Australian Midwives

by Paula Heelan

  It concerned Genevieve whenever she had to put a pregnant woman on an aircraft because it is never ideal for a baby to birth in the back of a plane. ‘We always carefully assess women before airlifting them to find out exactly where they are at. If a birth seemed imminent, we’d stay and birth the baby there.’

  With her children still young and casual flight-nurse work scarce, Genevieve began work in domiciliary midwifery in Kalgoorlie. ‘When women were discharged from hospital early with their babies, the midwives would visit them in their homes for postnatal care. With the support of a wonderful obstetrician /gynaecologist who was open to new ideas and different ways of working, we began a midwifery group practice. He brought pregnancy hand-held records to Kalgoorlie, which meant women could go anywhere, interstate or to other care providers, with their own pregnancy record. As part of the midwifery team, I made house calls for postnatal and baby checks. When I had Jonathan and Courtney, the community health nurse came to visit me and it was fantastic. It worked both ways – we would sometimes go to her. In mining communities there are not a lot of older women around to help young mums. For most young couples, their parents are interstate – like ours were. So it was nice to have a nurse come to your home to care for and support you. In remote communities, everyone looks after each other.’

  After more than six years in Kalgoorlie, Genevieve’s family moved back to Adelaide. ‘This time it was Andrew that didn’t want to leave, but Jonathan was nearly five, and I was keen for the children to get to know their grandparents and relatives and go to school in Adelaide. After lots of discussion we made the move. I found work with Ashford Agency which was part of the Adelaide Community Healthcare Alliance Group. They placed me mainly in the midwifery unit. I did a fair bit of postnatal work and some in labour and birthing. Since delivering my own children and having gone through some of my own trials and tribulations, I focused more on helping mothers with breastfeeding and managing their new babies. It was a very satisfying time in my career, and to my delight a lot of the girls I’d trained with back in the eighties were there with me.’

  Work at the agency was wonderful, with flexible hours when Genevieve had a young family. ‘If one of my own children got sick, I could call in and the management would say, Okay, no worries, we’ll find someone else to fill that shift. End of story. Their support was so much appreciated and very, very refreshing.’

  When the agency closed in 2002, Genevieve returned to work with the RFDS at Central Operations as a flight nurse and midwife. Andrew got a job with TAFE and was based at home, so Genevieve was able to go back to flying. ‘If I had a long shift or got stuck somewhere because of the weather, Andrew would be with the kids or sometimes they’d be with Family Day Care. When he was old enough, I used to get telephone calls at 10,000 feet from Jonathan saying, Mum, where are you? When are you coming home? He liked to know where I was and what I was doing. He was always, and still is, good at tracking me down.’

  At times Genevieve relieved at the Port Augusta and Alice Springs bases and Andrew and the children would come along and experience the different areas of work. However, Genevieve stopped flying when her daughter started to cry every time her mum went out in bad weather. ‘Courtney knew we were in a single-engine aircraft,’ Genevieve says. ‘She was afraid I wouldn’t come home safely. Also, Central Operations wasn’t the same as it had been when we were in Kalgoorlie. In Kalgoorlie the kids called the pilots “uncle” and were really involved in everything that was happening. We were like one big family. In Adelaide it’s bigger and understandably more formal.’

  Genevieve left at the end of 2007, and based on her experience in organising air transport for country patients, got a position at the Royal Adelaide as a rural liaison clinical practice consultant.

  In 2009 Genevieve began an honours degree in nursing to research how flight nurses maintain their midwifery skills in order to deliver best care to pregnant and labouring women. ‘It was a focus of mine at the time – to increase support for flight nurses to maintain and build their skill base. Women deserve the best possible care and those providing it need to be confident and competent.’

  Genevieve’s studies revealed barriers for flight nurses when it came to maintaining their skill base. ‘But to the credit of a number of RFDS operating sections, they took up my suggestions,’ she says. ‘They now ensure flight nurses are supported in maintaining their midwifery skills and have recently run a program with flight nurses in conjunction with the University of South Australia.’

  When Genevieve completed her honours degree she moved into the university sector. ‘For the last five years, I’ve lectured across the undergraduate nursing curriculum – first to third years. I don’t think I’ve ever worked so hard as I have at the university; the expectations are huge,’ she says. ‘There’s research to undergo, papers to be written, grant applying, group meetings and admin duties – on top of teaching.’

  Genevieve is now on leave without pay and halfway through her PhD. ‘I’m exploring the way flight nurses work in Australia and New Zealand. Currently, flight nurses are largely invisible. When I first started my honours degree, to my amazement I discovered that most academics in many disciplines had no idea that 85 to 95 per cent of the time it is a flight nurse in the back of the aircraft working alone. Like most people, they assumed a doctor was on board. They didn’t know a doctor only joined the flight nurse around five to ten per cent of the time. Also there is very little written about flight nursing.’

  Genevieve wants to make sure the general public is aware that most of the time patients retrieved by an aeromedical service are being cared for by a flight nurse. ‘If they need a doctor, one will be there,’ she says. ‘But nine times out of ten it’s a flight nurse that has assessed the patient and made the decision about whether and which other health professionals need to be brought in. My aim is also to increase the presence of flight nurses in the peer-reviewed literature and to increase recognition and support for the work they do among their health professional colleagues. I’m not flying anymore. Those that are flying are flat out working long shifts and saving lives. I’m doing it for them. After my PhD is completed, I’d like to focus my work in a number of areas that will help people in rural and remote areas to make sure they’re not forgotten when it comes to access to quality medical services. And of course, I’ll always keep a focus on the aeromedical system because that’s the glue that holds it all together.’

  THE MIDWIVES – BRIEF PROFILES

  Wendy Agars, Cairns, Queensland

  At twenty-three years of age Wendy Agars boarded a Qantas jumbo jet and flew to the United Kingdom to train in midwifery at the Edinburgh Royal Infirmary, where she lived in the Florence Nightingale nurses’ home. Leaving her home and family in Adelaide, Wendy was filled with misgivings about what might lie ahead. But her bold decision sparked her sense of adventure, desire to travel and extraordinary career in midwifery. From the old-fashioned training ground in Scotland she accepted a job at Royal Darwin Hospital and moved to the Northern Territory. And before the end of the year Wendy answered a call for midwives to work in East Arnhem Land. With sought-after midwifery skills and a patient, easy-going nature, Wendy has worked in myriad outback areas as a flight nurse and midwife with the Northern Territory Aerial Medical Service. She currently works with both the Royal Flying Doctor Service (Cairns) and the Cairns Hospital in maternity. In places of extremes, the work is hot, dusty and exciting. And for Wendy, the experience of working as a midwife in remote communities is unmatched.

  Catherine (Kate) Austin, Queensland

  Kate Austin’s extraordinary career as a midwife has seen her work in rural and remote areas from country Victoria to the Northern Territory. Tasked to focus on midwifery in remote Indigenous communities for three- to six-week stints, Kate has worked in small community clinics at Groote Eylandt in the Gulf of Carpentaria, Croker Island, Douglas Daly District, Maningrida, and Milingimbi Island in the Northern Territory and Lajamanu at Hooker Creek S
tation in the western Tanami Desert. Aware of just how short of midwives remote communities are, Kate is passionate about her work. Almost always the sole midwife on duty, she is on call 24/7 for childbearing women and new mothers. Kate is involved with a program called Strong Women, Strong Baby, Strong Culture where she works alongside community ‘strong women’. Kate strives to provide the best outcomes, health and wellbeing for local women and their babies.

  Olivia Bigham, Hobart, Tasmania

  Olivia Bigham has worked as a nurse and midwife worldwide. Based in Hobart, Olivia has volunteered on the floating hospital the Africa Mercy in Cotonou, Benin on the west coast of Africa, in Ugunja in Western Kenya, and in the Philippines. Olivia has worked at hospitals in Tasmania and Victoria and as a flight nurse and midwife for CareFlight in Darwin. Now back in Tasmania at the Hobart Private Hospital, Olivia has helped birth more than 100 babies. Despite enjoying midwifery work in Tasmania again and spending time with her close family and friends, her thirst for adventure hasn’t let up. A friend runs a maternity hospital on the Tanzanian–Kenyan border, so it might not be long before Olivia heads off again.

  Genevieve Brideson, Adelaide, South Australia

  Not having lived in the country before, let alone the outback, it was a culture shock for Genevieve Brideson when she and her husband Andrew left Adelaide, South Australia to work in Broken Hill in far western New South Wales. But the hauntingly beautiful desert-fringed country with intense blue skies grew on Genevieve and helped prepare her for a move to Alice Springs, where she became a midwife. Genevieve’s next move was to Kalgoorlie in Western Australia where she joined the RFDS as a flight nurse and midwife and where she also had her two children with the support of a midwife and in-home care. Returning to Adelaide so the children could spend more time with extended family, Genevieve worked in the midwifery unit of the Ashford Agency. In 2002, when the agency closed, she returned to work with the RFDS. Determined to increase recognition and support for the work flight nurses and midwives do, Genevieve is now completing a PhD exploring the way flight nurses work with the aim to improve health care for people in rural and remote areas.

  Chloe Coker, Adelaide, South Australia

  Chloe Coker, now 31, grew up on a farm near Port Macquarie, New South Wales. Energetic, gregarious and a natural frontrunner, Chloe was surprised to find she enjoyed the harshness and isolation of remote communities. Initially Chloe went to Wadeye in the Northern Territory for a two-month stint to provide relief coverage for the Christmas period and into the New Year of 2009. This first remote community work placement turned out to be Chloe’s calling. Embracing the challenge, she went on to work for the next six years in many remote areas throughout Australia. Connecting easily with the Indigenous women under her care and their families, Chloe spends as much time as she can with them, including visits to homelands. With a strong interest in Aboriginal culture, Chloe learns the language and customs and builds trust with the people in the communities she works in. Recently, Chloe began work with the RFDS in Adelaide, where she continues to provide care to women from rural and isolated areas as a midwife and nurse.

  Pia Croft, Geelong, Victoria

  Pia Croft’s passion for midwifery stems from her childhood in Nuremberg, Germany. She grew up in a home constantly busy with birth, babies and breastfeeding, enthusiastically minding babies and toddlers, and she loved it. At fifteen years of age Pia met Australian-born Chris, a soldier with the US Army based in Nuremberg. The two married in 1994, moved to Australia in 2000 and now have five children. Having yearned to become a midwife for as long as she could remember, Pia juggled training, work and small children to graduate in 2008 with a nursing and midwifery degree. Today she works independently through The Birth House in Geelong, Victoria. Pia assists women to bring babies into the world without medical intervention where possible and has a busy schedule of antenatal and postnatal care.

  Gayle Donaldson, Central Queensland

  Gayle Donaldson lives on a 20,500 hectare family-owned cattle station, Medway, west of Emerald in central Queensland – just below the ridge of the Great Dividing Range. Gayle works at the tiny Alpha Hospital, an hour’s drive from Medway Station. Since marrying her husband Rob, she has travelled to work along a lonely bush road, often with one or all of her four children in tow. Living in an isolated area, Gayle and Rob’s children – two girls and twin boys – learned through distance education before leaving home for boarding school to complete secondary and tertiary studies. For the love of work and midwifery, and often during floods, fires or drought, Gayle continues to ingeniously juggle children, farm duties, long-distance travel, distance education and babies.

  Mark Holmes, Sydney, New South Wales

  Born and raised in the small rural town of Clermont in central Queensland, Mark Holmes, now 33, was the 110th male midwife to register in Queensland. His extensive career in midwifery has seen him train in Edinburgh, Scotland, before working at Cairns Hospital in Far North Queensland, and then returning to Clermont for a twelve-month stint in his close-knit community. In 2009 he landed a job with NSW Ambulance as a flight nurse and midwife based in Sydney, flying into rural and remote areas. It was the job he’d been hankering for since he’d experienced his own aeromedical transfer to a tertiary hospital when he was ten years old and living in the bush. Upbeat, highly skilled and compassionate, Mark is aware of the gender difference in a female-dominated job. To counteract this he goes out of his way to build trusting relationships with the women in his care.

  Jo Hunter, Blue Mountains, New South Wales

  Jo Hunter has worked with new families since 1990. Jo worked first as a mothercraft nurse in the UK, then as a birth and postnatal doula and childbirth educator. Today Jo is a midwife in private practice supporting families who choose to birth at home. She lives with her husband and four children in the Blue Mountains, which has the second-highest homebirth rate per capita in NSW (after Byron Bay). Her first daughter was born in water at a birth centre in Sydney and her following three were born at home. Jo’s passion is to support women who strive to achieve a natural birth. With a caseload of two to four women birthing per month Jo works full-time to provide care in the woman’s home. With her warm and assuring nature, Jo has a gift when it comes to connecting with and responding to pregnant women. She wholeheartedly advocates for one-to-one midwifery care and says women feel safe when their midwife is self-assured and has the competence to support their choices in whatever setting they choose to birth.

  Lane Johnson, Darwin, Northern Territory

  Lane had longed to become a flight nurse ever since she saw a RFDS stand at the Sydney Royal Easter Show. That was it. That was her dream. At 25 years of age she landed a job as a nurse and midwife with CareFlight Darwin. Funny, expressive and extremely competent in her work, she is known among her colleagues as a disaster magnet. Lane has faced and coped with several medical emergencies while on her own in the back of a small plane. But working alongside exceptional bush pilots, she makes a vital difference to the lives of women and families living in remote communities in the Northern Territory. Despite the challenges of extreme weather, distance and limited medical resources, she loves every minute of her midwifery job.

  Marg McDonald-Ashe, South Australia

  Marg McDonald-Ashe is a mobile family health nurse and midwife with Remote and Isolated Children’s Exercise (RICE). Going by four-wheel drive, often travelling alone, she brings child health care and antenatal and postnatal care to women living on outback cattle stations in South Australia. Her visits might include checks for a C-section wound, mastitis or breastfeeding problems or help for someone suffering from postnatal depression. In desert country, coloured by stony, red earth and wildflowers, she traverses places like Mannahill, Broken Hill, Birdsville, Oodnadatta, Strzelecki Track, Marree, the Flinders Ranges and along the edge of the Lake Eyre basin. Throughout her career Marg has worked as a midwife in rural and remote areas, including Aboriginal communities in Central Australia and country hospital
s in the United Kingdom and Canada. Recently acknowledged for her health work in the outback, Marg exemplifies the pioneering work people still do in the bush. With limited resources, she does the hard yards in extreme country – and she is deeply appreciated by women in the outback, who are aware of her determination to help and her exceptional midwifery skills.

  Joy Motter, Fitzroy Crossing, Western Australia

  At 72, Joy Motter is a retired midwife living in Badgingarra, WA. In 1968, at 24 years of age, Joy made her way from country Victoria to the Fitzroy Crossing Hospital in the Kimberley region of Western Australia, unfazed by the unknown, for the start of an extraordinary life adventure. When Joy married a local stockman, Jim, she moved to a one-million-acre cattle station where she became nurse and midwife for more than 60 workers and their families living on the property. Without electricity, TV, air conditioning or even a telephone, the only communication was by radio through the RFDS. Travel in the wet season was by plane only and in the build-up it was hot, sticky and fraught with insect explosions. Despite the challenges of isolation Joy warmed to the Crossing the minute she arrived. With a practical, determined and tireless nature, she rolled up her sleeves and got on with the job. Through years of working in extremely harsh conditions, Joy dealt with both difficult and joyous midwifery cases for the mostly Indigenous women under her care. Cherished by everyone who knew her, she knew how to balance the fine line of being an active local and keeping a professional distance when she was needed instead as a trusted and confidential health professional.

  Lisa Peberdy, Queensland

  Lisa Peberdy grew up on Queensland’s Sunshine Coast. She has worked as a midwife in rural and remote areas across Western Australia, the Northern Territory and Queensland, and in 1999 she volunteered to assist in East Timor in the wake of the humanitarian and security crisis. Working out of Thursday Island Hospital, Lisa flew regularly to the outer islands in the Torres Strait archipelago to provide health care. From Mount Isa, Lisa ran outreach clinics across the Queensland Gulf region in conjunction with the RFDS. With a strong understanding of the challenges women in remote areas face, Lisa has driven long distances in a jam-packed LandCruiser, mostly on her own, to far-flung locations, working in very basic conditions – but with her quirky sense of humour and sunny disposition, that has never discouraged her. Lisa’s stand-out skills as a midwife and her determined nature make a difference to the lives of many women living in isolated areas.