not had babies delivered under routine care for years,” the minister said.

According to Osborn, about three in six patients have arrived at VGH under these circumstances in the past 20 months.

But Dau says the matter is more complicated because VGH is uniquely positioned. For example, advanced burn care and some cases of spinal cord injuries can be treated only at VGH, he says.

He further said, even one case of death of a pregnant patient is a failure because they do not get the necessary care.

“This is an important equity issue, right?” He says.

“It is a symbol of social justice that we take care of women and children.”