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"We all know this is a very, very stressful time for these patients," Coffey said in an interview. "It's also very stressful on the staff, knowing that their patients have to be diverted away from their centre and that they cannot provide safe care for them at this time."

Officials with the local health authority are "working hard," she said, to arrange travel and accommodations for everyone who must make the journey.

Happy Valley-Goose Bay is connected to Labrador City by a 530-kilometre highway that cuts across a vast stretch of wilderness, with nothing but scrubby evergreens and open land on either side. There is no cell reception along much of the two-lane highway. Churchill Falls, N.L., located roughly halfway between the two towns, is the only place to stop for gas.

The patient transfers began last Friday, according to a news release from Labrador-Grenfell Health authority. They're expected to end on Jan. 13, 2023.

Coffey said Labrador-Grenfell Health has been hit particularly hard by a provincewide nursing shortage. The health authority covers Newfoundland's Great Northern Peninsula and all of Labrador, and Coffey said about 60 per cent of its nursing positions are vacant.

About 50 per cent of the authority's working nurses are casual, compared with about 26 per cent in the rest of the province, she said.

The health authority increasingly relies on private nursing agencies and contract nurses to fill gaps in staffing, Coffey said. But during the holidays, those solutions aren't as widely available.

"I do know they are still working at securing relief to come up and help over the Christmas period," she said, adding that officials are also appealing to the province's three other health authorities for help.

Coffey said that if the province wants to find a permanent solution, it needs to pay its nurses better and allow them more time off and more control over their schedule. "We can't continue to operate on the backs of the registered nurses who are dying on their feet," she said. "We can't keep pushing them."

Stacey Hoffe, executive director of the Mokami Status of Women Council in Happy Valley-Goose Bay, said her organization is particularly concerned about the mental health of the patients affected by the diversions. Pregnancy can already be an uncertain, anxious time, and patients need close supports and care, Hoffe said in an email.

"Instead, families are having to think about arranging transportation in unpredictable weather on roads without cell service and making arrangements to be away from home for much longer than anticipated on very short notice," she said.

The nursing shortage is part of a "systemic issue," and health-care workers are not to blame, she added.

Kim Dyer, executive director of the Labrador West Status of Women Council, in Labrador City, said health services are also strained in her community.

"We've had a really hard flu season, our hospital is being hit really hard right now," Dyer said in an interview. "So it's mind-boggling to me how we're going to accommodate however number of new patients from across Labrador."

The health-care system in Labrador is already sparse and people are "sadly" accustomed to travelling across the province for specialized care, she said, adding that the obstetrics diversions now present another hurdle.

"It's scary," she said.

This report by ¹ú²úÓÕ»ó¸£Àû was first published Dec. 20, 2022.

— By Sarah Smellie in St. John's.