New data shows more people are filing complaints about obstetrical and gynecological care in Ontario, with insensitivity, poor communication and lack of trauma awareness among the most common grievances.

Ontario’s Patient Ombudsman Craig Thompson says his office received 168 complaints between April 2024 and March 2025, compared to 130 over the same period the previous year — a 29 per cent increase.

Complainants also detailed experiencing a lack of responsive care to factors such as history of sexual assault, pregnancy complications, miscarriages, and difficult births.

Many complaints were related to pregnancy, childbirth and postnatal care provided in hospitals, he said. There’s also been an increase in complaints regarding services at community surgical and diagnostic centres that do ultrasounds, X-rays and surgical procedures.

Complaints are filed online, by email, fax or mail, and then reviewed by the ombudsman, who engages with both parties to reach a resolution.

National data from the Canadian Medical Protective Association suggests patient complaints across medical disciplines are on the rise, with more than 4,045 in 2020, up from 3,379 in 2016. They said many complaints showed communication was an underlying issue.

The Ontario ombudsman’s data will be published later this year in an annual report on the overall number and themes of health-system complaints, but Thompson shared the OB/GYN numbers with The Canadian Press in the wake of an investigation published last week that included several patients alleging neglectful care going back almost a decade by the same Toronto doctor.

The patients described traumatic experiences while under the care of OB/GYN Dr. Esther Park, with some alleging they were not adequately informed about certain procedures performed at her clinic and the hospital she worked at for 25 years.

Dr. Park stopped practising medicine in April. Attempts to reach her for comment were unsuccessful.

In the ombudsman’s last annual report released in March, the number of obstetrical and gynecological-related complaints in the province was described as an “emerging concern” that Thompson said he would continue to monitor.

While Thompson said the way women’s health is delivered in Ontario has been an issue for many years, he said what’s new is the number of grievances about obstetrics and gynecology, and the nature of the complaints.

“We are in that role of a bit of the canary in the coal mine. We identify early signals of a problem,” he said, explaining that annual reports are shared with the province’s ministries of health, long-term care, and relevant health agencies.

The patient ombudsman’s role was created by the provincial government in 2016 to help resolve complaints and conduct investigations on issues of public interest.

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Thompson calls his office the “last resort” for patients who are not satisfied with a hospital’s response to a complaint, and who need help reaching a resolution. But he also tries to pinpoint if a broader issue needs to be investigated and what can be done.

Thompson said he tries to determine: “Where’s the breakdown? Is this a breakdown in policy? Is this a breakdown in education or training of our team? Is this a breakdown in practice? Is the practice that we’ve adopted not meeting the mark?”

He would not disclose if he’s conducting a broader investigation of obstetrical and gynecological care complaints. His last report included two pages on the practice, identifying “broader organizational issues, including a lack of trauma-informed care approaches that, if addressed, could improve the experiences of patients and their families.”

Dr. Heather Millar, an obstetrician and gynecologist at Women’s College Hospital and Mount Sinai Hospital in Toronto, says a trauma-informed approach begins with an awareness of how common painful childhood memories, sexual assaults and triggering medical encounters are. It also includes strategies to avoid traumatizing or retraumatizing a patient.

She said she first came across the method in 2015.

“I was working with a physician at the time who used trauma-informed care principles and I realized that this was something that we should all be doing and that really should be implemented across our specialty,” Millar said.

The premise is to treat each patient as though they have a trauma history, for instance asking permission before touching them and covering their bodies during an exam to facilitate an environment that feels safe.

Since then, Millar has been helping integrate the approach at hospitals, including within Mount Sinai’s obstetric emergency training, and she teaches trauma-informed care to residents at the University of Toronto.

She’s also working on national guidelines with the Society of Obstetricians and Gynaecologists of Canada (SOGC) to formally implement this approach as a standard of care.

“We’re much more conscious now of how common trauma is in the general population … and also how the encounters and procedures in our specialty can be traumatic for people,” she said, referencing vaginal exams that can feel invasive, and emergencies during deliveries, which may trigger painful memories.

Dr. Glenn Posner, vice chair of education for the department of obstetrics and gynecology at the University of Ottawa, said when he was a resident more than 20 years ago, trauma-informed care was not talked about. But now, he sees residents bring this sensitive approach to their patients, for instance asking for permission multiple times before an exam, or showing them how a speculum feels on their leg before using it.

But the stressful demands of the job and sheer volume of patients can at times hinder sensitive communication, and can translate into body language that patients will pick up on, he said.

“Having a conversation with somebody with your hand on the door knob is perceived as you’re rushing them. But you can spend the same amount of time or even less if you come in, pull up a chair, sit down.”

Similarly, Millar said there are small changes that can make patients feel more in control, such as raising the head of a hospital bed so that the physician can make eye-contact with them throughout an exam.

In response to an email from The Canadian Press containing the ombudsman’s new data, the ministry of health said it expects every hospital and health-care partner to uphold the highest standard of patient care. They referenced existing patient safety legislation and regulation, but did not say what they would do about the increase in obstetrical and gynecological complaints.

“One complaint about the safety of care is too many,” a spokesperson for the ministry of health said in a statement.

The SOGC said it would not comment on the data since it has not seen the full report.

The head of an advocacy group that speaks out on behalf of patients says she’s seen similar reports for years without any investment in changes.

“I am not surprised that there are more complaints that are coming in this particular area of practice,” said Kathleen Finlay, chief executive officer of the Center for Patient Protection.

Finlay, who has worked as a patient advocate for almost 20 years, said she often hears OB/GYN patients say, “They didn’t listen to me. I had a lot of concerns and I felt I was just being rushed through the process. My questions weren’t being answered.”

She said not enough is being done at the regulatory level to make changes to improve patient experience.

“There are many issues that are, from a woman’s perspective, very traumatic and so much of it is about not being treated with the respect that they deserve.”