Pregnant women in remote areas travel vast distances for antenatal care
Parents-to-be Peta Mackay and Michael ‘Dickie’ Absalom are finally on the home straight of a gruelling fertility journey that has culminated in a high-risk pregnancy.
And if that was not stressful enough, they live on a remote property that is a 2,000-kilometre round trip from their medical specialists in Adelaide.
As the managers of Lindon Station in Corner Country, the region where New South Wales, Queensland and South Australia intersect, their world is one of soaring temperatures, red dust, hard work, and cattle.
But over the past three months, Ms Mackay has also had to factor in the massive round trip to Adelaide every two weeks for antenatal care — a trip she makes on her own.
“I drive all of Tuesday, 14 hours, have my appointment, stay overnight [in Adelaide] and then drive to Broken Hill and stay there and then come back to the station Thursday,” she said.
Dickie and Peta tried to conceive for three years before committing to IVF, only for Peta to fall pregnant naturally. (ABC Broken Hill: Coquohalla Connor)
With their baby due in late January, Ms Mackay is at last preparing for her final trip to Adelaide, where she will give birth.
Being hundreds of kilometres from pregnancy care is a common challenge for many women who work and live in remote Australia.
Happiness after years of heartache
After three years of unsuccessfully trying for a baby, it was a happy shock when the couple learned they had fallen pregnant naturally the night they returned from picking up their first IVF kit in Adelaide.
They’d driven 18 hours through the night and just got home to Corner Country when Ms Mackay decided to do one last pregnancy test — just to be sure.
She was pregnant.
As time went on, and her bump grew, everything seemed to be fine.
But in the lead-up to a routine ultrasound around the 20-week mark, Ms Mackay was experiencing “heaps of chest pain”.
She’d just made the six-hour trip from Lindon Station to the imaging clinic at Broken Hill, and was watching the ultrasound screen, when the sonographer said he could see a cyst on a lung.
Ms Mackay assumed he was talking about one of her lungs.
A routine ultrasound at 20 weeks showed cysts on the fetus’s lungs. (Supplied: Peta Mackay)
“I was like … really oblivious and excited because I’m seeing this baby move around, and he said, ‘No, we’re not talking about you’,” she said.
She was warned not “to google anything” and to wait for her appointment the next day with the midwife and doctor, but as a former nurse, that was not in her nature.
“I needed to [do] research. I needed to read good, clinical papers that are Australian-based. I needed to know death rates and prognosis, which is quite morbid, but I wanted to know,” she said.
“I had a meltdown in the car, and cried, and then I was good to go.”
It meant she felt more emotionally prepared when she walked into her appointment the next day.
“If I didn’t research it … I would’ve broken down,” she said.
The diagnosis was congenital cystic adenomatoid malformation (CCAM), a rare condition where liquid-filled cysts form in the lungs of a fetus.
Ms Mackay called her family with the diagnosis but no one had heard of CCAM before. (ABC Broken Hill: Lily McCure)
In extreme situations, the cysts can put pressure on the baby’s heart. In other extreme cases, if the cyst bursts, the baby’s lungs can be damaged.
Ms Mackay was sent to Adelaide for another ultrasound, which determined her baby’s CCAM as stage two.
This means he might need surgery within his first year of life, but after that, there shouldn’t be any ongoing impact on his quality of life.
However, the condition meant Ms Mackay’s pregnancy was classified as high-risk and she would need fortnightly check-ups in Adelaide, nearly 1,000km away from her home.
‘You have to be resilient’
Claudia Simounds was heavily pregnant with her first child when she made the nearly six-hour-long trip to Adelaide on her own to give birth.
Ms Simounds found out she was 10 weeks’ pregnant at her wedding in 2023. (Supplied: Claudia Simounds)
Originally from remote stations, both Ms Simounds and her husband, Mick, lived and worked in Broken Hill, but regularly returned to their families’ respective properties to help out.
It meant Mr Simounds was unable to attend many of her prenatal appointments, and was not able to accompany his wife to Adelaide when she was 37 weeks pregnant.
Ms Simounds remembers the isolation of being alone in doctors’ waiting rooms, seeing other couples holding hands. But opting for a private obstetrician in the city meant she could achieve her wish of a natural birth.
“It was a bit sad. I’d be in the waiting room and there would be people with their partners there and I’d be there all by myself,” she recalled.
“When you live remotely, to a degree, you are quite resilient and you get used to travelling alone, but it would’ve been nice to have Mick close, but he obviously had to stay and work.”
Ms Simounds was eager to have a natural birth. (ABC Broken Hill: Lily McCure)
Fortunately, the dad-to-be made the trip south in time to be by his wife’s side before she went into labour and delivered a healthy baby boy named Jett.
“There were so many tears, Mick and I just cried,” she said.
Nearly seven months on and despite the long hours travelling and the lonely doctors’ appointments, Ms Simounds would not change a thing.
“I’m super happy for anyone to get whatever planned birth they want, and if they can get that, that’s a blessing,” she said.
Jett was born with a tongue tie that was lasered when he was 10 days old. (ABC Broken Hill: Lily McCure)
A final solo trip
Back at Lindon Station, Ms Mackay was getting ready for her final solo trip to Adelaide.
As a high-risk pregnancy case, she had to be in Adelaide a month before the baby was due in late January.
Her husband plans to make the trip himself the week she is due, and then, the duo will be a trio.
After so many years of heartache, followed by nearly nine months of pregnancy stress that was further compounded by hundreds of hours behind the wheel, Ms Mackay cannot believe she will soon be holding her baby.
“Even now, a few weeks out from having the baby, I was so in my mind that it was never going to be our turn and now it is,” she said.
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