Having a baby is stressful enough, so imagine preparing to give birth during a cyclone.
In 2010 Proserpine woman Michelle Hughes was days away from her scheduled caesarean section when a category three cyclone crossed the coast.
"I could hear debris and things flying around," she said.
"I was terrified of something falling on us, on the house.
"I was scared, absolutely scared about everything that was going on.
"You can feel all of those emotions running through your body and you do think, 'I need to calm down because I didn't want to go into labour early in the middle of a cyclone' — because obviously that is quite terrifying."
After being told it would be dangerous to go into natural labour, Ms Hughes mustered all her strength and tried to remain calm.
"I was saying, 'Stay in there baby, stay in there — don't try to come out yet,'" she said.
More hurdles at hospital
Cyclone Ului left about 50,000 homes without power, including the Hughes's property.
"Living rurally without power we had no water, so we had to fill up bottles of water from the tank," Ms Hughes said.
"I only had to live for a day in that situation before we went into the hospital for our scheduled birth."
Ms Hughes's husband and her dad had to cut a path through fallen trees to get to the hospital — but the stress did not stop there.
With many of the doctors on call for the cyclone and the hospital reliant on generator power, staff asked Ms Hughes to delay the birth.
"It's a lot of mental preparation to get there to that point in time," she said.
"Lot of hormones and emotions — I just broke down in tears.
"They could see what an emotional toll that had taken on me.
"They ended up coming back saying, 'OK, we can do it'."
Just after 10:30am on March 22, a day after the cyclone, Madeline was born.
"I was relieved that she was here," Ms Hughes said.
"Relieved she was OK and she was healthy."
'Higher odds' of poor outcomes
Ms Hughes is one of a number of participants who have contributed to a study looking at the experiences of women during cyclones.
The research, led by the Australian National University, found areas impacted by the natural disaster had a significantly higher risk of a preterm birth and low birth weights.
"When thinking about Cyclone Marcia [in 2015], specifically, we were seeing that women were almost twice as likely to have a low birth-weight birth in affected areas than unaffected areas," lead researcher Cynthia Parayiwa said.
The research, which has been published in the Australian and New Zealand Journal of Public Health, considered 600,000 birth records from 2007 and 2018 and focused on major tropical cyclones Yasi, Marcia and Debbie.
"What we were able to find, which was really interesting, is that women who are estimated to be in the earliest stages of pregnancy based on the month of their birth of their baby's birth, had significantly higher odds of having a preterm birth across all three cyclone events," Ms Parayiwa said.
Ms Parayiwa said the stress associated with these events and the difficulties in accessing adequate food and water in the days after a disaster may have contributed to the outcomes.
"Something that can happen, especially with cyclones and more remote communities, is being cut off," she said.
"If mothers aren't adequately prepared for that, that can lead to changes in the diet that can flow on to fetal growth."
With the increasing risk of disasters due to climate change, the researchers hope their work will help better inform policies going forward.
"It's something that is really important for us to note that in disaster risk management women at all stages of pregnancy are quite vulnerable and something that we need to make sure we're not overlooking," she said.
Ms Parayiwa hopes increased understanding of the experiences of expecting women will also improve pregnancy care guidelines and the information and resources available.
"I'm really hoping this kind of research will help women feel more in control of the situation if they find themselves pregnant during a disaster," she said.
