title: Birthing in rural South Australia: The changing landscape over 20 years.
abstract: OBJECTIVE
  To map trends in the maternity service availability for rural women in South Australia and identify the frequency of women birthing outside of their region of residence.
  
  
  METHODS
  A retrospective review of birth location for rural South Australian women from 1991 to 2010.
  
  
  METHODS
  Rural maternity units in South Australia.
  
  
  METHODS
  Birthing statistics from the Pregnancy Outcomes Statistics Unit in South Australia
  
  
  METHODS
  Rural birth statistics, including place of birth in relation to place of residence and location of maternity units.
  
  
  RESULTS
  Over 60% of maternity units across rural South Australia have closed since 1991. There has been a rise in the percentage of women birthing away from their usual region of residence, rising from 18% in 1991-1995 to 24% in 2006-2010.
  
  
  CONCLUSIONS
  This study has revealed that almost one quarter of all women residing in rural South Australia relocate to another area to give birth. This is a significant concern for rural women and their families through the expectation of separation, and for the local health services who might now not have the facilities and skills to manage an unplanned maternity presentation. These concerns need to be considered and addressed in order to provide safe and effective care for child-bearing women regardless of location.
authors.affiliation: Schools of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Linda P
authors.initials: LP
authors.lastname: Sweet
authors.affiliation: Medicine, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Boon
authors.affiliation: Medicine, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Brinkworth
authors.affiliation: Medicine, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sutton
authors.affiliation: Medicine, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Allison F
authors.initials: AF
authors.lastname: Werner
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D006297:Health Services Accessibility / Q000639:trends*; D006301:Health Services Needs and Demand; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration / Q000639:trends*; D008507:Medically Underserved Area; D011247:Pregnancy; D012189:Retrospective Studies; D019035:Rural Health Services / Q000458:organization & administration / Q000639:trends*; D013021:South Australia; D055815:Young Adult
keywords: maternity care; rural health; rural workforce