In just weeks, Gunnedah mum Kaitlyn Bywater will welcome her fourth child.
But with the current reduction of maternity services in Gunnedah hospital, the physiotherapist and Executive Director of the Nurtured Village Hampers faces a daunting question: where will her baby be born?
“It’s really sad but it’s almost accepted if you’re pregnant in Gunnedah, you can’t deliver here. You’re going to have to travel to Tamworth,” she said.
“Because of the lack of staff and the renovations are happening at the moment too, you’ve got to be really low risk (to birth there),” she said.
The official statistics show a similar story.
Quarterly BHI statistics show 66 babies were born at Gunnedah Hospital’s birthing unit during the January to March 2010 quarter. In the April to June 2024 quarter, only 10 babies were born there. Birthing units in Moree and Narrabri show similar downward trends.
Unfortunately, this scenario is increasingly common for New England residents.
Many people in the region knows someone who couldn’t deliver at their local hospital, usually because it’s on ‘bypass’ due to overgrowing or understaffing.
Armidale resident Jen Laurie hears about the struggles constantly. The perinatal and paediatric mental health clinician regularly talks about maternity access on her rural mums podcast HerHerd.
“One woman I interviewed on my podcast who came from Gunnedah said the parameters around birthing at Gunnedah hospital was that you had to see the one doctor who was an OBGYN GP and the birth needed to occur Monday to Friday, nine to five,” she said.
She said some women in the region live up to 10 hours from a maternity hospital or their local birthing hospital doesn’t offer anaesthetics.
“If you get into labour and you want an epidural, they’ll move you by a road. It’s the Wild West, and people just aren’t aware of it,” Jen said.
Kaitlyn highlighted that even the bigger centres like Tamworth are experiencing shortages.
“When you look at reports, they’ve only got 40% of maternity staff and have eight beds available. It’s essentially a rural referral hospital that we can’t refer to because don’t have the capacity,” she said.
The mental and physical health outcomes of reduced services
There are less specialist and generalist services in recent years, Armidale Rural Generalist and new president of the Australian College of Rural and Remote Medicine (ACRRM) Dr Rod Martin told the New England Times.
“It’s one of the riskiest times that we’ve had, not just because of the challenge of not having enough doctors, but also not having enough nurses and midwives as well,” he said.
“We have times where patients have to be moved a couple of hundred kilometres to come into hospital to have a baby. Everyone’s concern, from an obstetric point of view, is that sooner or later, there’s going to be a bad outcome from that. The processes to get that to happen are done as safely as we can, and there’s lots of coordination built into trying to get all the right things to happen. But it’s a vulnerable system,” he said.
It’s not just the ongoing fear of an obstetric emergency. Kaitlyn highlighted there could be other health impacts that are difficult to measure.
“(There could be) an increase in C sections as well because of hospitals being on bypass. More scheduled inductions, which can then escalate into complications and varied birth outcomes.
“It’s just this ongoing cycle,” she said.
It can also have mental health impacts. Kentucky resident Claire Brett felt the impact of the lack of staff firsthand when she went into hospital for a dilation and curettage (D&C) after a miscarriage.
“I feel like there is no care factor, because they’ve got so many other people there, and it all rolls into one another, the whole hospital system, lack of nurses, the wait times,” she said.
After leaving the hospital, she felt completely alone and received no information or support services to help her deal with her grief.
Over the next few years, Claire ended up going through multiple miscarriages and chemical pregnancies. When she fell pregnant with her son, she experienced extreme anxiety and PTSD symptoms.
She wonders whether receiving a bit of extra care and support in the initial stages might have reduced her care burden in the future.
“It would have given me validation leaving the hospital that I mattered, and they cared I was hurting… I would have felt I can call this number. I can go on their web page and find resources to help. I had a lot of problems, but maybe it wouldn’t have been so intense,” she said.
The women all acknowledged that it’s not the fault of the doctors and nurses. As Jen highlighted, the problem is the intense workload they face.
“You could be the best doctor in the world, but there is no way you can provide the best care if that is the pressure you’re working in… Under those circumstances, no one is going to be their best self, and this is a greater issue that we need to address,” she said.
The fight for more services
It’s stories like this that have inspired Jen to join with the Maternity Consumer Network to reignite the 2025 Bush Babies Campaign which they launched at Parliament House on the 20th November.
“Since 1990 they’ve closed 50% of the rural maternity hospitals… that equates to about 140 services that have been closed.
“If you’re a woman in your 30s, your mum had more options that were better resourced and better funded than you do today,” Jen said.
“We know that the number one protective factor for birth trauma, as found by the inquiry in New South Wales, is MGP, which is Midwifery Group Practice, but only 11% of the population can access that.
“What we’re asking for is a commitment for bundled funding, so funding trimesters and then postpartum. If women are accessing different health networks in different areas, that funding follows them and people don’t miss out on funding,” she said.
Claire is also campaigning for better perinatal mental health services. She recently spoke at Parliament Health as part of Perinatal Mental Health Week and has joined miscarriage support service Pink Elephant as their Regional and Rural Ambassador.
“There definitely needs to be professional help that’s given to you from the second you’re told, not after three miscarriages, not after 12 months of trying.
“We all go through the same thing, whether we live in Sydney or Kentucky. My emotional health and well-being is just as important to those that live in the city. So I should have access to all the same type of healthcare,” Claire said.
The fight for better maternal healthcare highlights the urgent need for fair access, but it’s just one part of a much larger challenge.
The widespread workforce shortages leaving rural Australians without the medical support they depend on.
This article is part of a series on Health Care in Crisis. See our other stories on this topic here.
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