If you were to draw a hypothetical line from the Tropic of Capricorn across Australia, there is a significant disparity in maternal, fetal and neonatal outcomes in Northern Australia with fewer resources, personnel and perinatal specialists to manage the increased morbidity and mortality.
There are many contributing factors including the environmental diversity, wet seasons restricting travel and access, low population numbers and density, higher proportion of First Nation peoples living remotely, food insecurity along with the significant distances to access health care.
The vast distances that women living in remote Australia have to travel for routine pregnancy care and ultrasound is unfathomable. It can be a minimum of one or two flights on commercial aeroplanes which often have significant delays, or 5 to 8 hours by car with limited options for accommodation along with the financials restraints and transportation challenges once women and their families are in town. Things that we take for granted include getting transport out of hours, to and from the airport and their accommodation and then getting to the health services in time for appointments, the cost of food while women are away, not to mention the fact that many women do not get to bring an escort or have a family member with them during their travel times for routine ultrasound and pregnancy care. For a young 16 year-old woman living on Mornington Island in the Gulf of Carpentaria, in her first pregnancy, these barriers are prohibitive to accessing routine ultrasounds at the correct gestation.
Our story began on Palm Island over 20 years ago, when a sonographer and midwife team, Sue Bloomfield and Alexandra Gosden, established monthly visiting sonography service via Queensland Health to compliment the visiting midwifery services.
In the last 4 years, I became involved as a visiting Obstetrician/Sonologist to Palm Island to facilitate the timely reporting of the ultrasound scans, appropriate management of abnormal ultrasound findings and to provide higher risk models of care to prevent women from travelling back and forth. This evolved into the development of pregnancy screening to prevent obstetric complications and working collaboratively with the local medical service through the Palm Island Community Council. Check Up Australia funded additional visits for both Obstetric care, sonography and Gynaecology visits.
Other remote communities in the Gulf of Carpentaria approached Check up Australia with a request for a similar service, and we were approached. The communities included Mornington island, Normanton, Karumba, Doomadgee and Burketown, of which 96% of women usually deliver at Mount Isa Hospital.
Published O&G Magazine, Digital Health Vol. 26 No 4 | Summer 2024
