The smoke which blanketed much of the east coast throughout the Black Summer bushfires resulted in babies being born early and small as well as diseased placentas which looked 'horrifying', one GP said.
NSW-Victorian border-based General practitioner Rebecca McGowan told a senate inquiry into the fires the country needs to implement a nation-wide real-time air quality monitoring system.
"It's groundhog day here," she said. "We are again [coming into] another summer that's predicted to be quite high fire risk... and it's deja vu back [to] 2019.
"What am I going to tell my pregnant patients, that meaningful advice? How do we monitor the weeks or months of inhaled smoke? What do we do?
"We're nearly two years down the track, I don't have any more tools to tell them apart from stay indoors, shut your doors, shut your windows, wear a mask or evacuate. It's pitiful really."
Dr McGowan said during Black Summer smoke shrouded the Albury-Wodonga area for weeks on end, causing her smoke detector to go off so regularly she had to turn it off despite the fact her doors and windows were closed.
The doctor and Country Fire Authority volunteer said she didn't want to distress pregnant women, but had seen first hand smoke's impact on unborn babies.
I know the babies I saw were small, born early and the pictures of the diseased placentas were horrifying.Dr Rebecca McGowan
"I'm frustrated," she told the committee on the lack of a national air quality system.
"I don't know how many more unborn babies that I need to see in my practice... who will be affected and born in April and May with long term health affects of inhaled smoke."
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Dr McGowan said some mothers who gave birth after living Black Summer were told their placentas looked as though they'd smoked a pack of cigarettes a day.
The placentas looked 'small, grainy and very unhealthy looking', Dr McGowan said, and often didn't come away properly as afterbirth.
As a result parts of the placenta were left inside the womb, and the women had to return to have them surgically removed after giving birth.
"I know the babies I saw were small, born early and the pictures of the diseased placentas were horrifying," she said.
The smoke also increased the anxiety of pregnant women and affected people with respiratory issues.
"I don't want to create more alarm and more anxiety for pregnant women but I do want to advocate for clear guidelines as to how we can assist these most vulnerable people when we have another bushfire," Dr McGowan.
Dr McGowan was also concerned about the impact smoke from controlled burns were negatively affecting pregnant women.
Senator Tim Ayres told the committee and Dr McGowan her experience and anecdotal testimony echoed the early conclusions reached by researchers at the Australian National University who were studying the effects of bushfire smoke.
She said ideally, every CFA or fire station in Australia should have an air monitoring system which feeds information back to a centralised app or website so people can access in real time the conditions in their area.
For now, the GP would settle for monitoring systems based in all moderate to large rural communities.
"The national consistency of air quality is urgently needed," she said.
"My community needs clear advice and instruction of what to do according to the measurement of air quality.
"I would like to see a clear and simple system, the GARs principal let's call it, Green Amber Red.
"So in my community we know if it is a green day, we know if it's an amber day, we know if it's a red day according to what the air quality is at the time or perhaps we can piggyback off a system such as is already in place for bushfires - we all know that wheel and the colours or what is already in place for pollen."
Dr McGowan said the country has the technology, but now must act to protect the most vulnerable.