Dr. Poungui warns of maternal care crisis

Tashi Farmilo

The former head of obstetrics and gynecology at Gatineau’s largest hospital is warning that persistent staffing shortages, diminished operating-room access, and a lack of government action are threatening the safety of mothers and newborns across the region.

“We are on the edge,” said Dr. Lionel-Ange Poungui. “We’re not asking for miracles. We’re asking to keep mothers and babies safe.”

Though he has recently stepped down from his administrative duties at the CISSS de l’Outaouais, Dr. Poungui continues to practise as a clinician. He described a health system still hollowed out by the pandemic and struggling to rebuild. Where the hospital once operated seven surgical rooms, it now functions with as few as two or three per day. That reduction has forced physicians to delay non-urgent procedures and make difficult decisions about which cases to prioritize, even when lives are at stake.

“All of our caesareans, elective or emergency, happen in the operating room,” he said. “If two emergencies arrive at the same time, and you only have one room, what do you do? That’s the reality.”

The hospital, which handles thousands of births annually, is the only maternity centre in the region. Dr. Poungui said that while some nurses have been hired to fill gaps left by a wave of resignations, many are early in their careers, with less than four years of experience. “They’re still vulnerable,” he said. “They can leave at any moment.”

What is pushing them out, he argues, is not only compensation but the environment they are expected to work in. Nurses are frequently required to work overtime — sometimes voluntarily, sometimes not — and often without sufficient managerial support. “If you’re constantly asked to do overtime, day after day, it burns people out,” he said.

In neighbouring Ontario, where salaries are higher and overtime is less common, many Quebec-trained nurses have found a more stable and respectful work culture. Dr. Poungui described conversations with nurses who left Gatineau for Ottawa and never looked back.

“One nurse told me, ‘Even if you doubled my pay, I wouldn’t return. My manager in Ottawa checks in on me to see how I’m doing. They care,’” he said. “That’s not just about money. It’s about dignity.”

Dr. Poungui and his colleagues raised these concerns in a letter addressed to Quebec Health Minister Christian Dubé. The letter asked the province to implement pay equity with Ontario, to recognize the Outaouais as a region with unique staffing challenges, and to take immediate steps to prevent the collapse of maternity services.

They never received a response.

“It wasn’t a protest. It was an attempt to collaborate,” Dr. Poungui said. “We were saying, ‘There’s a risk. Can we work together to fix this?’ Even just an acknowledgement would have meant something.”

The shortage of operating-room nurses dates back to the COVID-19 pandemic, when staff were redeployed to critical care and never replaced. Many left the profession. Others joined the federal government or private clinics. “We lost a lot of people, and they didn’t come back,” he said.

The result is a fragile system where obstetrics now competes for surgical space with oncology and other departments. “Every day we are forced to choose,” he said.

Dr. Poungui believes the crisis is not only a matter of recruiting new workers but retaining the ones already in place. “There’s always a focus on attracting new staff, but what about the people who’ve stayed?” he said. “They’re exhausted. They need to know their work is valued. That means better pay, better schedules, better treatment.”

He also expressed concern about the looming impact of provincial legislation, including Bill 15, which may discourage family physicians from continuing to deliver babies, placing even greater pressure on obstetricians. “If family doctors stop doing births, we don’t have enough people to take over,” he said. “The system can’t absorb that loss.”

Despite stepping away from leadership responsibilities, Dr. Poungui remains committed to his practice. He spoke of building the department from four gynecologists to nearly ten and working through some of the most difficult years in recent memory. But pride alone, he said, won’t be enough to hold things together.

“We’re not so different from anyone else,” he said. “If you give people decent working conditions and a bit of respect, they’ll stay. But if you push them until they break, they’ll leave. And when they do, it’s the patients who pay the price.”