Visit the BC Women's Hospital Birthing Program.
The rate of cesarean section births in BC has risen a remarkable 30% in recent years. This despite the fact that they can expose women and their babies to health risks they do not face with vaginal birth.
The Best Birth Clinic is the first clinic of its type in BC to offer free consultations to pregnant mothers on the risks and benefits of different birth options.
BC Women's is a major provider of maternity care services. We believe that we should be champions of natural birth, which is the preferred option for a majority of women," said Dr. Jan Christilaw, president of BC Women's Hospital & Health Centre. "The Best Birth Clinic is here to help women who face difficult decisions during their pregnancies."
The clinic is part of an interactive public education campaign called Power to Push. This
educational site dispels birthing myths, and offers a forum where women can connect with other women about their birthing experiences.
"We know that people are having conversations about pregnancy via social media," said Dr. Dale Steele, an obstetrician at the clinic. "If we can join in and positively influence some of those conversations with reliable and expert knowledge, then that will be really exciting!
Visit the BC Women's Hospital Best Birth Clinic.
Click here to link to Breast Health Services.
State-of-the-art tomosynthesis digital imaging will save even more women’s lives through the early detection of breast cancer.
Digital imaging technology has transformed modern medicine, but nowhere has its vital importance and value been more evident than in the early detection of breast cancer. As a key referral centre for breast screening and diagnostics in BC, the Sadie Diamond Breast Health Imaging Centre at BC Women’s Hospital will employ the latest innovations in advanced digital breast imaging, including a system called tomosynthesis.
The 3-D Advantage
While traditional film mammograms take images from two different angles, digital mammography with tomosynthesis takes high-resolution pictures from multiple angles, and then combines them into computer-generated 3-D images. This provides an ability to see the tissue of a woman’s breast in slices so the doctor can view critical details more easily. Tomosynthesis is an advance in breast imaging that Dr. Paula Gordon, Medical Director of the Breast Program at BC Women’s, describes as “an important step forward” for mammography and women’s health in BC.
Gordon says that high-quality imaging has other benefits, too, including minimizing the need for recalls. Traditionally, for every 1,000 women screened, 70 are called back for further imaging and tests. Using tomosynthesis has the potential to reduce callbacks, while still finding more cancers. In most cases, conclusive images will be taken right at the initial screening. It’s an advance that will help eliminate difficult days or even weeks of waiting for results.
The Sadie Diamond Breast Health Imaging Centre, made possible thanks to a $3-million donation from the Gordon and Leslie Diamond family, promises to improve the chances of finding a woman’s breast cancer at its earliest and most treatable stages. In addition, its Fellowship Program will play an important role in training the next generation of breast imagers.
As chair of the Academic Committee of the Screening Mammography Program of BC, Gordon knows that regular mammograms save lives. The key to reducing deaths due to breast cancer lies in women attending screening, and having access to high-quality examinations. It’s an effort where healthy, breast-cancer-free women will be the living proof of its success.
Article by Nancy Gratham
In photo: Dr. Paula Gordon at the Sadie Diamond Breast Health Imaging Centre.
Within 24 hours, she was desperately ill. “It was like being hit by a truck.” Nicole recalls. “It was tiredness I had never known. It felt like I had a major accident. That was the first day I felt symptoms of Lyme disease. It was about a week later I finally ended up in the ER. From that day forward, my life changed.”
6 weeks before, she was spending Christmas with her boyfriend in Costa Rica. An avid surfer, Nicole traveled the world chasing the perfect wave. While on vacation, Nicole came down with what felt like a bad flu that came with a rash.
When she recovered and came back home to Canada, Nicole never thought she would end up in the Emergency Room. Nicole was tested for a number of illnesses: the prime suspect was Multiple Sclerosis. She was the right age and the symptoms fit. However, her neurologist saw no signs of MS from her MRI.
Still sick, Nicole returned to work and tried to cope with the constant exhaustion. “I started searching for answers, and I visited about 20 doctors over 6 years. I tried everything under the sun, but still no one could help. I was suffering, it was very hard and scary.”
Nicole’s mother started to suspect her daughter had contracted Lyme disease in Costa Rica. She was referred to a tropical disease specialist, but the test came back negative for Lyme. It seemed like a dead end. However, Nicole tested positive for another tick-bourne illness. “The testing in Canada is in the dark ages,” explains Nicole. “Years later, I discovered that people who are infected with the illness I tested positive for very often contract Lyme disease from the same tick.”
Between her trip to Costa Rica and her diagnosis 6 years later, Nicole married her boyfriend and had two beautiful children. However, Nicole was suffering: “It was heartbreaking. It was so sick. I tried everything to make it work, but I had to quit my dream job. I feel really fortunate my husband is able to support our family financially. If I was single and unable to work I don’t know what would have happened to me. ”
Fortunately, along the way Nicole visited a Naturopathic Doctor who listened to her story and felt Lyme Disease could be the answer. This led Nicole on the road to a diagnosis and treatment, but still she encountered doubt and reluctance from medical professionals. “The stigma against Lyme disease is huge in Canada,” Nicole explains. “If I’m seeing a doctor for some other reason, I won’t let him or her know I have Lyme if I can help it. The attitudes I encountered made me doubt myself and my sanity.”
Nicole hopes the tides will change for people with Lyme Disease in Canada. “The BC Women’s Complex Chronic Diseases Program is our only hope in Canada,” Nicole says. “I really appreciate what they are doing. They are the only medical establishment acting as an advocate for us. BC Women’s can push forward and challenge the stigma by educating medical professionals and the public. It will take time, but everyone across the country is counting on BC Women’s to develop a test so we can finally get quality care and acceptance for Lyme Disease.”
You can reach the clinic at firstname.lastname@example.org.
Make a donation to the Complex Chronic Diseases Program and help those like Nicole.
Visit the BC Women's Hospital Early Pregnancy Assessment Clinic.
Pregnancy is an emotionally charged time for an expectant mom - equal parts joy and stress. There's a lot to think about - Am I eating enough? Too much? Should I stop exercising? And then there are the periodic nausea, mood swings and insomnia. On top of this, about 30 percent of pregnant women experience complications such as bleeding and cramping during the first half of pregnancy - complications that while common, are sometimes an indication that something is wrong. In fact, 10 - 20 per cent of women miscarry in the first trimester.
Women with these symptoms typically go to their ER, sometimes waiting hours to be seen. Some are referred elsewhere for test to wait for what could be the worst - or best - news of their lives. Dr. Stephanie Rhone, Medical Director of the Reproductive Medicine program at BC Women’s Hospital (pictured above) knew there had to be a better way to support these women. The answer came in 2007 with the opening of BC Women’s Early Pregnancy Assessment Clinic (EPAC).
Based on a best-practices model in the UK and offered only at BC Women’s Hospital in British Columbia, EPAC is an inter-disciplinary clinic devoted entirely to providing medical and emotional care to women in the first trimester of pregnancy who are experiencing complications. Everything these women need is under one roof: assessment, diagnosis and management of complications and pregnancy loss, as well as supportive counselling.
“With specialized nurse clinicians on staff, as well as obstetrician-gynecologists who are ultrasound certified, patients don’t have to wait for answers,” says Rhone. “We share what we see on an ultrasound as we see it.”
One of the keys to the success and importance of the clinic is the speed at which it able to deliver healthcare to women experiencing miscarriage. Where women often wait up to 10 days to resolve a failed pregnancy through an ER, the clinic is able to provide compassionate medical care and closure quickly – often on the same day.
If the news is not good and a miscarriage is imminent, they have nurses on staff who help patients decide how they would like to resolve the pregnancy. If medical or surgical interventions are required, they’re done right on the premises.
Counselling is a key part of the process, says Dr. Rhone, who adds that there’s generally a real lack of acknowledgement of the emotional impact of miscarriages: “People tend to say, ‘Oh, it’s early on and you’ll get pregnant again.’
“They minimize it. That’s why we’ve made sure the care here is emotionally, as well as physically, supportive.”
“If I’d been in an ER, it would have been treated as an unfortunate medical issue,” says one young woman, who was referred to the clinic after an ultrasound and blood tests revealed that her six-week pregnancy was no longer viable. “But the EPAC staff acknowledge how disappointing a miscarriage is, how heartbreaking. They support you through part of your life story. It certainly had an effect on how I was able to move on.”
The care provided doesn’t stop once the patient leaves the clinic.
“We touch bases with all our patients at regular intervals after they leave to make sure they’re okay,” says Marie Rose McDonnell, a long-time nurse clinician at the Clinic with post-RN certification in prenatal nursing. “Our focus is TLC.”
The response from patients confirms that the supportive approach to helping women deal with miscarriage is meeting a very real need.
“All of our patients tell us that we’ve made a bad situation better,” says McDonnell. “Now we have women coming from as far away as Chilliwack and Squamish.”
Over the past five years, the Clinic has evolved into a top referral centre for women from throughout the entire region.
“The Early Pregnancy Assessment Clinic is a fantastic resource for us,” says Dr. Lyne Filiatrault, an ER physician at Vancouver General Hospital. “We regularly refer women there, and we know they’ll get the care that a fast-paced ER can’t give them.”
Ruth Comfort, a midwife at BC Women’s, has also referred women to the Clinic: “I know my clients will get all the answers and attention they need from an incredibly caring team of professionals.”
Today, after five years in operation, they’re operating at capacity. Open Monday to Friday, from 8 am to 4 pm, it averages between 30 and 40 patients a week. Dr. Rhone’s vision now is to expand the clinic’s hours.
“Ideally, we should be providing care seven days a week, into the evening hours,” she says. “In the UK, these clinics operate like mini emergency departments.”
Meanwhile, in keeping with BC Women’s leadership role in developing women’s health programs that can be replicated elsewhere, Dr. Rhone is currently sharing the EPAC model with other hospitals. Ultimately, she’d like to see clinics like this become the standard of care throughout BC, meeting the needs and greatly reducing the stress of early pregnancy for women everywhere.
More information about the Early Pregnancy Assessment Clinic at BC Women's.
Originally published in the Spring 2013 issue of Women's Magazine. Free subscription here.
Written by: Helena Bryan
Photography of Dr. Stephanie Rhone by: Brian Howell
Visit the BC Women's Hospital Fir Square Combined Maternity Care Unit.
“If there was appropriate, safe, supportive, supervised housing in the community, these babies would not be in foster care,” he said. “What that also means is that these mothers are at risk now of going back onto the street or back into the environment that they were at because they’re separated from the babies, and that’s another additional trauma to them in their lives”.
Abrahams, who on April 24 will receive an award for his longstanding harm reduction work among Downtown Eastside mothers and their children, says the Lower Mainland needs at least 200 supportive, supervised long-term housing spaces for the women he works with, whose lives are complicated by poverty, a lack of social support, drugs and pregnancies. But he knows of only six or seven beds available in Greater Vancouver.
“Over the last five years, we’ve delivered (babies for) 500 women” said Abrahams, who provides pre and post-natal care to women in the Downtown Eastside through Sheway on East Hastings and an outpatient clinic at BC Women’s Hospital and Health Centre.
“Probably a third of the babies went into foster care. Of those third, I would say half didn’t have to go into foster care, but they went into foster care because there was no housing for the mother.”
Abrahams has applied the harm reduction model of care to drug using pregnant women in Vancouver since 1983 by working to limit the amount of drugs that mother and baby are exposed to.
Abrahams’s peers nominated him for a 2008 National Award for Excellence in Leadership from the Kaiser Foundation, which is honouring seven Canadians and organizations for their outstanding work in reducing the physical and mental harms associated with drug use and mental health problems.
Sheway provides health and social services to pregnant women and mothers with children under 18 months, who have previous or current drug use problems. Abrahams also operates a private practice.
Sheway is integrated with a program at BC Women’s. He and Sarah Payne, a midwife started the Fir Square Combined Care Unit there 15 years ago. It’s the first program in Canada to care for both drug-using women and drug-exposed newborns in a single unit.
Previously, babies were taken away from their mothers at birth and put into a quiet room with no stimulation. Abrahams said the medical community believed the women were incapable of looking after their children and that the children were unhealthy.
“Any time you take the baby away from its mother and put into a sort of abnormal environment, you’re going to get abnormal behaviour. So it’s a self fulfilling prophecy,” he said.
The babies born at the Fir Square Combined Unit stay in the same room as their moms.
His clients are addicted to heroin, cocaine or crystal meth, and alcohol may be involved in the mix. They usually have no fixed address and many have spent years living on the street. “We make sure that they get first-class prenatal care in the context of third and fourth world social conditions, which is the Downtown Eastside,” Abrahams said.
Staff try to help the women find stable housing and reduce their drug use. The hospital has 12 beds for women who need support and stabilization, before, when or after they have their babies. They can stay for a maximum of four months. Sheway also has 12 units where women can stay up to 18 months after they’ve delivered.
Mothers and babies are kept in the hospital a minimum of seven days after delivery to ensure the babies gain weight and show no signs of withdrawal. New mothers receive parenting advice from nursing staff.
Dr. Sue Harris, head of the department of family practice at BC Women’s, helped nominate Abrahams because she said he’s a “tireless leader” in a tough niche.
The Kaiser Foundation, a national organization based in West Vancouver that’s committed to promoting understanding of addiction and mental health gives each award recipient a $10,000 grant for a charity of their choice.
Abrahams will give the money to the Women’s Health Research Institute at BC Women’s so it can collect more data on the Fir Square program.
Courtesy of the Vancouver Courier Staff Writer - Cheryl Rossi