Giving birth to Millie, now four months, while worrying about COVID-19 and living 400 kilometres from a doctor was a stressful time for Bourke mother, Sonya O'Connor.
Although first-born Nate, now two, also born at Dubbo Base Hospital was not as difficult for Mrs O'Connor, a teacher at St Ignatius Parish School, at Bourke, she had to choose caesarian birth to make it safer to get back home and return to work.
"We used to have a [Royal Flying Doctor Service] fly-in midwife coming to see us but because of COVID that got canceled so I went through the whole pregnancy [with Millie] not seeing anyone.
"I didn't know if my baby was okay, I had no prenatal care until I got to Dubbo where I had my first baby scan at 20 weeks."
Even Millie's blue book only recorded she was weighed, checked, and properly assessed only once with a doctor's signature while she was growing in her mother's womb.
Nate was seen by a string of anyone available such as doctors flying in, from the local clinic or hospital and at the Aboriginal Medical Service at Bourke.
Mrs O'Connor said she is envious of her friends living in towns where there is a well-staffed hospital with ready birthing facilities they can choose to labour at home and drive to the nearby hospital instead of potentially giving birth by the roadside.
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Her husband, Brett, a science teacher at Bourke's high school, said he "always has our car fully fueled because you never know there could be an issue one night while the flying doctor might be too busy."
For both pregnancies, Mrs O'Connor said she stayed at the expectant mothers' facilities at Macquarie Home Stay in Dubbo which is a not-for-profit facility for families from towns over 100 kilometres away scheduled to give birth at Dubbo Hospital.
As more families like the O'Connors from remote towns are coming to Dubbo for medical treatments due to the declining number of doctors and health care services in remote towns, the facility is in fact getting smaller for the more than 300 people with various types of illnesses such as cancer that seek an affordable place to stay.
The O'Connors said they need at least $500 in their pockets to stay in Dubbo to see a doctor or they'd simply drive back.
It's more frustrating than a lot of my friends in other towns they can go to birthing suites and labour at home and nest. I never really got a chance to have that nesting place.
Every year, at least 200 expectant mothers and their babies who live more than 100 kilometres away from Dubbo Hospital are accommodated at MHS so the mothers and their babies are safe and well, director Rod Crowfoot said.
The family's experience living in a remote town lacking basic medical services such as maternity care for expecting mothers and their babies was highlighted in the latest report by the Australian Institute of Health and Welfare.
Of the 288,760 babies born in 2019, those born in NSW total 89,163 or 30.9 per cent including those born in remote towns around NSW.
The lack of a range of healthcare for expecting mothers in remote towns also gave rise to pre-term birth (98.6pc) and low birth weight of babies (6.6pc), while caesarian birth is becoming a choice for 36pc of the mothers from remote towns, according to the report.
In the AIHW report released on July 7, an estimated 2897 babies have died of congenital defects, 714 died while still in their mothers' wombs, and 75pc or 2,183 were stillborn which could have been detected much earlier if the mothers received appropriate care during pregnancy.
In the same year, 200 mothers died during pregnancy or within 42 days of the end of pregnancy mainly caused to cardiovascular disease.
Mrs O'Connor said while she was fortunate to have given birth twice, she was hoping health services for mothers in remote towns would improve.
"My second pregnancy with Millie and everything I went through with her was very frustrating and horrible partly because of COVID.
"It's more frustrating than a lot of my friends in other towns they can go to birthing suites and labour at home and nest. I never really got a chance to have that nesting place," Mrs O'Connor said.
Recently, Millie had some complications and the only available doctor on duty at Bourke Hospital was from the Gold Coast in Queensland who could be consulted through Telehealth.
"It's crazy ... my daughter was having respiratory issues so I had sat her on my lap while the doctor zoomed in using a video to look at her breathing...yeah you can look at it but you don't really hear what's going on...I'd be so worried if there is a more serious health issue," Mrs O'Connor said.