Expectant parents in northern Alberta hamlet hope gov't will deliver on promised birthing centre
Area has a high birth rate, as well as a trek of 110 kilometres to the nearest hospital
Skylar Braun knew there was a possibility she could give birth in the car or on the side of the highway on her way to the hospital in High Level, Alta.
Throughout her pregnancy, she heard stories about women from the La Crete area, about 700 kilometres northwest of Edmonton, who weren't able to make the drive to the High Level hospital, the closest health facility equipped for deliveries and located more than 110 kilometres away from the hamlet of La Crete.
"I was very scared because I know a woman two weeks before me had given birth in the ambulance on the way to the hospital. So I was very nervous," said the first-time mother.
For her, the drive from La Crete to High Level's Northwest Health Centre in the early morning of March 29 was slowed down by fog and snow on the road.
"The road was rough so it would hurt, it would make the contractions worse. It was just really stressful," said Braun, whose daughter Grace was born later that evening through a caesarean section.
The commute is something expecting mothers in the community have to be prepared for, said Nella Fehr, a pharmacist in La Crete and mother of two boys.
"If you're pregnant, there is already the whole unknown of your delivery and your baby, but add [the drive] on top of it. I feel like it's almost too much for some ladies," she said.
Fehr has fielded many calls from expectant parents in her role as a pharmacist. She also hears from them because her second son was born on the side of the highway just outside of High Level three years ago.
She knew she couldn't make it to the hospital in time when her water broke in the car.
Her husband pulled the vehicle over so that she could deliver the baby.
"I was so uncomfortable with my back, I told [my husband] I would rather lie on the road than I would in the seat of my car. We got some old shirts and a jacket from the back of my car and I laid down," she said.
A 911 operator guided the couple through the delivery, she added.
"We were really blessed and thankful for things to have turned out so well as they did. But I still feel like this is something that should not happen in our area with the type of health care that we have.
"I would never wish this type of experience on any mother at all."
For more than a decade, La Crete residents have pushed provincial governments to establish maternity care services in the area so women wouldn't have to leave the community to give birth and risk the potential complications that could arise on the way to High Level.
Community members asked Alberta Health Services in 2010 and again in 2011 for prenatal and postpartum services in the region, according to documents obtained by CBC News.
"I would never wish this type of experience on any mother at all.- Nella Fehr, pharmacist and mother of two
The area has high birth rates for a hamlet of about 2,300 people.
Joyce Fehr, a community member and former member of the region's health advisory council, said that is partially due to the large number of Mennonite families in the region who sometimes have more than two kids.
In February, the provincial government's fiscal plan announced $35 million over the next three years for a new La Crete maternity and community health centre that "fully integrates ambulatory care, primary care, maternal health care and diagnostic services."
"To have this announcement in the budget was huge and it's a real morale booster for the community, especially for the young moms," said Fehr, a three-term member of Alberta Health Services' True North Health Advisory Council, which represents the northwestern portion of the province.
But with no details on what the maternity centre will include, questions are mounting, she said.
"We don't know what the facility is going to look like. Is it going to have surgical capabilities? Is it going to be just a low-risk birthing centre? There's a lot of details that we don't know," she said.
She and other community members were hoping for about $60 million to ensure the maternity centre is equipped for all deliveries, not just low-risk ones.
"I don't think it's going to do enough," Fehr added.
Alberta Health Services and Health Minister Tyler Shandro did not provide comment.
Huge demand for midwife services
Long travel times to a hospital are familiar stories to expectant mothers in rural and remote areas throughout Alberta and across Canada.
According to an analysis published in 2013 by the Canadian Institute for Health Information, 40 per cent of women living in rural Canada drive more than an hour to give birth, while 17 per cent would drive for more than two hours.
Kendra Peters, a mother of two in La Crete, said many area women have accepted that they'll need to leave their community to give birth.
"I feel like so many people here are so used to it," she said. "You have to be prepared and plan ahead to be delivering further away from where you live."
To La Crete's only midwife, Tamar Quist, the number of expectant mothers who are travelling one of the two routes to High Level demonstrates the "huge, huge need" of the northern community.
"About 90 per cent of my clients are coming from the La Crete area," she said.
From 2014-2019, about 300 babies have been born each year to La Crete parents, according to provincial birth numbers.
Quist said the hospital in High Level saw about 700 babies born last year alone. Specifics on where the mothers were from were not readily available.
"That's quite significant for being a northern, rural and remote community," she said.
An Alberta Health community profile of High Level published in 2013 found that from 2008-09 to 2010-11, High Level's birth rate of 55.9 per 1,000 women was much higher than the provincial rate of 27.4 per 1,000 women.
Quist is in the process of helping to hire another midwife for the region.
Midwives in Alberta are registered through a provincial association to offer primary medical care to moms and their newborns through pregnancy, birth and six weeks afterward.
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Quist is only allowed to take on about 40 clients a year. That means she has had to refuse about 70 parents-to-be each year since she started practising in 2015.
She often takes on some clients for free because of the demand.
"I don't know very many people who work for free, but it is so hard for me to say no. I feel so guilty and, being the only midwife in the area, it gets to be quite difficult," she said.
Jessica Shaw, an assistant professor with the University of Calgary's faculty of social work, said there are many rural, remote and Indigenous communities across Canada where women are recommended to leave their community to give birth in more urban centres.
And as health-care systems continue to deal with COVID-19, she said it's important to remember the important role midwives can play in rural settings.
"We think about urgent care and we think about emergency situations and we need to think about those things. My worry is that normal, everyday experiences like giving birth are sort of put off to the side because they're one-off, because they don't require the resources or the urgency that surgeries do or that COVID does right now," she said.
"I think there is an opportunity and a need to follow up with providing more accessible health care in general in all regions of Alberta — specifically for birth work, where we do have a committed group of people, midwives specifically, who are ... wanting to make sure that it's accessible and safe to people who qualify for midwifery care."
While construction timelines and details for the maternity and health centre are still unknown, Joyce Fehr is hopeful that the community's needs are considered and incorporated.
"It's key that the community be involved to some extent on what this facility is going to look like."