Care Coordination

Labour & Delivery

Labour and delivery services continue uninterrupted at Royal Inland Hospital . We continue to have 24/7 coverage for low to moderate risk patients with Registered Midwives and Family Physicians providing on-call services, and 24/7 ObGyn coverage.

Any patient with urgent maternity needs above 20 weeks gestation should be directed to present to RIH LDR.

As TRFO has closed, the group of providers seeing low to moderate risk patients on LDR is being renamed Kamloops Perinatal.

Referrals for Routine Antenatal Care

Current options to refer for pregnancy care are more limited than they were a year ago. However, there are still several options available:

EPACT (Early Pregnancy Access to Care & Triage)

Longitudinal Midwifery

STEPS Third Trimester Care

  • STEPS North Shore is able to care for patients without a primary care provider from 30 weeks to delivery

    • Unfortunately, they are not able to see anyone who has a family physician, attached clinic, or NP

  • Referral needed from episodic care provider

  • stepshealth.ca 250-312-2127

Referrals for High Risk Consultation

Drs Chuang, Sutton, and Adams are accepting referrals for consultation for obstetrical concerns. They are not accepting transfer of care for ongoing antenatal care.

Common reasons for referral to OB include:

  • Pregnant patient with Type 1 Diabetes/Type 2 Diabetes on insulin

  • Multiple gestation (twins)

  • Early onset IUGR on anatomy scan (consider review with RACE line first)

  • Maternal vaginal abnormality (eg bicornuate uterus)

  • Cervical insufficiency/cerclage

  • Severe pre-eclampsia <36 weeks

  • Severe IUGR in 3rd trimester, EFW or AC <5%

  • Placenta previa past 32 weeks

  • Oligohydramnios under 36 weeks

  • Breech presentation near term (34-36 weeks)

  • Previous Caesarean section, to discuss TOLAC vs elective repeat Caesarean section (refer at 32 weeks)

If you are unsure whether your patient requires OB consultation or if outpatient vs inpatient consult is approrpiate, consider speaking to the RACE Line, Kamloops Perinatal on-call provider, BC MFM, or the ObGyn on call.

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Common Questions

Who is seeing prenatal patients in town?

When should my patient go to Labour & Delivery?

My patient is at their due date and not yet labour. What do I do at this point?

My patient has had a C-section in the past. Where do I refer them?

  • See “Referrals for Routine Prenatal Care” and “Referrals for High Risk Consultation”

    • Reduced fetal movement (advise on 2hr kick counts)

    • Vaginal bleeding

    • Painful cramps/contractions before 37 weeks

    • Their water breaks and they have at least one of:

      • Positive GBS status

      • Breech or transverse lie

      • Under 37 weeks

      • Bloody fluid

      • Thick, dark, or odorous fluid

    • They seem to be in labour and:

      • Contractions are increasing in strength and regularity

      • There is active bleeding

      • They need pain management

      • They are GBS positive

    • Blood pressure greater than 140/90, or signs/symptoms of preeclampsia:

      • Headache

      • Visual changes

      • Elevated protein in the urine

    • They have a pregnancy concern that you do not feel can safely wait for an outpatient visit

  • Any complaint that is not pregnancy related should not be seen on LDR. Although we know that the ER is busy, other urgent concerns are best addressed there if they cannot be addressed by the primary care provider or UPCC.

  • Speak with the on call Perinatal Provider to book the patient for an NST and fluid check. They will also discuss post-dates induction with the patient. Most babies aren’t born on their due date, but we do want them born by 42 weeks at the latest.

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