Triage birth at Surrey Memorial prompts apology from Fraser Health

Surrey Hospitals Foundation (surreyhospitalsfoundation.com) | A Surrey mother who delivered her baby in the Maternity Unit triage area of Surrey Memorial Hospital poses for a photo with her newborn (Submitted)

The doctor in charge of Fraser Health’s maternity wards is apologizing to a Surrey woman who was denied an epidural and not given a room and ended up delivering her baby in the triage area.

Dr. Darren Lazare, co-program medical director for the maternal, infant, child and youth department within Fraser Health, acknowledged Surrey Memorial Hospital is experiencing resourcing issues and said what happened to the Surrey woman that night is not something he wants to see.

“My heart goes out to the patient, her family, and everyone involved,” Lazare said. “This is not the standard to which we want to provide care.”

A mother who gave birth in the triage waiting area at Surrey Memorial Hospital last month holds her newborn at home. (Submitted)

The mother, who Daily Hive is not identifying because she works for Fraser Health and fears professional repercussions, was induced in the afternoon on May 2 and sent home. She came back, was turned away, and came back a third time close to midnight when her contractions were five minutes apart, and the pain was intense.

But she was told there were no rooms available for her, and that she couldn’t get an epidural — as she’d later learn, because only 14 nurses were working when there were supposed to be 24. None could be spared to give her an epidural one-on-one.

The woman knew from her previous two births that she labours quickly, and with her third, she jumped from seven centimetres dilated to nine centimetres within five minutes.

She gave birth on a trolly bed in the triage area. There was no doctor present. The triage nurse and her husband delivered the baby.

“I would like to apologize for the care that she received,” Lazare said. “I think it’s important to acknowledge her courage for coming forward. I welcome [stories like this]. Because it helps me to my job, which is to advocate and enact changes.”

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The problem at Surrey Memorial is both a lack of physical space and staffing shortages, Lazare said.

“Are we having resource issues at the moment? And has this been the case for a while? The answer is yes. Sometimes, particularly at Surrey, it’s a bed issue, so physical space shortage. And sometimes, it’s a nurse shortage. And adding to the complexity, sometimes it’s a bit of both.”

That night, the mother was told there were plenty of empty rooms but not enough nurses to manage them. She was moved to a private room after she gave birth to recover but wasn’t taken to one while she was in labour.

As for why she was induced, given the lack of resources, Lazare said staff would only induce when there are enough resources in place at the time — but that can change quickly. Shift changes happen around 7 pm at the hospital, so when the mother was induced in the afternoon, the providers may not have known how short-staffed they’d be by nightfall.

“This is the uncertainty in obstetrics. We don’t know how quickly you’re going to progress in your labour. Everybody is different,” Lazare said. “At the same time, we don’t know what else is going to roll through the door.”

Part of what’s contributing to the problem is that population growth in Surrey is far outpacing the rate of growth of service delivery.

Surrey Memorial is Fraser Health’s busiest Maternity Ward, seeing upwards of 5,200 deliveries per year when it was built to handle 3,500. The only busier Maternity Unit in the province is BC Women’s Hospital in Vancouver, which has more beds, more staff, and more resources.

“Demand is outstripping supply, not just with respect to the Family Birthing Unit, but really across all aspects of the hospital domain,” Lazare said.

The scope of what staff do at Surrey Memorial has also increased. It used to be a community hospital but now provides high-level “tertiary care,” meaning patients with more complex cases are dealt with at the hospital.

The Surrey mother’s story comes as doctors at the hospital raise the alarm about what they call dangerous conditions for patients. Last month, 36 doctors within Surrey Memorial’s Obstetrics and Gynecology units signed a letter decrying the under-resourcing at the hospital.

“[The] mismatch in resources has resulted in a newborn death, countless near misses, and moral injury to our care providers,” the doctors wrote in the letter. “Compounding these issues, women often lack access to effective pain management and do not receive the necessary privacy during and after childbirth.”

The problem has been raised to BC’s provincial government, and last week Health Minister Adrian Dix announced changes would be coming to Surrey Memorial. Those include additional funding for more nurses and doctors, working with hospitalist physicians to finalize a new contract, and expanding the hours of nearby urgent and primary care centres.

In addition, a new hospital is opening in Cloverdale. Dix hopes it will help alleviate the crunch at Surrey Memorial.

But in the meantime, Lazare wants to reassure patients that Surrey Memorial’s staff are prepared to deliver excellent care in spite of the challenges.

“If you do need to come to the hospital, please know our doors are open. We will do everything in our power as healthcare providers to look after you.”