Risk and childbirth in rural and remote Australia

Across Australia, comprehensive maternity services in rural and remote areas are becoming a scarcity and yet it is in these areas that the fertility rate is the highest1. Consultations suggest that many women, particularly Indigenous women, would prefer to give birth closer to home and many government sponsored documents recommend changing current models of care2,3,4,5,6,7. Nationally, maternity services are becoming centralised and yet internationally, studies have shown it is possible to improve birthing outcomes and consumer satisfaction when birthing services are provided in very remote areas.8,9,10,11,12,13,14 Maintaining birth as a social event, is a central principle of these overseas models. The social risks for the women and their families who have to endure relocation for birth are often not considered in the risk equation performed by the policy makers and key professions. Women in Australia are demanding a different approach. They are uniting under the banner of the Maternity Coalition and in September 2002 released the National Maternity Action Plan (NMAP).15 This document is calling for significant change in the delivery of maternity services across Australia.