Docs on call

Family physician network offers baby delivery services

Jon Margolis (left) with wife, Danielle, son, Zev, and family physician Dr. Sarah Kredentser (right).
Jon Margolis (left) with wife, Danielle, son, Zev, and family physician Dr. Sarah Kredentser (right).
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Delivery options

Winnipeg Health Region
Wave, March / April 2015

Danielle Margolis did not hesitate when it came time to choose a doctor to deliver her baby.

She picked her family physician, Dr. Sarah Kredentser, much to the surprise of many of her friends, who thought only obstetricians and midwives delivered babies in Winnipeg.

"Dr. Kredentser is my family doctor," says Margolis. "So it didn't take much thought to have her deliver Zev, and then continue caring for my son and myself after his birth."

Margolis gave birth on Feb. 5, 2013 at Health Sciences Centre Winnipeg's Women's Hospital, after 43.5 hours of labour, including 12 hours after having an epidural. Along with Kredentser, there was a doula (a labour coach) in the delivery room, several nurses, a visiting doctor, a student nurse and Margolis's husband Jon.

"We wanted to have a comfortable experience," says Jon, adding that he's still in awe of the fact they walked into the hospital as husband and wife, and came out as parents. "We knew we could talk about anything with Sarah. I felt 100 per cent confident in her abilities."

After Zev was born, the baby stayed with his parents in the room at the hospital. Kredentser returned the next day, checking on Zev, and reassuring the couple they were doing fine as new parents.

At first glance, there might not seem anything unusual about a family doctor delivering a baby in a hospital. That used to be common place 10 to 15 years ago.

But the fact is there aren't as many general practitioners providing maternity care in Winnipeg as there used to be. Other major Canadian cities have a higher percentage of low-risk deliveries performed by family doctors.

In 2004, 22 per cent of Manitoba family doctors delivered babies compared to a national average of 13 per cent. According to the 2010 National Physicians Survey, this number has dropped to 14.4 per cent compared to 10 per cent across Canada.

And so three years ago, a group of family physicians got together - with the support of the Department of Family Medicine and the Primary Care program of the Winnipeg Health Region - and decided to do something about the declining numbers. They established the Family Medicine Obstetrics Network (FMON), a group of family physicians who work together to provide care.

As Kredentser explains, the drop-off in family doctors doing deliveries can be attributed in part to a change in lifestyle for family physicians. "Today's family physician wants a balanced lifestyle between work and their own life," she says, explaining that babies are frequently born outside of office hours.

In addition, Winnipeg family doctors found that providing care took away from their busy medical practices. "The unpredictability of deliveries sometimes causes havoc in scheduling and that means calling all your patients to make new appointments."

FMON addresses both issues. The threeyear- old network includes 18 family physicians who perform deliveries in Winnipeg. That means they can work together to ensure after hours and vacation coverage. The network has also prompted younger family doctors to include maternity care in their practices.

The doctors provide pre- and post-natal care to their patients, and view childbirth as an important family event and as a natural process. They provide high-quality, safe, lowintervention maternity care in their offices, says Kredentser, adding that the network only accepts patients with low-risk pregnancies. If a woman is expecting twins, has diabetes, addiction issues, or has had a previous caesarean section, it is recommended she see an obstetrician.

"FMON doctors maintain their skills through continuing professional development. If a pregnancy or delivery changes from low risk, the doctors assess the situation and determine whether an obstetrician's involvement is needed," says Kredentser.

Women are enjoying having this option for delivery again, says Kredentser, adding that delivering newborns is a passion for her and all the other family doctors who participate in the network. "We offer family-centred care. We recognize the value of support persons for the laboring mother, and welcome their involvement," she says. "And after the baby is born, we continue that care."

Susie Strachan is a communications advisor with the Winnipeg Health Region.

Wave: March / April 2015

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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