Bourke mother Jade Smith has thanked a NSW Ambulance flight nurse for delivering her baby girl 15,000 feet above Warren.
The birth of Ms Smith's second child, Ameiliah, required a little innovation in the limited cabin space of an Air Ambulance aircraft flown by pilot Ben Hinton
Mid-flight he informed a bewildered traffic control officer that the number of people on board had risen from three to four.
The sky-high delivery was the first for flight nurse and experienced midwife Lynnette Heagney, who has made the completion of a birth certificate for Ameiliah possible.
Ms Heagney recorded the birth occurring at longitude 147.93 and latitude 31.71 SE 136.
The Air Ambulance aircraft was sent to Bourke on Tuesday to transport Ms Smith to Dubbo Hospital.
Ms Smith, 25, woke to labour pains in the early hours of Tuesday, the day her baby was due.
After leaving three-year-old son Lahkeilyn with her mother, Ms Smith went to the Bourke District Hospital which does not offer birthing services.
On arrival in Bourke, the flight nurse consulted with Ms Smith and a Telehealth team before making the decision to move her to Dubbo.
"Given she had been at Bourke (hospital) for quite some time and had been fully dilated for quite some time with no progress, we felt that it was better to start heading towards Dubbo and if the delivery did happen then we would deal with it as it came," she said.
"I moved her because Bourke didn't have what she would have needed if it was an emergency."
The Air Ambulance aircraft took off with the pregnant woman on board at 4.40pm, with one patient becoming two at 5.19pm.
"It was actually one of the nicest deliveries I've done in a very long time," Ms Heagney said.
"Jade did wonderfully. She is a wonderful mother. We worked together through the process."
Ms Smith said her daughter "all of a sudden came along".
"The midwife passed her straight to me and I cut the cord," she said. "I want to thank her for being there and helping me, and delivering my baby, her first baby on a plane."
Ms Smith was to spend a couple of nights in Dubbo Hospital before returning to Bourke where her newborn has been dubbed "plane baby".
"I won't be waiting until nine months next time," she said.