A remote area pregnancy – pregnant with twins

remote area pregnancy twins

Author:  Jess Webster

The realities of having a remote area pregnancy means I’m writing this to you from a motel room, hundreds and hundreds of kilometres from my home, my husband and my children.  I am about to miss my daughters first ever day at school because I’m waiting forever away, in another state. Had this been a single baby, I would have been home still, however because it’s twins I had to come into town early. So here I am.

Don’t get me wrong, I’m not complaining. I love where I live and I feel so blessed to be having twins, it’s just some of the logistics are less than ideal. It starts with something simple like finding out if in fact you are even pregnant. We don’t have a grocery store, let alone a pharmacy. I had been having pregnancy symptoms for nearly two weeks and was well past due on my period before I was able to get into town to grab a simple pee stick. It wasn’t a case of just running up the road and grabbing every box of them that you can find, and testing daily until you see those 2 lines.

About my “local” hospital

In my town, we have what we colloquially call The Hospital but in reality it’s a small clinic, staffed by 3 registered nurses, Monday to Friday, 8:30 to 5. Zero inpatient facilities and minimal outpatient facilities. It’s basically there for emergencies, to assess you to see if you can just go back home or if the Royal Flying Doctors need to fly in and take you elsewhere. The Flying Doctors also send in a GP twice a week for a few hours. This is the entire extent of our medical facilities. It’s usually enough. Enough for the towns needs. However, upon finding out at 7 weeks that I am suddenly blessed with an automatic high risk pregnancy, a lot of questions came up.

I started bleeding, and it was a nine hour drive to hospital.  This is one of the issues with a remote area pregnancy.

I was diagnosed quite early on, even before I knew there were two, with hyperemesis. I was able to attend our clinic to have fluids and ondansetron given through IV, and see a GP about obtaining a script for Maxalon and Ondansetron wafers. The script, which gets faxed off to town and you wait for your medication to come in one day on the town delivery truck. I had a horrible reaction to the Maxalon but for the most part, my sickness was well managed at home. It’s when I started bleeding that I found my first little obstacle in care.

I was 9 weeks along when I started bleeding some brown sticky blood. Because it was brown I tried not to worry and just hoped it would go away. After a few days of it, it suddenly turned bright red, had clots and was accompanied by pretty painful cramps. I went up to our clinic but of course there was nothing they could do. No hospital could at that gestation, but the lack of ability to get a scan for some closure was horrible. I went back home and by the next day, it looked brown again.

A few days later again, so about a week and a half since the first brown bleeding, the bright red blood came back. My husband, seeing me distressed, decided to take me to hospital. Leaving at 3:30am and reaching the hospital mid-morning. A medium sized subchorionic hematoma was found, but the babies were okay. I was sent home to rest until the bleeding stopped.

All was travelling smoothly and we started seeing the obstetrician monthly.

We were also on monthly scans almost immediately. I am having DCDA twins so it’s not the most dangerous for twins, and I have a good obstetric history, 4 single pregnancies with no complications, so my OB was confident that a good care plan could be maintained despite my distance from her. Everything progressed as it should. A few false anomalies in growth scans, leading to additional scans but that’s about it. All sorted out.

That is, until the 23rd of December. I had noticed a decrease in movements from my Twin A. His placenta is anterior and he was always the more quiet one anyway so I assumed I just hadn’t noticed his movements because I had been busy all day continued about my day with the intent to sit down and feel his movements at 10:30pm. He woke up at that time every day without fail. I sat down and tried all of the usual tricks to rouse him. Cold water, ice blocks, jogging on the spot and star jumps, poking and moving him around. No response.

My husband was at work, on night shift, the second part of a double shift.

I spoke to him and he said to call up the clinic. After they close, there is an oncall number as one nurse is always on call for emergencies. This was now two hours of deliberately trying to wake the baby with no luck. I phone the nurse who just gave me the number for the Flying Doctors and hung up. Without going into too much detail, I contacted the Flying Doctors however, no doctor was available and it took another 2 hours for one to phone me back, and I was given a “wait and see” response.

Not being satisfied with that response, because to me reduced movements is the number one thing to go get check for, my husband rang the hospital for me. I was in tears by now so he called on my behalf and they stated I needed to attend hospital immediately. So at 2:30 in the morning, he called his boss to come in and cover him so we could drive to the hospital. By the time we dropped the kids off with my mother-in-law, it was 3am and we headed off.

The road to the hospital

Now is probably an appropriate time to describe what the road to hospital, which is also just across the road from my OBs office and the ultrasound place, consists of. It’s a mixture of tar and dirt roads.  400kms of openness and zero phone reception. It’s littered with literally hundreds of kangaroos, sheep, cows, goats and emus. This is what we were driving along to get to the hospital. We finally arrived at the hospital at 7:40 in the morning. So that’s over 7 hours between my first phone call, and receiving face-to-face medical care.

I was put on a CTG trace and had an ultrasound. Everything was fine phew but for some reason, even when we could see him kicking, I couldn’t feel a thing. Given that it was now Christmas Eve morning, they released me so I could be with my family for Christmas however, I was to return in a few days for another trace. So we left, trekked the 4.5 hours back home, both having not slept for more than 36 hours and that was that.

Another 9 hour round trip on the 28th to confirm that little boy was still doing well. My visits got bumped up to weekly, so by this stage in pregnancy, I would take 4 or 5 days to fully recover from the drive, only to have to do it all again a couple of days later. My feet and legs were permanently swollen and it started to feel like I had a broken tailbone just from sitting for so long.

I finally make it to 34 weeks.

At the wonderful stage where I get to move to town to wait for the babies arrival. It was pointless to move before . I would have to be flown elsewhere anyway, due to no NICU available here as even this is still a country town. So I am relieved to have the hospital close by, and I am thankful I get to escape the housework but I miss my bed. I miss my children and they miss me. I miss having my husband nearby to rely on.

I’m thankful now though, that if I’m curious about something that’s happening with my body and the babies, I can just pop into hospital. It’s hard to make the call of “do I go in or not” when you know there is a plane or a 9 hour drive involved. Take that feeling most pregnant women get, about not wanting to be a nuisance and times it by 10. So I’m glad I’ve passed that stage.

The realities of having a remote area pregnancy means we have to wonder will my husband make it in time?

I’m now just shy of 36 weeks. I have 10 sleeps left until my induction date which I am desperately hoping I make it to. I’ve had 4 previous babies. The first labour was 12 hours long due to a bit of a problem with his position however the subsequent ones were between 3-5 hours long. Let’s do the math. If I go into labour spontaneously, the chances of my husband making it here in time are….



Note from Twinfo:  Jess has very kindly update us with her birth story, which you can find HERE






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