So you’re pregnant. Let’s talk care options?
Image my Jessica Prescott
“Knowing the lay of the land could completely change the outcome of your birth. Women don’t realise there are so many care options for birth and that continuity of care doesn’t just look like a homebirth or private ob. It can be a combination of everything - you just have to be clever.”
Understanding your options for pregnancy and childbirth is a crucial part of the journey. In Australia, we’re fortunate to have a diverse range of care providers to support us throughout pregnancy. However, it’s important to remember that the care provider you choose can significantly impact your birth experience. Often, the person you meet during your prenatal appointments may not be the one who attends your birth. And just because you didn’t get into a Maternity Group Practice (MGP) program doesn’t mean you can’t receive exceptional care.
Here, we’ll demystify the idea that there’s only one way to approach birth. Sometimes, continuity of care involves a few different hands. Much like the saying it takes a village to raise a child, this approach should be taken into birth and antenatal care. If you’re smart, it doesn’t need to break the bank. So, if you're pregnant and seeking guidance, the Radiant Birth team has put together a helpful guide to navigate your birth care options. Why? Because birth is no gamble — we believe you should do things your way from the very start.
Image by Jessica Prescott
Public Care Model: Public Hospitals and Shared care
We’d like to preference that in Australia we have such an incredible healthcare system! If you consider our healthcare on a global scale - we are so lucky. Statistically, 96% percent of women choose to birth their babies in the hospital system with the majority at their public hospital. If you have a medicare card, you won’t pay a cent for your pregnancy, birth or postpartum care in the public hospital system regardless of whether you see obstetricians or midwives or if you have a vaginal or caesarean birth. Much like primary schools you will zoned to a public hospital for your birth. This is generally measured by the distance from your home to the hospital (within a 30 min radius). If you are lucky you might find yourself in two catchments and this is when you can choose where you’d like to birth. Researching your hospital first is always a must. For example, not all public hospitals have array of birth pools, so if you dream of a water birth this might be why you choose Boxhill over The Mercy. All public hospitals are generally midwife lead (unless you are deemed high risk) and expect to see several people during your antenatal appointments. There is a falsity that being under a microscope and having more appointments equals better care . If you are low risk and need minimal attention it means you are doing great. A reminder to trust in your body.
You also have an option to do shared care with your public hospital. This means you can do some of your check in’s with your local GP and some at the hospital. The idea is that both care providers talk to one another and you have less appointments in the hospital.
On a personal note, even though public hospitals may seem busy and you may not get a private room after birth - it also means these midwives are extremely experienced doing the work on a day-to-day basis. A private room after birth will not change the outcome of your actual labour experience.
Cost: FREE
Birth Doula and Public Hospital
To bridge the gap between public hospital care and seeing multiple midwives, an incredible and affordable option is to engage a birth doula alongside your public care provider. A birth doula can assist you in navigating the system, help you make informed decisions, decipher medical jargon, and provide emotional and steady support throughout your pregnancy to you and your partner. They’re also on call for your birth, ensuring you have someone you trust by your side.
Not only do doulas offer continuity of care, but they also provide emotional support that may be lacking within the hospital system. Most doulas are experienced in the public system and may even know some of your care team from working in the wards, which can make your experience feel more familiar and supportive. Reach out for our doula rates.
Cost: Starting at $2500 (depending on the number of appointments and the doula’s experience).
Midwifery Group Practice aka MGP
Also known as caseload midwifery, this model of care involves one midwife (and their backup) providing care throughout your pregnancy and being present at your birth. Often referred to as the "gold standard" in maternity care, these programs are completely free and offer a mother the comfort of familiar care from start to finish. They are available in some public hospitals but not all. For example, they are offered at Sandringham and The Royal Women’s, but not at Monash. They are of course incredible but highly competitive to get into. Teams are typically small, with midwives on call to attend births. When allocating places, several factors are considered, such as the number of lower-risk pregnancies, second-time mums, and women of colour. The system can be bureaucratic, and timing often plays a big role in whether you’re accepted into the program. So, if you don’t get in, don’t be discouraged — it’s often just a matter of timing, and there are still many other great options for care available.
It is common for those who are in the MGP to engage with birth doulas also.
Cost: FREE
Home birth and Private Midwives
The hospital setting isn’t for everyone, which is why home birth can be a great alternative for those who are low risk or even those seeking a healing birth. Many women have had successful vaginal births after caesarean births in under this care model. For a home birth, you would engage a private midwife and a secondary midwife (both of whom will attend your birth). One of the best parts of this care model is that most of your appointments will take place in the comfort of your own home, making it incredibly convenient. It’s great for teaching siblings about birth and not worrying about logistics as everything and everyone can come to you . Home birth is also available in the public system under the Royal Women’s and at Sunshine in Victoria. You’ll have to get into the caseload progam to unlock access to this the guidelines may differ compared to working with someone in private practice . However a great option for those who can’t afford the latter.
You don’t necessarily have to choose a home birth to work with a private midwife. Many women engage a private midwife for their antenatal care, even if they plan to give birth in a public hospital . In this case, you’d attend your appointments at the midwife's practice, and they would provide personalised, consistent care throughout your pregnancy, with the option to support you at your birth. Some private midwife practices have exisiting relationships with public hospitals too.
Cost: $6200 + (home) $4500 + (private midwife)
Obstetric Care
Continuity of care with an obstetrician is an option for those seeking consistent support throughout pregnancy. Obstetricians typically have established relationships with private hospitals, so it’s best to choose one located nearby for convenience. While obstetric care is often associated with low-risk pregnancies, some obstetricians also specialise in specific birth options, such as maternal-assisted caesareans, vaginal birth with twins and also VBAC’s. What is interesting barely any private hospitals have birth pools so it’s best to research this when choosing your care provider.
If you’ve had obstetric coverage with your health insurance for over 12 months, your insurer will help cover some of the costs. If not, the costs start at around $10,000 but with this price you’ll be guaranteed a private room for your aftercare.
Some obstetricians also work within the public system, which allows you to receive private care throughout your pregnancy while having your birth costs covered by the public hospital. To learn more about this option, you’ll need to contact the obstetrician’s office directly.
Cost: From $5,500+(depending on cover and care provider).
Informed Care
For those passionate about birth and confident in their partner’s support, birth can be approached as an informed, empowering process. This typically involves attending birth courses to start, reading and engaging in self-reflection. Many also turn to alternative healthcare practitioners like naturopaths, acupuncturists, and pelvic floor specialists for additional support. Doulas are also available for 1:1 preparation sessions, helping you feel more prepared and confident for the big day.
Cost: $575 +(for our birth course)