Lost in transition: Perspectives from women and their families living in rural Australia on relocation for specialist maternal and neonatal care.

Problem: Families living in rural communities need to relocate, be transferred or travel long distances to access specialist maternal and neonatal care, leading to isolation from their support networks.
Background: High-risk maternal and neonatal complexities in rural maternity units results in more transfers and retrievals to metropolitan services. There is limited understanding of the physical and psychological impacts for women and their families when they are transferred or displaced from their rural communities during pregnancy.
Aim: To investigate the lived experience of relocation for specialist pregnancy, birthing, postnatal and neonatal care on women and families.
Methods: Women (n=5) and partners (n=4) from rural South Australia, participated in semi-structured interviews on their experiences of transfer from local maternity providers. Couples interviewed together, interactions were recorded, transcribed verbatim and thematically analysed to identify overarching and sub-themes.
Findings: The overarching theme was 'mismatched expectations', with three identified sub-themes: 'communication', 'compassion' and 'safety'. Discrepancies between expectations and realities during relocation left participants feeling isolated, alone and needing to self-advocate during this vulnerable period. Despite receiving specialist care, women and partners encountered unique hardships when separated from their rural community. Their social needs were poorly understood and seldom addressed in specialist units, resulting in poor experiences.
Discussion: Consideration regarding the impact of attending specialist maternity services for women and partners from rural areas is required. The 'one size fits all' approach for maternity care is unrealistic and research is needed to improve the experiences for those uprooted from rural communities for higher levels of care.
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