At 33 weeks pregnant, Lisa Lehtinen cannot sleep at night as she worries about going into labour in her car or alone in a motel room far from home.
Her local maternity unit at Biloela in central Queensland has been on bypass since August, meaning expectant parents have to travel 140km to Rockhampton Hospital to give birth.
The 29-year-old, who has a toddler son, must decide whether to stay in a Rockhampton motel weeks before the birth, drive there closer to the time or present at the Biloela hospital and be transferred.
"I was pregnant during COVID, and this is more stressful," Ms Lehtinen told AAP.
"I had a really quick birth with my first, so giving birth on the side of the road is a legitimate possibility."
There's a good chance her husband would not be able to be present for the birth if it was in Rockhampton, she said.
Ms Lehtinen is among hundredsin rural and regional Australia forced to travel long distances for maternity care and make difficult decisions about childbirth, as workforce shortages set in.
Gladstone Hospital south of Rockhampton has been on maternity bypass for more than six months, while there have been inconsistent services in the last month at Beaudesert Hospital in southern Queensland.
Shrinking maternity care is being felt beyond the Sunshine State with Victoria's Epworth Geelong Maternity, where 600 babies are born per year, set to close in March.
Recent parliamentary inquiries into rural health in NSW and Tasmania heard from families who travelled hundreds of kilometres for maternity care and basic procedures like ultrasounds.
The Rural Doctors Association this week urged state and federal governments to save maternity services, saying rural women and their babies are at risk.
"Enough is enough," association president Megan Belot said.
"These recent examples are sadly the tip of the iceberg when it comes to the continuing erosion of regional and rural birthing services across Australia."
Dr Belot said a national training pathway for rural generalists, who have advanced skills across a range of specialities including obstetrics, should be urgently set up along with more rural placements for junior doctors.
In its October budget, the federal government provided $143.3 million over four years for improved access to health care in country areas, including funding for rural generalists and more training places.
In the shorter-term, the Queensland government said Gladstone Hospital will likely remain on bypass until mid-year until four obstetricians can be recruited.
Health Minister Yvette D'Ath denied the bypass was due to funding cuts.
"It is about a lack of obstetricians nationally right now, and particular challenges at that hospital due to personal circumstances and a range of reasons why other obstetricians who were there had to move on."
Ms Lehtinen said rural families deserve better.
"We're just asking to be able to give birth close to home and I don't think that's too much to ask," she said.
"Everyone in Australia should have access to basic maternity services, and basic health care."