“I see myself as an advo­cate for flex­i­ble and holis­tic care,” says Don­na Stephen, who works in remote com­mu­ni­ties in the West Kim­ber­ley region for the Kim­ber­ley Abo­rig­i­nal Med­ical Ser­vice (KAMS).

“Am I a dri­ver, a social work­er, a cook? I’m all that and more,” says Don­na who reck­ons the ever-adapt­ing role of Remote Area Mid­wife suits her per­son­al­i­ty perfectly.

“I think I’ve got the best job. Every day for me is a unique jour­ney and holis­tic care, cre­at­ing a sup­port­ive net­work for fam­i­lies, can mean many things.

“It includes health edu­ca­tion and health pro­mo­tion in the com­mu­ni­ty as well as pro­vid­ing health ser­vices. It’s speak­ing to a preg­nant mum who may also ask about skin sores or oth­er health issues for her oth­er chil­dren; it means giv­ing med­ical advice and sup­port beyond the issues revolv­ing around preg­nan­cy, ante­na­tal and post­na­tal care.

“When­ev­er I can, I attend com­mu­ni­ty events to get to know the fam­i­lies, like sports car­ni­vals and health pro­mo­tion days at school. Com­mu­ni­ty engage­ment is 100 per cent impor­tant. That can also be spend­ing time with groups of women, cook­ing a cur­ry, putting on face packs.”

Don­na is based in Broome and her cur­rent job sees her reg­u­lar­ly fly 180 kilo­me­tres south to the Abo­rig­i­nal com­mu­ni­ty of Bidyadan­ga, and dri­ve north out to Bea­gle Bay, meet­ing women in the com­mu­ni­ties on a reg­u­lar basis, col­lab­o­rat­ing close­ly with health work­ers at the local clin­ics and oth­er health­care providers, and involv­ing com­mu­ni­ty resources.

“Dai­ly life is dif­fer­ent each day,” she says. ​“KAMS doesn’t have strict rules about time spent with each patient and this flex­i­bil­i­ty allows me to pri­ori­tise my work to suit each patient’s needs and cater for the num­ber of patients I see on any par­tic­u­lar day, which can vary widely.”

Donna’s career as a mid­wife began at 30, when she said to her­self: ​‘What am I doing with my life?’ Before that, she worked in banks, work­ing her way through the ranks from teller at 20 to bank manager.

“Once I had my first son, I realised what an hon­our it was to be a mid­wife, to be help­ing women at such an impor­tant time in their life,” she says. Don­na has now been nurs­ing for 20 years.

After com­plet­ing her nurs­ing and mid­wifery train­ing, Don­na, her hus­band and two young sons set off on a trip around Aus­tralia and, in those 15 months, Don­na got oppor­tu­ni­ties to work as a nurse/​midwife in places like Kal­go­or­lie and Der­by in West­ern Aus­tralia and also in Queensland.

Back in Perth, Don­na worked for a mul­ti­cul­tur­al NGO focus­ing on migrants and refugees. The fam­i­ly always want­ed to live in the coun­try, how­ev­er, and when her hus­band got a job trans­fer to Broome ​“we thought we were the luck­i­est peo­ple on earth,” she says.

The fam­i­ly has lived in Broome for just over 12 years, and Don­na has worked for KAMS for eleven of these in var­i­ous roles – region­al coor­di­na­tor, research and child health nurse – and has vis­it­ed and worked in many of the clin­ics in the Kim­ber­ley region.

“We talk about holis­tic care all the time in the health indus­try,” says Don­na. ​“Mid­wives know how ben­e­fi­cial it is, and we all want to pro­vide it. It’s not always easy but here, there’s no ques­tion of tick­ing box­es or lip ser­vice to the concept.”

The KAMS mid­wifery mod­el also pro­motes con­ti­nu­ity of care, and Don­na reg­u­lar­ly meets her patients from ear­ly preg­nan­cy through to 36-weeks ges­ta­tion. At the 36-week point, the women trav­el to either Broome or Perth to pre­pare to give birth. Don­na then has them back again with­in days of birth through to eight weeks post­na­tal (and often beyond).

This goes a long way to help the mid­wife gain a deep under­stand­ing of indi­vid­ual needs and ​“it’s well recog­nised that con­ti­nu­ity of care improves health out­comes for moth­ers and babies,” she points out.

Donna’s dream is to bridge the con­ti­nu­ity gap when the moth­ers go to the hos­pi­tal, to enable remote mid­wives to attend to women in the birthing suite. But she acknowl­edges that there are bar­ri­ers and hur­dles to achieve it.

“Research shows that con­ti­nu­ity of care is a good thing: with sta­tis­tics show­ing, for exam­ple, that it results in low­er lev­els of cae­sare­an births. 

Don­na sees that bridg­ing that gap would also ben­e­fit mid­wives in remote com­mu­ni­ties, enabling them to keep up their birthing suite skills. She would also like to see stu­dent mid­wives get­ting more train­ing in ante­na­tal care.

In the mean­time, as she con­tin­ues to advo­cate for change, Don­na spends her time sup­port­ing her expec­tant moth­ers and con­tin­u­al­ly look­ing to improve on the service.