When Port Lincoln mother Claire Stanley travelled to Adelaide for a routine check-up during her first pregnancy, with only a small bag of clothes, she expected to fly home the next day.  

But after specialists discovered she had high blood pressure, making her pregnancy high-risk, she gave birth at just 32 weeks.

Ms Stanley stayed in Adelaide for three months, where there were doctors available to treat her underdeveloped baby – a daughter named Dorothy.

“[I] ended up experiencing the world of having a destabilised life,” she said.

“I was in and out of hospital.”

Lack of resources for regional mums

Travelling to the city from regional areas for birthing issues is a challenge many mothers face daily.

Port Lincoln Hospital — more than 650 kilometres from Adelaide — is classed as level three (the highest is six), which means it has limited resources to deliver babies safely.

Dr Kris Bascomb, a rural generalist obstetrician at the hospital, said practitioners could only deliver full-term babies (gestation 37 weeks and above) weighing more than 2.5 kilograms.

“If either of those conditions aren’t met, then the families need to go to Adelaide to deliver,” she said.

Unlike higher-level hospitals, Port Lincoln does not have a full-time paediatrician.

Nadia Baldissera with partner Jake Giles and children Arley and Beau. (Supplied: Nadia Baldissera)

Nadia Baldissera, a mother from Ungarra, a small town 80kms north of Port Lincoln, said this led to a “traumatic” experience after the birth of first child, Arley, at the hospital.

“About a week after he was born, I started feeling really sick – I had an infection they couldn’t find,” she said.

“[Arley’s] heart rate started dropping, so they had to get him [to Adelaide] as soon as possible.”

He was urgently flown to the city on a Royal Flying Doctor Service plane to be treated by a paediatrician there.

Ms Baldissera decided to have her second baby in Adelaide last month, staying in the city for weeks before the birth.

“If anything goes wrong during the birthing process, they have surgeons that are ready to go. Then on the other side of birth, they have paediatric care to start straight away,” she said.

Ms Baldissera had family support in Adelaide, but she has friends from Port Lincoln who weren’t so lucky in similar situations. They had to stop working for long periods and pay rent in the city, which she said was “very stressful” for them. 

Issues across regional SA

Meanwhile, Whyalla mothers have been diverted to give birth in Port Augusta, an hour’s drive away, for almost a year after the level-four hospital’s birthing service closed due to workforce shortages.

Whyalla Hospital’s birthing unit has been closed since June 2023. (ABC News)

Despite a new birthing facility being built at the hospital, it isn’t delivering babies as it waits to recruit midwives – some from overseas.

Whyalla mother Sarah Lewis, who recently gave birth in Port Augusta, said it was a stressful situation.

“I heard horror stories of people giving birth in the emergency department in Whyalla because they had progressed too far to travel,” she said.

“EDs are usually full of people with various issues. It’s not an intimate setting … certainly not an ideal place to give birth in.

“My biggest fear was travelling to Port Augusta in the middle of the night and having to dodge kangaroos.”

Ms Lewis said she was grateful the birth went well and that she had good family support.

“I’m middle class and in a good socio-economic position – I can’t imagine how stressful it would be for other people who don’t have the same support or even transport like a car,” she said.

Better chance of a natural birth in city hospitals

Another reason Ms Baldissera decided to give birth to her second child in Adelaide was because she believed there was a greater chance she could have a vaginal birth as opposed to a caesarean section, which were often favoured in rural hospitals.

Dr Bascomb said small teams in rural hospitals worked hard to get the safest results for families, which was sometimes not a vaginal birth.

Port Lincoln obstetrician Dr Kris Bascomb leads the team at the town’s hospital. (ABC Eyre Peninsula: Emma Pedler)

She said the biggest risk of vaginal birth was a one in 200 chance of a uterine rupture, where a woman’s uterus splits open, and the baby ends up in the abdominal cavity. 

“There are criteria that we follow that say, ‘to keep this as safe as possible, this is how we do it’,” she said.

Dr Bascomb said rural hospitals did not have the resources to induce women with drugs to help during labour “and push it along a little bit where they need to”.

“In Adelaide, they have 24 hours a day [support] … they can do things a little more that we can,” she said.

Regarding paediatric care, Dr Bascomb said that even if the hospital could recruit enough workers to provide full-time care, it did not have adequate equipment, such as breathing devices, to facilitate it.

Government doing its best

SA Minister for Health Chris Picton said the government was trying to get more doctors to stay in regional areas to provide urgent care, including launching a new program for trainee GPs.

However, he said it would take time for regional hospitals to be able to provide doctors wishing to stay on after training with enough facilities.

“There’s no doubt that we face issues in terms of various workforce shortages in a number of our regional areas,” he said.