Obstetrics and gynecology clinics are closing one after another, due to a lack of agreement between specialist physicians and the Quebec government that could correct the underfunding of office expenses. The allocation intended to cover administrative costs has not been increased in about 15 years. Obstetrics, which covers deliveries and pregnancy follow-ups, is a particularly disadvantaged specialty. According to the Qebec’s association of gynecologists and obstetricians (AOGQ), physicians receive $29.45 for each prenatal follow-up visit, of which $6.55 is intended to cover clinic operating costs, including rent, staff, electricity, internet and phone bills. Over the past year, six obstetrics or gynecology clinics have permanently closed their doors. Within two years, at least five more clinics could be added to that number. “Office fees are one of the discussion items for which it is essential that we correct the underfunding. We are not the only specialty with problems. In our case, what is unfortunate is that it has fallen so far behind that for us, there are already clinics that will not reopen and that are already closed or will close in the coming weeks,” said AOGQ president Dr. Dominique Tremblay in an interview. That’ss the case for an obstetrics and gynecology clinic in Châteauguay, which will officially close on April 30. The eight physicians who ran the clinic followed approximately 900 pregnant patients per year, totalling 23,000 annual visits. The physicians will go to work in a family medicine group (GMF), but will no longer provide pregnancy follow-ups — only gynecology. Dr. Olivia Marra, co-owner of the clinic, says the decision to close was “heartbreaking.” She and her colleagues had to decide in May 2025 whether to renew the lease or not, for a period of five to ten years. The physician-owners tried several solutions, including recruiting other gynecologists to the project. “We even met with our CIUSSS to see if there was a possibility of getting funding from them to try to keep our doors open. Unfortunately, we were not able to,” she said, disappointed. Dr. Marra gave an example of the financial challenges. “The funding we receive for a half-day of obstetrics is $550. And the operating cost for that half-day is $580. We had already been running at a slight loss for two or three years,” she said. Dr. Marra worries above all for her patients about what comes next. “In our area, we have family physicians who specialize in obstetrics and provide follow-up care, as well as a midwifery service. But these health professionals already existed. They are already saturated when it comes to pregnancy follow-up, so we unfortunately anticipate that there will be a real gap in our area for pregnancy care,” the doctor said. She believes women will be forced to travel to neighbouring cities for delivery and medical follow-ups, but other regions are equally stretched to capacity. Closures difficult to stop without an agreement As with dermatology, obstetrics generally no longer has dedicated space in hospitals, which means patients are largely seen in private clinics. “Most of the clinics that have currently closed have requested that their activities be brought back into the hospital system. Some clinics have managed to bring a portion of their activity back into hospitals,” said Dr. Tremblay. “Hospitals sometimes don’t have the space to take them in. And at that point, we end up with a net loss of visits.” The AOGQ estimates that within two years, patients will be deprived of nearly 90,000 annual visits. Negotiations between the Quebec’s medical specialists’ federation (FMSQ) and the government remain at a standstill. Physicians are asking for a 14.5 per cent increase in their compensation over five years, while Quebec says the 11 per cent increase it is proposing is its final offer. “We can hope that negotiations will help prevent the continued carnage that risks occurring with the repeated closure of clinics,” said Dr. Tremblay. “The more time passes, the more announcements we get of clinics closing. So we are particularly concerned about the availability of services to the population.” He maintains that the FMSQ is well aware of the office fees issue and is defending this point in negotiations. But without an agreement, clinics will continue to close, according to Dr. Tremblay. “This is something that will be difficult to stop if there is not a significant turnaround,” he said. - By Katrine Desautels The Canadian Press’s health coverage is supported through a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content. This report by The Canadian Press was first published in French on April 1, 2026.
