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Likelihood of delivery on transfer was not increased with preterm gestation, cervical dilation or other presenting diagnosis. There was not an association of increased number of indications for transfer and likelihood of delivering after transfer. Conclusion:This study suggests that the rural doctor workforce in the Riverland region appears to be well skilled at identifying obstetric emergencies despite the lack of guidance around what constitutes a high risk perinatal situation. Furthermore, this study quantifies the number of women who would potentially require support services associated with rural perinatal transfers from this area. There was a comparatively lower rate of delivery on transfer and, as such, these women eventually delivered their babies either at their hospital of origin or returned to a metropolitan hospital as part of a planned admission for delivery. Further research is needed about the practical implications of transferring pregnant women to tertiary centres and clinical decision-making tools to improve this process.