Isolated, overwhelmed and hours from a psychologist: regional Australia facing a perinatal health crisis
Getting a psychologist’s appointment in regional Tasmania is difficult. It took Stephanie Trethewey more than a year after the birth of her second child to secure one of the rare slots with the visiting psychologist at a local doctor’s office.
“When I finally got an appointment, I turned up and they’d accidentally booked me under podiatry instead of psychology,” she says.
“I got in the car and I just cried because no one had my back and the system totally let me down.”
Feeling isolated during the perinatal stage of her first born’s life and struggling with postnatal depression, Trethewey started Motherland, a national charity that supports rural mothers. She says perinatal support in rural and regional Australia is “very disjointed”.
“Some women are travelling hours to the nearest birthing hospital and then on top of that we’re sending women home when they’ve just become a mother. Where is the mental health support for that new mum?
“You put a new mum into that scenario where she’s trying to raise a baby, she’s trying to wear all the hats, support her family and they’re dealing with a financial crisis on a farm, for example. It’s very complex.
“I always think ‘thank God I wasn’t a danger to myself’ because when you’re dealing with isolated women, further isolating them by letting them down is a very dangerous game to play.”
Perinatal health refers to the period of time between becoming pregnant and up to a year after giving birth. One in five Australian women suffer perinatal anxiety and depression each year but only 10% actively receive treatment, according to the Parent Infant Research Institute. The risk is higher in regional communities, PIRI states.
Holle O’Donnell, a mother of two lives in Broken Hill. The nearest major city is Adelaide, a six-hour drive across the border. She was unable to get the mental health support she needed after the birth of her second child.
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“I felt like I was spiralling,” she says. “I felt so unwell and didn’t know what was wrong with me at the time. I went to the GP … but she said there just weren’t any services locally that were a good fit.”
O’Donnell believes the lack of support delayed her return to work. In a regional community, where essential service workers are often women with families, being unable to return to work within the first year can have far-reaching effects.
“I’m a nurse and the whole community suffers because you have all those essential jobs sitting there vacant,” she says.
‘We need to stop waiting till we’re at breaking point’
According to a 2023 survey of rural mothers conducted by Motherland, 85% of respondents said feeling lonely or isolated is the hardest part of motherhood and 50% didn’t have access to a mothers’ group.
Trethewey’s charity includes an online mothers’ group for rural parents, which she says offers “a safe place to talk about the hard stuff”.
“We need more funding and more care, but we also need to put more funding into digital services,” she says.
“There’s a disconnection and a lack of awareness of what telehealth services there are, but physically on the ground we also need to do more. I think back to when I was pregnant – no one talked to me about what might lay ahead. We need to stop waiting till we’re at breaking point because it’s just so dangerous, particularly in rural Australia.”
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Campaign director for advocacy group The Parenthood, Maddy Butler, says overlooking maternal health during the perinatal period can have long-term effects.
“A mother who is well supported through the perinatal period will be better placed to raise and nurture her children in a thriving environment,” she says.
Butler says that while becoming a parent is rewarding it can also be isolating, particularly in rural and regional areas. “Some mothers we have spoken to have experienced anxiety and depression during the perinatal period, and have struggled to find adequate supports,” she says. “This adds another layer to the struggle, with the administrative burden of trying – and failing – to find services which can support them through this time.”
New parents are assigned a parent or mother’s group by the hospital where they give birth, often with the local council facilitating to link up parents with babies of the same age. Some groups form strong, long-lasting bonds, but not all gel together and there is no easy way in for people who are on their second or third child, or whose children are slightly older. That’s one of the reasons Melissa Brennan decided to launch her own mother’s group program, called Node Mothers, in Ballarat.
Brennan also plans to open the Node Motherhood centre in Ballarat in October. She says the centre will be a hub for friendship and education and a place for new parents in the regions to find much-needed support.
“Their challenges are often much more pronounced due to the lack of local perinatal services,” Brennan says. “Many are travelling hours just to attend a mothers group or see a specialist, which only adds to their exhaustion. It’s heartbreaking because I know how crucial that sense of community and support is in the early stages of motherhood.”
O’Donnell says while she didn’t experience postpartum depression and had strong family support in place, that sense of community could be lost with the birth of subsequent children.
“That first time you have so many people around you but it wasn’t offered as much the second time,” she says.
For O’Donnell, the hardest part was understanding how to cope with the “unusual feelings in my brain”.
“After chatting with the GP and psychologist, I guess my feelings were validated and I was given some coping mechanisms to help me come out of this ball of stress.”
“It’s not for ever. It’s just for now. I just kept telling myself that.”
