David Lemoine of Swan’s Island was a bit concerned when his wife went into labor with their first child.

“We weren’t really expecting it for a week or two,” he said.

Many first-time fathers fret when labor begins, but Lemoine’s worry was unique. His wife would have to travel by ferry to the mainland hospital and he thought there was too much ice for the ferry to dock.

He says his wife didn’t share his anxieties.

“She was very casual about it, but everyone else was worried,” he said.

The ferry made it to the island and took the Lemoines across the water. Lemoine joked during the voyage that if their daughter were born en route, she might be granted fishing rights to Bass Harbor. They arrived at the hospital at 10:45, and their baby was born within an hour.

Expecting islanders must grapple with both ferry schedules and rough seas while planning for birth. While some islands have monthly medical clinics, most prenatal and obstetric care can only be obtained on the mainland. So in addition to the usual upheaval that occurs in the nine months leading up to birth, pregnant islanders must also juggle frequent and costly overnight trips to the mainland for checkups.

And as the due date approaches, many elect to stay on the mainland rather than risk braving the ferry schedule or rough seas when the time comes.

Until recently, Samantha Sawyer lived year-round on Frenchboro Island. Yet she spent much of the third trimesters of her two pregnancies on the mainland.

She was confined to bed for the last ten weeks of her first pregnancy. During that time, she stayed at her husband’s grandparents’ house on Mount Desert Island. Her then-husband Chris was forced to divide his time between maintaining their home on the island, fishing and visiting her.

“My husband transferred back and forth,” she said.

Their first child, a healthy boy, held out to full term. Within the year, Sawyer found herself pregnant again. The doctors said they didn’t expect any problems with this pregnancy, but she and her husband decided to plan for complications just in case.

“Me and Chris were kind of leery of it,” she said.

They rented a house off-island for the month of her due date. It turned out to be a smart move because Sawyer was again confined to bed. Her daughter was born prematurely.

“My daughter was pretty sickly, and still is,” she said.

Sawyer stayed on the mainland after birth and began a long daily commute from Hull’s Cove to the Bangor hospital to visit her daughter.

While Sawyer’s case may be extreme, Nurse Sharon Daley of the Maine Sea Coast Mission says the frequent prenatal medical commutes come at a time when most islanders would rather stay close to home.

“The island is probably where they feel safest,” she said.

The Mission’s medical ship, SUNBEAM, is wired with a video link to allow medical teleconferences between mainland doctors and island patients. Expecting mothers can talk face-to-face with doctors via satellite.

“All of this would save 24 to 36 hours or more,” said Rev. Rob Benson, the ship’s pastor.

The teleconference technology can even provide islanders with access to medical specialists all over the United States, if need be. Meanwhile, Nurse Daley can take vital signs and do any lab work necessary. Rev. Benson says their program tries to combine high-tech with the human touch.

A few islanders have found a low-tech and age-old alternative to the birth commute by choosing to give birth at home.

Christine Dentremont opted for a home birth on Swan’s Island. While the majority of her prenatal visits were still on the mainland, Christine enjoyed the luxury of staying on Swan’s in the final weeks of her pregnancy. Her midwives came to her.

She says that while her family and friends were leery of her home birth plans, it wasn’t giving birth on Swan’s that was the main concern.

“It was more the difference between hospital and home,” she said.

Her midwives gave her husband some material to study, just in case.

“It was kind of like a cheat sheet of what to do if labor progresses quickly,” she said.

When Dentremont began labor the ferry service was done for the night, so she sent a friend with a lobster boat to pick up her midwives. It was a new moon, pitch black- and foggy.

Pam Dyer Stuart, one of the midwives, remembers standing at the Bass Harbor dock in thick fog, waiting for someone she had never met to pick her up in a lobster boat.

“Out of the fog it materialized,” Stuart said.