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Expectant mothers across Canada face serious - even deadly - health risks because of a critical shortage of obstetricians that is expected to worsen in the coming years, a new report warns.

The looming crisis is made more serious by the fact many women now delay childbearing until later in life, raising their risk of pregnancy and delivery complications that may warrant immediate intervention by an obstetrician, according to a report released yesterday by the Society of Obstetricians and Gynaecologists of Canada.

"You can have emergencies happen very suddenly, and if you don't have the personnel available to take care of those emergencies, people can die and babies can die," said Scott Farrell, the society's president. "Obstetrics doesn't wait for anybody."

Obstetricians are specialist physicians who provide medical and surgical care during pregnancy and are trained to address medical emergencies that may arise during childbirth.

The problems facing obstetricians are part of a larger, more complex human-resources struggle occurring throughout Canada's health-related professions. Cross-country shortages of family doctors, midwives, nurses and nurse practitioners have resulted in an increasing number of obstetricians taking on bigger workloads and responsibilities that normally don't fall to a specialist.

"I think it's an urgent issue," said Madeline Boscoe, executive director of the Canadian Women's Health Network. "This has been an alarm that's been going off from our colleagues for a long time."

For instance, instead of focusing on women with complex infertility issues or high-risk pregnancies, obstetricians are increasingly expected to fill the role of family doctors or nurses by delivering healthy babies and conducting pelvic exams and other routine tests or procedures.

It's a problem that not only leaves obstetricians overworked, but also underutilizes their expertise, Ms. Boscoe said.

And it may prevent women with serious health issues that require a specialist from getting sufficient care, she said.

The SOGC report is based on a survey - involving new and veteran obstetricians - that is designed to identify gaps in the availability of specialists and determine what the future landscape of the profession will look like.

About 1,370 obstetricians practise in Canada, according to the report, and that number is expected to drop by as much as one-third in the next five years, according to the survey.

More than 400 obstetricians practise in Canada's 53 teaching hospitals, located in large urban centres, leaving fewer than 1,000 available to treat patients at Canada's 300 other hospitals.

The society representing obstetricians says the specialists' workloads are enormous, and that they're expected to deliver upward of 300 babies a year and be on call 24 hours a day.

The shortage is compounded by the fact many of the country's obstetricians are expected to retire in the near future, and there may not be enough new specialists to take their place. While there are 413 obstetrical and gynecology residents in Canada right now, some won't pursue an obstetrical practice, the survey found.

Another major issue is that about 80 per cent of the residents are women, and many say they plan to take time off to raise their own families and may not be willing to put in 60-hour work weeks for their entire career.

Many of those surveyed also reported that they plan to work in a major urban centre, which indicates smaller cities or remote and rural areas may feel the shortage more acutely.

"I think flexibility, in addition to work-life balance, is going to be really important to people," said Ashley Waddington, a third-year obstetrical resident in Halifax.

"If you're the only obstetrician in a small centre, you don't have the option to take leave at short notice," she said.

Women's health experts say that Canada should adopt a birthing strategy in order to help solve this looming crisis. Rather than zeroing in on a shortage of specialists, Ms. Boscoe says, a strategy would focus on issues such as ensuring health professionals work together, as well as on the need for more midwives, nurses, nurse practitioners and family doctors with skills to care for women during pregnancy.