Now that her baby has arrived safely, Nicole McDonald is sure that everything would have been fine if she were delivered at Moree Hospital.
But it didn't feel that way when her waters broke eight weeks and four days before her baby was due, knowing that she had a high risk of haemorrhage, when the baby was in the wrong position and her doctor could not for life nor money arrange her a bed at a major hospital.
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"Dr Woollard was trying to do the best he could to get me out in a rush to help my little girl in an environment where it would be better and we would be safe," Ms McDonald said.
"I knew she was way too early. I was really concerned about my little girl."
While there is a workable transfer network for babies who experience problems after being born in regional hospitals, pregnant women were excluded from the service in 2011.
Doctors can get high level advice on newborn babies by calling a central telephone line known as NETS, which also organises transfers where required.
But if the baby is still in utero, the situation is more complicated.
They are advised to call their local tertiary hospital in the first instance, and failing that a Perinatal Advice Line where midwives can find beds but cannot force hospitals to make them available.
When Ms McDonald, 19, presented to Moree Hospital with complications that required the expertise and facilities of a major hospital, her managing GP Les Woollard had to make eight phone calls to organise a transfer, by which time she missed the flight.
Following the auto-prompts on the advice line, at one point he was transferred to a recorded message.
The only doctor at John Hunter Hospital who would answer his questions was a training obstetrician who had delivered fewer babies than he had, and he eventually had to ring a colleague on holiday.
"The system seriously failed Nicole," Dr Woollard said.
"That lady needed to be transferred out. She had a constellation of things that I will never see again. She could have bled, she had the baby facing the wrong way, she had a cord that was possibly going to come down, she was a potential disaster and I just needed to get her out.
"In 35 years, this was the most appallingly handled transfer case I've ever had."
Rural GPs and obstetricians have long been frustrated over the lack of a maternity transfer system, which was removed from NETS when the obstetricians who staffed the service pulled out because they were not paid and had no medical indemnity.
The Perinatal Advice Line was re-established in 2013, but because it has no transport capability women frequently miss the window of opportunity to be transferred.
Perinatal medicine specialists recommended that maternity transfers be included in the NETS service in a proposal submitted to the NSW Government in August.
The new service would co-ordinate maternal transfer, escalation, referral and advice, with a high risk obstetrician available 24 hours.
This would allow more premature babies to be born in hospitals with neonatal intensive care units, which offer a survival advantage of up to 50 per cent at early gestations.
"Over 10 per cent of very preterm babies are still out-born in NSW, frequently leading to poor outcomes for babies," the document said.
"Often this is because of a delay in decision making around a transfer or because of fear of delivery during transfer."
A Sydney Children's Hospital Network spokeswoman said in a statement that the Perinatal Advice Line was frequently used and effective.
"While we cannot comment on an individual case at this time, consideration has been given recently to further improve this service and it is under constant review by the Pregnancy and newborn Services Network (PSN)," the statement said.
"A submission has been made including a number of improvement strategies. This submission has been received and is currently under evaluation."
Dr Woollard had hoped a plane due to transfer a burns patient to Sydney would be able to transfer Ms McDonald to John Hunter Hospital, but in the hour it took him to organise the bed the plane departed and he was told there could be no transport until 7am the next morning.
Fortunately, the pilot had a change of heart and returned to pick her up.
Nicole McDonald gave birth to Mirrii Spearim by caesarean section at John Hunter Hospital on October 21. Mirrii weighed 1.6 kilograms.
Have you had problems being transferred while pregnant? Contact halexander@smh.com.au