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Few people get to be part of the special moment when your child is born and three Antigonish family physicians consider their participation in the delivery a privilege.

Amanda Worden Rogers, Maude MacInnis and Marlene Fuhrmann have a passion for family medicine and said they love the process of following a mother and child from the first trimester to the baby’s 10 day check up and beyond.

“It said, ‘I want to do the kind of medicine where I get to know people through generations. If someone breaks their arm I might be the one to put the cast on it, if they have a baby I might be the one to deliver it and if they’re dying I might be the one holding their hand,” she recites. “Going into it, that was always what I wanted to do and I think obstetrics is just part of that.”

Worden Rogers, MacInnis and Fuhrmann combine to make up the Family Obstetric Group in Antigonish. The three women are currently the only family physicians with obstetric privileges in town. They see the mother throughout her pregnancy and, as long as there is an obstetrician on call and no complications arise, through the birth.

“I really enjoy following patients from when they get pregnant to the delivery,” MacInnis said. “I get woken up in the night from many other things, but these are the ones that don’t make me tired. I can be awake all night doing a delivery and then go to the office all day. It doesn’t stress me out because I love it so much.”

MacInnis has been in Antigonish since 2012, while Worden Rogers arrived last year and Fuhrmann has been practicing in Antigonish for 30 years.

Fuhrmann said being able to do obstetrics, along with her normal family medicine responsibilities, provides an important continuity of care.

“Now I deliver babies of people I delivered,” she said. “It’s such a cool thing to know the family that well. It’s rewarding.”

In Antigonish there have been two obstetricians, however this spring when one announced he would be retiring, concerns arose.

For a family doctor to do a delivery at the hospital, the standard of care requires an obstetrician to be available in case of an emergency. Obstetrics must be covered 24/7 and if the obstetricians are on call every night they get tired.

“That’s a little bit of the issue we ran into,” MacInnis said. “It becomes unmanageable and we lose good people.”

Since the news broke in April, an obstetrician has been hired to begin in July,
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so there will, once again, be two obstetricians at St. Martha’s. Another midwife has also been recuited and will begin in August.

Although another obstetrician has been hired for the summer, problems arose this week when it was announced obstetrical services at St. Thursday.

Women who could be affected by the situation were advised to call their doctor’s office if they had questions.

A press release noted a contingency plan has been developed to address patient safety and ensure care continues to be delivered.

Fuhrmann said she thinks approximately 3/4 of the deliveries at St. Martha’s Regional Hospital are low risk and she, MacInnis and Worden Rogers have recently seen an increased number of referrals.

“Hopefully that will be really helpful for the obstetricians,” Fuhrmann said.

“For future recruitment you can say something like, OK you can come here and you’ll be on call one in three, but usually you won’t get woken up because we’ve got a really strong group of family physicians doing the bulk of the deliveries,” MacInnis added.

The women said it’s hard to tell if family physicians with obstetric privileges are becoming a trend because it varies from community to community.

“I don’t really know for sure, but it seems to me the obstetricians are happier if the family physicians are doing deliveries because then they can focus on the consultation service, because that’s what they are, they’re specialists,” Fuhrmann said.

“They’re supposed to look after abnormalities and if they spend all their time and energy doing normal deliveries, they’re too busy.”

At present, the women are focusing on their current service.

MacInnis noted things began with Fuhrmann working solo over three years and she anticipates they will soon be doing half the deliveries at the hospital.

“It’s a huge influx,” MacInnis said.

Fuhrmann said one of the most important things they have to concentrate on is availability.

“It’s not just an office visit once every four weeks, it’s also being available for things that happen,” she said. “We’re not in a clinic on Thursday morning we’re in our office so people can access us more often.”

Fuhrmann added she feels continuity of care is an important factor because people like it when they can attach themselves to somebody so they don’t have to continue voicing their concerns to someone new.

Fuhrmann said as they get busier they will have to adjust things because they still have full family practices. She said the team they are a part of, including the nurses and obstetricians, all work together to provide that care.
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