Women & Babies in YMM
If the Horse River Fire in May had any positive impact on Fort McMurray, it may have been allowing the world to see what the residents of the Wood Buffalo region have always known; far from being a working town filled only with men, the community is really the home to thousands of families. The point was brought home in the images of young women with infants, toddlers and children surrounding them that flooded media, and suddenly the outside world understood that Fort McMurray is really all about a young, vibrant and energetic demographic, including young women of childbearing age.
Any discussion on women inevitably leads to the topic of women’s health, as there are some aspects of health care for women very specific to their gender, including pregnancy and childbirth. While general physicians can address many of the health issues women experience, specialists such as OB/GYNs become a key factor in maintenance of health, and once pregnancy and childbirth enters the picture an entirely new range of health care support becomes critical. Fortunately, Fort McMurray has benefitted from the booms of the past, both of the oil and baby variety, and developed a robust network of support systems for women, and particularly those in their reproductive years.
The three practicing obstetrician/gynaecologists (OB/GYN) are kept busy tending to the thousands of women with specific medical concerns as relate to their gender, including of course pregnancy and childbirth. Jordanna Lambert, Director of Patient Care of the Northern Lights Regional Health Centre (NLRHC), shares that Alberta Health Services (AHS) is on the hunt to recruit new physicians to the region, particularly Family Medicine Specialists who have received additional specialized training enabling them to take on low risk pregnancy care, which could free local OB/GYNs to prioritize higher-risk patients. Anecdotal tales of long wait times in the local OB/GYN waiting rooms would seem to indicate the need and support for this initiative, which could help address those wait times and ensure all women receive timely care appropriate for their individual situation.
The birth rate over the last ten years in Fort McMurray has continued to rise, with 2016 being a somewhat anomalous year due to the unusual events in May. In 2015, 1,467 babies were born at the NLRHC, and by the end of November, 2016, over 800 births were recorded in the hospital. With an average of 115-120 babies per month in 2015, it is clear the Fort McMurray baby boom has continued. The NLRHC has expanded their bed capacity to help meet this need, and continues to work collaboratively with a variety of local organizations such as Public Health to ensure ongoing patient care even once mom and baby have left the hospital setting and returned home.
But what about pregnancy and post-delivery care? Are there other options available in Fort McMurray in addition to the local hardworking OB/GYNs? The answer of course is yes, as the need for support services both before and after delivery have been recognized, with at least one individual developing a business to address them.
Dianne Angelopoulos, the Nurse Practitioner at Higher Health Pregnancy Care, has been a nurse for 17 years, serving 12 years as a Nurse Practitioner at the NLRHC Labour and Delivery Department. Her initial inspiration for developing her new business was experiences with gaps in service, and she realized a niche existed for patients seeking options like home visits and evening and weekend appointments for prenatal care.
In practice for a year, Angelopoulos found a perfect fit with the team at Higher Health, where she sees some of her clients, although 75% of her visits are done at the patient’s home. She is able to provide the same services as a Family Physician, including ordering ultrasounds and lab work, and works with the local OB/GYNs, who refer patients to her for prenatal care.
Part of her focus is including the family in prenatal care, allowing dad or the other children to help with tasks and involve them in the arrival of a new family member. This holistic approach enables the entire family to be part of the pregnancy experience, and helps them build bonds with the baby soon to arrive. Angelopoulos is on call for her patients, and can quickly answer their calls and texts with responses to their questions and reassurances for their concerns as their pregnancy progresses. When test results arrive, she is able to communicate them immediately to expecting families, reducing stress and wait time.
As a Nurse Practitioner, Angelopoulos refers patients back to OB/GYNs for delivery, but her services lessen the “bottleneck” the specialists can experience with third-trimester patients. She provides another option for pregnant women, and while there is a fee for her service as her practice is not covered under AHS, many health benefits may cover the expense. Her relaxed and family-centred approach is a great option for patients looking for something a bit more personal than the traditional OB/GYN visit, and Angelopoulos also provides postnatal care, checking in with families a couple of days post-delivery and again for a 6-week checkup. Visits with the new family in the early post-partum period can include assistance with breastfeeding as well as simple reassurance on the care of infants in those initial days.
Through another separate business called “Sleep Tight Consulting”, Angelopoulos also provides sleep consulting services for children from newborn to teenage years, allowing her to be part of the lives of some of her patients for some time as they transition from pregnancy to early infancy and beyond.
Along with the services of a Nurse Practitioner, another option for women during pregnancy exists through doulas, individuals who provide support to pregnant women throughout their pregnancy and labour and delivery.
Jennifer Stephenson, President of the Fort McMurray Doula Association, indicates there are several practicing doulas in the community. The doula association, developed to offer support between doulas and educate the community on the concept of doulas, offers free prenatal classes on a monthly basis, providing an opportunity for expecting parents to learn about birthing practices. Doulas encourage natural birth, but are able to provide information on all birth choices and options to ensure women and their partners are well-informed as they undergo an often unfamiliar experience. Doulas provide support for dads and other support people, acknowledging each labor and birth is unique, and are there to support the expecting mom and her support people, whomever they might be.
Stephenson emphasizes that doulas are not midwives or physicians, and do not receive medical training; they are however keenly interested in pregnancy and childbirth, and have taken a course in learning to support women and families through the labour and delivery process. While confusion may exist on the role of the doula, it is perhaps best understood as a non-medical person who is there to provide support, information and assistance to pregnant women, their partners and their families as they interact with medical professionals.
No discussion of women’s health, particularly as it pertains to pregnancy and childbirth, would be complete without delving into the world of breastfeeding and the support available to women who choose this option after delivery. The Wood Buffalo Baby Friendly Initiative launched in 2012 to “raise awareness around the importance of breastfeeding and to improve the support available to all families in the community of Wood Buffalo – breastfeeding or not.” More specifically, the WBBFI, an AHS-led initiative, connects families with community resources related to breastfeeding and infant feeding, supports healthcare professionals to seek and complete appropriate education to provide evidence based breastfeeding care, supports community businesses and employers to adopt breastfeeding policies, plans and participates in community events to raise awareness about the importance of breastfeeding and plans local annual World Breastfeeding Week celebrations to celebrate the breastfeeding families in our community and showcase breastfeeding support available. Through these activities the WBBFI hopes to increase the breastfeeding rates in our region and ensure all those interested in breastfeeding can access the appropriate support and information.
One of these supports includes mom-to-mom volunteer support networks, such as the Fort McMurray Breastfeeding Support Group, which operates twice-weekly drop-in sessions which address breastfeeding, but which also touch on a variety of issues mothers encounter with infants and children. Lucie LaPierre, a volunteer with the group, shares that Vilia Tosio, a well-known advocate for breastfeeding and mothers, founded the group in 2010. The group, which is a community-based and volunteer-only format, is truly a grassroots organization dedicated to supporting women whether breastfeeding or not, and providing peer support throughout pregnancy, early infancy and even the toddler years.
Moms with a wide range of breastfeeding experience are able to provide support to moms who may need assistance and encouragement, as evidence has shown peer-led support groups to be the most effective support mechanism. This support includes social media support, through a Facebook page dedicated to the group and allowing individuals to connect in both the virtual and real world to share experiences. The group is not limited to breastfeeding, and welcomes attendance and involvement from all mothers looking for an opportunity to connect with other mothers.
If there is any remaining gap in health care services for women in our region, it may well be this: the lack of midwives. Any who knew Vilia Tosio, mentioned above, know that this remarkable woman was a warrior for the health and well-being of women and babies in our region, and her untimely death due to cancer in 2016 was a harsh blow to all those who not only loved her as an individual but respected her passion for providing options and support to women in our community. One of these passions included the concept of a women and baby care/birthing centre, a place where so many of the disparate health options for women in their reproductive years in our community could be found in one place, from traditional health care to doulas, breastfeeding support and the elusive midwives, a service still sadly lacking in our community.
One of the greatest challenges women in this community may face is finding the resources available to them, as they are scattered in location and one needs the ability to ferret them out, a daunting task for those who may find themselves not even knowing where to begin beyond the traditional OB/GYN. Vilia’s dream of a centre where these services and options could be found under one roof is a dream shared by many in our community, and during interviews with those passionate about women’s health, pregnancy, labour, delivery and infant care, both Vilia’s name and this dream are frequently mentioned. Securing the services of midwives in our region and establishing such a centre may well be the final pillar in developing the robust variety of women’s health care opportunities this region both deserves and needs, and it is heartening to know that many individuals, groups and organizations are continuing to work towards making this dream a reality in the future in Fort McMurray.
From Family Physicians to OB/GYNs, Nurse Practitioners, Doulas, breastfeeding and peer support groups, the health care concerns of women are fundamentally well-met, but gaps exist in the services available and challenges continue to be seen in the sheer numbers of residents versus those providing services. If there is any other positive impact from the Horse River Fire in 2016, it may be the opportunity to revision the future of the region as relates to realistic population growth and demographic, including a frank assessment of gaps in services and innovative ways to fill those gaps. The fire in May showed the world that Wood Buffalo is filled with young families, and this is unlikely to change given the nature of the community; ensuring the health needs of this demographic are met is critical to both retain and attract residents. In doing so, Fort McMurray will remain the young, vibrant, energetic – and healthy – community it has always been.