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Women in Rural Areas of Australia Must Travel to Give Birth According to Experts, This Should Not Be the Case

Women in Rural Areas of Australia Must Travel to Give Birth According to Experts, This Should Not Be the Case

Published By HealthcareLink , 2 years ago

Women who are very pregnant and live in distant and rural locations around Australia are being forced to pack their belongings and travel to hospitals to give birth, distant from family, culture, community, and connection.

According to women's health experts, this experience is painful for pregnant parents and costly for governments, but the solution is simple: build more culturally appropriate birthing centers outside of major cities.

Sue Kildea, a midwifery lecturer at Charles Darwin University, said that Australia had "medicalised birth."

She said that they felt that they were making things safer for women by relocating them to larger metropolitan hospitals and shutting down all our local facilities.


'It's difficult missing them.'

Mother-of-three Yolngu The saddest part of leaving her home in East Arnhem Land to give birth to her daughter Judy, who is now six weeks old, according to Leah Ngalirrwuy, who talked to the ABC via a translator on Elcho Island, was leaving her young kids behind.

Ms. Ngalirrwuy said that it’s missing them

Ms. Ngalirrwuy's daughter was born in Darwin, around 550 kilometers southwest of the family's rural Aboriginal hamlet of Galiwin'ku.

And her experience is far from unusual.

Birthing services are only available in four main hubs in the Northern Territory, which is twice the size of Texas. These include Darwin, Alice Springs, Katherine, and Nhulunbuy.

Women who reside outside of these four locations must go to the closest hospital at 38 weeks to give birth to their child (although those with higher-risk pregnancies are sent to Darwin, which is equipped to manage complications).

The majority of these ladies do not speak English as their first language, and others do not speak English at all.

Most women travel alone, and though translators are provided at hospitals, they are not always accessible.


A 'ridiculous' condition to travel

Northern Territory Health's distant childbirth policy, according to Professor Kildea, is "outrageous."

She asked, why do they send women and children alone?

Theresa Clasquin, co-director of women, children, and youth at Royal Darwin Hospital, said discussions were already ongoing on how to reintroduce birthing services to rural and regional regions in the NT, but that change would take time.

She pointed out that how can they get to the point where we establish a birth center in, say, Galiwin'ku?

The eventual aim might be five to ten years away.

Learn how families in other rural and remote parts of Australia deal with pregnancy and birth:

  • The territory of the Australian Capital Territory
  • The state of New South Wales
  • Queensland is a state in Australia.
  • The state of South Australia
  • Tasmania is a state in Australia.
  • Victoria's formal name is Victoria.
  • Western Australia (WA)
  • The territory of the Australian Capital Territory

The ACT contains four institutions, including Canberra Hospital, that can handle high-risk deliveries.

ACT Health Directorate representatives stated that women in the ACT do not have to travel far to get birthing services. 

CC-BY-00

The Australian Capital Territory has a fairly tiny geographical footprint.

The Winnunga Nimmityjah Aboriginal Health Service provides First Nations families with publicly financed, culturally safe prenatal and postnatal care, as well as at-home assistance.


The state of New South Wales

There are 16 hospitals in NSW that can treat difficulties, and a health department spokesman said all public hospitals in the state could care for low-risk pregnancies.

Women in distant villages must still go to a hospital to give birth, while they may be able to have remote obstetric consultations at neighboring facilities.

The Isolated Patients Travel and Accommodation Assistance Scheme, which assists patients who must travel considerable distances for medical treatment, receives more than $26 million in funding from NSW Health each year.


Queensland is a state in Australia.

High-risk deliveries are handled at Queensland hospitals such as Cairns Hospital, Townsville Hospital, Sunshine Coast University Hospital, Royal Brisbane and Women's Hospital, Mater Hospital, Logan Hospital, and Gold Coast University Hospital.

There are 40 public maternity services in the state that offer childbirth, prenatal, and postnatal care, 32 of which are in regional, rural, or extremely distant locations.

A spokeswoman on behalf of the health department said all Queensland public hospitals could manage low-risk births and about 96 percent of women who gave birth between 2013 and 2017 lived within a one-hour drive of public maternity service.

Of course, some women in distant locations must still travel to access services, and those with high-risk pregnancies must go to a hospital prepared to minimise possible hazards.


The state of South Australia

In South Australia, all women with high-risk pregnancies are sent to Adelaide between 34 and 37 weeks of pregnancy, based on a predetermined degree of risk and pregnancy history.

Maternity treatment is available at Port Augusta and Mt Gambier hospitals for "moderate risk" patients, and there are over 20 rural maternity facilities that provide "normal/low risk" treatment.

The Aboriginal Family Birthing Program has been operating in South Australia since 2004, and there are hubs based in Port Augusta, Ceduna, Whyalla, Gawler, and Murray Bridge hospitals.

Hospitals in Port Lincoln and Mt Gambier also have an Aboriginal-specific antenatal/postnatal support service within the local Aboriginal Health service.


Tasmania is a state in Australia.

The Tasmanian Health Department didn't respond to questions.

However, as the state only accounts for about 0.9 percent of Australia's landmass, it doesn't face the same complex geographical issues with service delivery as the Northern Territory (which accounts for 17.5 percent).

The Royal Hobart Hospital has a birth centre available for women with low-risk pregnancies.

Other public hospitals thT offer maternity care in the state are Launceston General Hospital, North West Regional Hospital, and North East Soldiers’ Memorial Hospital.

The state has its own Patient Travel Assistance Scheme to help with travel and accommodation costs for patients.


Victoria

The Victorian Health Department also didn't respond to questions.

The state comprises about 3 percent of Australia's landmass, making it about one-tenth the size of WA, which accounts for 32.9 percent.

Across Victoria, 68 clinics offer public maternity and neonatal services (although not all of them provide services for pregnancy, labour, and post-birth).

Victoria may also help cover the cost of transport if families have to drive a long distance to give birth.


Western Australia (WA)

The WA Country Health Service provides health services in rural and regional locations across the state.

In 2019-20, a spokeswoman on behalf of the service said it supported more than 4,200 families across 2.5 million square kilometres to birth in the country and close to home.

Six hospitals managed by the WA Country Health Service can manage high-risk pregnancies.

In WA, expectant families who have to travel to give birth usually do so at about 37 weeks, depending on their risk factors.

Very high-risk patients may need to travel to a regional centre or metropolitan area.

The state also provides outreach antenatal and postnatal clinics to Aboriginal communities.


Birthing on the country an international movement

Birthing in the country is an international movement that aims to improve birth outcomes for Aboriginal and Torres Strait Islander mothers and babies.

But it's not just about where a woman physically births a child — it also encompasses culturally safe care for First Nations families during pregnancy and after birth.

Vijay Roach, president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, says any initiative that supports Indigenous women and helps them stay connected to community, culture, and tradition will improve clinical outcomes.

He said that it is so frustrating when we talk about all of these issues because we've said it before, the answer's right there. 

It's as simple as it sounds: women should be able to be looked after in pregnancy, or indeed in any other area of their lives, in a culturally safe way.

Professor Kildea said Australia needed to open more birthing centres to manage low-risk births in regional and remote locations.

She said that the evidence says we can do this, and we can do this safely.

She said women with a higher risk of births would still need to travel to bigger centres, for the wellbeing of mum and baby.

Professor Kildea said that you don't want to be having women out in remote communities who have complex health histories and really do have risk factors and would be much safer with a team of medical professionals around them.


"Nobody's talking about doing that.”

Government 'supportive' of birthing on country

Dr. Roach said if Australia was going to offer services to assist women having babies in remote settings, it was vital these centres were adequately supported.

He added that by the support he meant with the appropriate infrastructure and appropriate personnel, not just, 'here's a building and it has one midwife who is available occasionally.

It's obviously a very desirable thing, but it's also very resource-intensive and it's not always able to be provided across such a large country.

It would need to be looked at on a case-by-case basis.

Federal Health Minister Greg Hunt declined to be interviewed, and a spokesman directed questions to the Department of Health.

A spokeswoman on behalf of the department said the Australian Government was supportive of the birthing on country approach.

NT Health said the department was also supportive of birthing on the country model.


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