Good morning, Mark Iype filling in for Wendy Cox today.

A health care system that forces obstetrician-gynecologists to ration care and make decisions about which mothers and babies will get treated is a problem.

That is one of the outcomes cited by seven OB/GYNs in Kamloops who have recently tendered their resignations from in-hospital care at Royal Inland Hospital in the city.

In a letter dated Oct. 11, the seven specialists said unsafe workloads, staff shortages and a lack of government support have made the situation untenable.

“It is fairly unprecedented for an entire group of physicians to depart, but with the state of obstetrics in our community and with the upcoming loss of the [Thompson Region Family Obstetrics] group, we see no viable way forward,” said the letter. The physician group referenced operates a maternity clinic in Kamloops and announced last month it would close to new referrals because their doctors were needed for labour and delivery services at the hospital.

As reported by The Globe last month, obstetrical care in B.C., not just in Kamloops, is in a dire state. Persistent staffing shortages have meant that some pregnant patients are being forced to travel hundreds of kilometres to give birth, while OB/GYNs are routinely taking extra shifts to fill critical gaps, increasing risks of burnout and to patient safety.

In a statement released on Monday, the seven Kamloops doctors – Hilary Baikie, Jennifer Kozic, Paula Lott, Erin Adams, Michael Hsiao, Rita Chuang and Christine Sutton – said they had raised several issues with B.C.’s Ministry of Health as well as Interior Health, the local health authority. They include OB/GYNs on-call for 24-hour shifts being expected to cover all obstetrical emergencies and perform surgical assists, which the doctors said forced them to make “impossible choices” about who they could tend to and who had to wait.

“When we are forced to ration care, have patients wait longer than they should, or suffer the harm that long waits can cause, everyone involved experiences stress and moral injury,” the doctors said in the statement.

Last week, Health Minister Josie Osborne tried to reassure worried patients that obstetrical services will still be available, despite the resignations of the seven specialists.

Osborne said the doctors are working with the local health authority on a 90-day transition plan, followed by a phased withdrawal of the OB/GYNs’ services.

In the short-term, the province is hoping to expedite the hiring of shortlisted OB/GYN candidates and fill service gaps with locums at a daily rate of $7,100 each, with overnight premiums.

“I know that any interruption of health care services like this, especially obstetrics and gynecology and maternity services, is very stressful for people, for mothers and families and the wider community too,” Osborne said.

Chelsea Elwood, vice-president of the Society of Obstetrics and Gynecology of British Columbia, said staffing issues have an immediate impact on patient care and safety.

She compared locums to substitute teachers – important in the short-term but not a sustainable long-term solution.

“They don’t provide the ongoing continuity of care that individuals need to keep high-risk pregnancies safe,” she said.

As The Globe’s Gary Mason argued in his column last week, “If you live in B.C., you are by now used to a certain amount of chaos and uncertainty in the health care system.”

He said the inability to find a family doctor, emergency departments closing from time to time, and now the loss of these OB/GYNs, is a sign of a system with issues.

And while Mason argues there is lots of blame to go around, there is no easy fix for a health care system in crisis.

“I just know that these stories aren’t going away. If anything, they are likely to become far more common,” he said.

This is the weekly British Columbia newsletter written by B.C. Editor Wendy Cox. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.