Di’s first taste of rur­al and remote mid­wifery was over the Christ­mas peri­od of 2015, when she took long ser­vice leave from her Mid­wifery Unit Man­ag­er role on the Gold Coast to help a friend in the Kather­ine Mater­ni­ty Unit. 

“I absolute­ly total­ly loved it. I saw that there was a niche that met my core val­ues in mater­ni­ty care-pro­vid­ing, and gave me the oppor­tu­ni­ty to think out­side the box to deliv­er mater­ni­ty care,” she says. 

Over the past sev­en years, Di’s remote area mid­wifery work has also seen her liv­ing and work­ing along­side RANs in Abo­rig­i­nal com­mu­ni­ties, includ­ing two-and-a-half years that she ​“absolute­ly loved” in Wad­eye, NT deliv­er­ing con­ti­nu­ity of care and mak­ing a difference.

Nowa­days, you will find Di trav­el­ling in her Land­cruis­er 200 series across rur­al and remote Aus­tralia under­tak­ing 12-week con­tracts in com­mu­ni­ties in need of mid­wifery care.

“From Wad­eye I went to the Tor­res Strait, to Thurs­day Island, and to Port Hed­land and com­mu­ni­ties in WA and Queens­land,” says Di.

“Recent­ly I’ve been doing some rur­al place­ments, Glad­stone, Esper­ance and Carnar­von, with that rur­al and Indige­nous health focus – they’re not as remote, but just to recharge and keep current.”

Di used to run impromp­tu emer­gency birthing cours­es when she met RANs at out­reach cen­tres. She has since trans­ferred this pas­sion to her vol­un­teer role as a CRANAplus facil­i­ta­tor on the Mater­ni­ty Emer­gency Care (MEC) and Mid­wifery Upskilling (MIDUS) cours­es. 16 months in and she has five course facil­i­ta­tions under her belt.

“I have huge respect for remote area nurs­es, hav­ing worked with them real­ly close­ly in remote com­mu­ni­ties,” Di says.

How­ev­er, Di believes a fear of mater­ni­ty can at times pose a risk to the pro­vi­sion of evi­dence-based care to moth­ers and babies in remote areas, where birthing ser­vices are not often avail­able locally.

Di says that the MEC course is about expand­ing the ​“mas­sive tool­box of skills” RANs have even fur­ther, in order to alle­vi­ate under­stand­able anx­i­ety about mater­ni­ty care includ­ing emer­gen­cies and equip RANs with the right ques­tions to ask and the aware­ness of whether a woman can be man­aged in Community.

The end result is that they will be able to col­lab­o­rate as effec­tive­ly as pos­si­ble with the mid­wife or dis­trict med­ical offi­cer, and pro­vide as much care as pos­si­ble on Country.

“For exam­ple, is it preterm labour or is it just a sim­ple uri­nary tract infec­tion that is giv­ing her con­trac­tions?” Di asks.

“If we treat the infec­tion ear­ly, she may not have to go into a ter­tiary unit for weeks pri­or, to await the arrival of her baby.”

Di says that RANs can also play a vital role in shap­ing healthy preg­nan­cies and lim­it­ing the occur­rence of preterm birth; for exam­ple, by screen­ing for STIs and anaemia dur­ing the pre­con­cep­tion period.

“A healthy mum grows a healthy baby,” says Di.

A trust­ed, flu­id, cul­tur­al­ly safe and appro­pri­ate health­care ser­vice that strength­ens healthy lit­er­a­cy is key to pre­vent­ing preterm birth and achiev­ing opti­mal mater­nal outcomes.

“It’s about being in that yarn­ing space, being trust­ed,” says Di

“Trust is the most impor­tant thing… and these RANs are trust­ed, and they’re there all of the time, as unfor­tu­nate­ly, not all ser­vices have access to a mid­wife on the ground.

“We just need to empow­er that trust… that goes some way to pre­vent­ing adverse outcomes.”

Di encour­ages any nurse who has an inter­est in rur­al or remote health to attend a MEC course and expand their tool­box further.

“Once nurs­es have done a MEC, they have the skills to take back to their indi­vid­ual work­ing envi­ron­ments and pro­vide great imme­di­ate ante­na­tal assess­ment and care,” she says.

“We’re not expect­ing RANs to know how to be a mid­wife; we’re just expect­ing them to be able to know what’s nor­mal… and know that it’s okay to not know and to con­sult and refer.”