It was decided that the most pressing topic was the safety of obstetrics without cesarean section capability. The SRPC formed the Rural Obstetrics Committee to represent rural physicians in the discussions. The group emailed, faxed and teleconferenced literally dozens of documents and formed draft after draft of policy statements. For urban physicians trained and practising in urban centres, there is often little knowledge of the rural reality, and practice patterns in the country may appear to them as foreign as life on Mars. Even in isolated rural settings one county may look like Mars to another.
Women get pregnant despite the fact that there are no obstetricians in rural Canada.
In 125 hospitals across the country we do so without local cesarean section back-up. The job that we do stands up to scrutiny. In Nova Scotia, Peddle and colleagues 4 demonstrated that community hospitals with fewer than 100 deliveries a year had the lowest perinatal morbidity and mortality rates in the province. Their work was not referenced when the Nova Scotia government closed practically all of these small units. 2 Restructuring is not needed to make rural maternity care difficult.