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‘It’s a nightmare’: ER doctor

May 10th,2024 | News

Gatineau ER doctor Dr. Peter Bonneville says that the entire region wil be just down to one operating room this summer, and he worries about emergency cesarean sections, as Gatineau is the only hospital in the region to perform such surgeries. Photo: Trevor Greenway

Gatineau Hospital will go down to just one operating room this summer, and an ER doctor is raising the alarm about what this could mean for anyone giving birth who may require an emergency cesarean section.

Dr. Peter Bonneville, who works as an emergency room doctor in Gatineau and is the president of Conseil des médecins, dentistes et pharmaciens (CMDP) of the Integrated Health and Social Services Centre of Outaouais (CISSSO) explained that Gatineau is “the only hospital in the area that does obstetrics now. And we may not have good 24-hour-a-day coverage for cesarean sections, which is a nightmare.” 

He added, “I’m very concerned about the safety of those women.”

Bonneville told the Low Down that the hospital has seven operating rooms in total, but not enough staff to run them.

“If you go back about seven or eight years ago, all seven were working every day,” he said. “But right now, we’re down to two per day. Sometimes with retired people coming to help, we can get three operating rooms a day.”

However, over the summer “the nursing staff, because they are allowed, like any human being, to have vacations…we’re going to be going down to pretty much one operating room. And that operating room is going to need to work, obviously, 24 hours a day because you can’t function [otherwise].”

“So those nurses for the summer, they’re going to be either on vacation or working non-stop,” which Bonneville admitted doesn’t make for a “great lifestyle.”

According to CBC News, the Gatineau birthing unit delivered more than 2,300 babies last year. The only other hospital in the Outaouais with a birthing unit is the Pontiac Hospital in Shawville. 

In Quebec, a little more than one in four births results in a c-section, according to the not-for-profit organization Naître et grandir. A portion of these are planned in advance, but some are unplanned or emergency c-sections, which require surgery to be done immediately once a doctor has determined it’s necessary. 

However, if the operating room is already in use, Bonneville said there will be nowhere else in the hospital for the woman to receive that necessary surgery.

When asked what hospital staff would do in this event, Bonneville said, “We’re trying to work on contingency plans.”

For now, he said, “We’re going to make sure that the government understands there’s a sense of urgency to this. I mean, I’m totally against Band-Aid solutions, but we’re going to need a Band-Aid here until [the government can] manage the complete problem.”

“I think most women right now do not realize that that is the case,” he said, adding that part of his plan is to alert the public to this situation.

According to the CISSSO, five hospitals in the Outaouais can perform emergency surgeries, including Gatineau, Hull, Papineau, Pontiac and Maniwaki hospitals.  In December 2023, CBC News profiled the Gatineau birthing unit, calling it a rare success story in a healthcare system otherwise struggling with a lack of resources. At that time, the unit had 28 vacancies without replacement out of the total 188 positions. 

A doula’s perspective

Local doula, Kaëlla Charette, told the Low Down the news that Gatineau Hospital will go down to just one operating room this summer is “definitely concerning.”

A doula is a trained professional who supports parents during childbirth. 

According to Charette, emergency c-sections are relatively rare. In her five years of experience, she has assisted more than 100 births including many at Gatineau Hospital. She said that only two of the births she’s attended as a doula have resulted in what is known as a “P0” cesarian, or a c-section that needs to be performed without any delay. Most c-sections are less urgent, she explained, although typically surgery is performed within 30 minutes to two hours after a doctor deems it necessary. 

She pointed out that research by the World Health Organization has found that countries where more than 10 per cent of births result in c-section do not see any increased benefits in maternal or newborn mortality rates. Currently, Quebec’s rate of c-sections is around 28 per cent. Charette hopes that, in the face of an operating room shortage, health care providers will focus on “evidence-based care” that is proven to reduce the need for a c-section. 

“Some c-sections are absolutely life-saving and necessary,” Charette said, “but lowering the overall number [of c-sections] will lessen the burden on the system.”

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