Your antenatal care and childbirth options explained
We’ve produced this article as a summary of the main types of antenatal and childbirth care available in Australia. Options for care do vary slightly from state to state and even within different regions of a state.
There are many things to think about when considering your antenatal care and childbirth options. So where to start? Read through the options below and see which suits you and your budget.
Who do you want to care for you?
Obstetricians - Obstetricians are doctors with specialist training in childbirth. Your obstetrician will look after all your medical needs during your pregnancy and can cater for all types of pregnancy from low to high risk. If you wish to be treated privately and you already have an obstetrician in mind, you will need to contact them to find out which hospitals they have admitting rights to. If you don't have a prefered obstetrician, ask your GP for a referral or ask your chosen maternity hospital for details of obstetricians who can practice there.
Midwives - Midwives are health professionals who provide specialist care, education and support during pregnancy, birth, postnatal and the early parenting period. Midwifery care includes the detection of complications in mother and baby, the referral to other specialists, and the initiation of necessary emergency care. Midwives provide many additional services for complete birth care such as...
- preconception health (preparation for pregnancy)
- all medical ante-natal care
- childbirth education
- well-being during pregnancy, such as nutrition, exercise, support
- information on birthing options and the effects of any drugs which may be used in labour
- postnatal care for mother and child, including infant feeding and settling
- lactation consultants, providing specialised support for mothers, with breastfeeding
Independent midwives can also be employed privately for any aspect of pre and post-natal care from childbirth education to post-natal care of the mother or baby, breastfeeding advice and sleeping and settling techniques.
Will you see the same OB/midwife at each appointment?
Your main antenatal and childbirth care provider will work as a team with others - even doctors and midwives are allowed to sleep and have days off.
When making your final choice, check who else you are likely to see and how often if that is something that is important to you.
For example, if you choose a private obstetrician, you're likely to have all your antenatal appointments in their private rooms. During labour you will be seen by the midwives at the hospital until delivery is imminent, when your obstetrician will be called to attend. If your obstetrician is not available, it's likely another member of their practice group will attend in his/her place.
if you attend a midwives clinic in a public hospital and have an uncomplicated pregnancy, you are likely to have each antenatal appointment with any one of the team of midwives or obstetricians available on your clinic day. Your birth will be attended by whichever team of midwives and obstetricians is on duty at the time.
A number of hospitals are also now offering Caseload Midwifery or Midwifery Group Practice. This is where the pregnant woman is cared for by the same midwife, supported by a small team of other midwives, during their pregnancy, birth and early weeks at home. Ask if it is an option at your hospital.
At the Royal Hospital for Women in Sydney expectant mothers can join a Pregnancy Centred Care Program - where they participate in four group sessions with up to 12 women due in the same month.
Antenatal and childbirth options
Private hospital facilities (cost involved) - If you wish to have your baby as a private patient, you get to choose where you give birth and who your main care provider will be. You can choose your obstetrician first - and then find out which hospitals he/she has admitting rights too - or you can select your maternity hospital and find out which private obstetricians work there.
Once you are booked in with an obstetrician, you will have all your antenatal appointments with him/her at their private practice. Your obstetrician will conduct all antenatal tests or make arrangements or recommendations for tests and scans with specialist providers.
You will have no need to go to the hospital at which you will give birth until the time arrives to have your baby. However, many obstetricians and hospitals will arrange for a familiarisation visit beforehand so that you can have a quick look around before the big day.
If you wish to use private medical insurance, ensure that you check your policy carefully for the services covered before undertaking any costly consultations. Some policies have exemption clauses for cover for pregnancy in the first year (or more) of membership. Check also what private cover you would have for your child once born. Family cover often includes the child automatically, but this may not be the case if you have individual cover. Check your policy carefully. If all is well and your insurance will cover you, select your preferred venue and speak to your health insurance provider about what steps to take from there. Private hospitals should be able to provide you with details of care providers who are able to practice at their hospital. If you would prefer to select your care provider first, ensure that they have admitting rights to any hospital that you wish to attend.
If you wish to be treated as a private patient but do not have private medical insurance, you will be required to pay all costs yourself. Check payment terms and conditions with your care provider and chosen maternity hospital before undertaking any consultations.
What costs am I likely to incur – see the recent experiences of our members…
Public facilities (generally no cost for eligible patients) - For care as a public patient under Medicare you will need a referral by your local GP. Call your local matenity hospital for details of their booking-in procedure. The birth should take place at the hospital and there are usually no out-of-pocket expenses providing you have valid Medicare cover.
After 'booking in' and an initial assessment, you may then have the following options for continuing care, providing your pregnancy is low risk and no complications develop:
- maternity clinic at a hospital
- midwife-managed 'birthing centre' at a hospital
- community-based midwifery programme
- shared care with your local GP (some costs involved)
- community-based ante-natal clinic with a hospital birth
If you are considered to be at risk of a more complicated pregnancy, you are likely to be requested to visit the hospital for all your check-ups.
Hospital maternity clinic - If you elect to have your antenatal care through the hospital maternity clinic, you are likely to have all your antenatal appointments at the hospital with your care being provided by a team of midwives and obstetricians. Who you see on your appointment day will depend upon who is on duty on the day. On the downside, there can be long waiting times for appointments, but on the positive side, the hospital will arrange for all your tests, scans and other care, which, in most cases, will take place in the hospital itself, at no cost to you. Hospitals often offer additional services such a pregnancy exercise classes, postnatal education and specialist physiotherapy services.
The birth should take place at your chosen hospital where you will be seen on the day by the midwifery team and obsetricians on duty at the time. Postnatal care will often be in shared wards and you can elect for an early discharge if staff feel that you are coping well (particularly if it is not your first baby).
Midwife-managed birthing centre- Midwife-managed 'birthing centres' and free standing childbirth units provide for more natural 'at-home' style ante-natal care, labour and birth. Places are limited and are only available to pregnancies considered low risk. Early enrollment is advised. Midwives take primary professional responsibility for care. Since teams and patient numbers are smaller, you have a much higher chance of seeing the same midwife more often during your antenatal apointments and the birth. During labour and birth, medical services should they be needed, including obstetric, neonatal and anaesthetic care are available, sometimes from a separate site. Most centres are within hospitals so more intensive medical care is available should an emergency arise. Details of facilities are included in our maternity hospitals & midwife managed birthing centres listings.
Community midwifery programs Community midwifery programs usually operate through a local health service or maternity hospital providing publically funded antenatal care at local community facilities or even homebirth care. The programmes operate in only very localised areas within Australia. See our list of community midwifery programmes.
GP - shared care (may be some costs) - Under the 'shared-care' scheme, you split your check-ups between your GP and the maternity clinic at the hospital. After an initial assessment at the hospital, the scheme allows you to visit your GP for regular check-ups, whilst you visit the hospital for scans, ante-natal classes and any tests above and beyond those that can be carried out by the GP. Regular checks after approx the 36th week (depending on your maternity facility) will usually take place at the hospital. If you are interested in shared care, check that your GP is willing and able to provide this service. Any fees due to your GP will depend upon your GP's individual fee scale and billing policy.
Home birth (costs involved in most cases) - A home birth option is only available to low-risk pregnancies and is only available on a private basis in most states. Because of current public liability insurance issues, home birthing options are limited. There are exceptions in limited areas of NT, SA and WA - these are listed in the community midwifery programme page.
See our info page home birth - having a home birth in Australia for more indepth info on this subject.
Other childbirth services
There are a number of additional private and community services to assist you with antenatal care and childbirth preparation, offering assistance from parenting antenatal classes to hypnobirthing, birthing partners (doulas) and more. See our pregnancy info hub for relevant links and useful tools and checklists such as a birthplan template, maternity leave checklist and pregnancy checklist.
If you would like to read more about birthing options or contact local support groups regarding childbirth issues, see the organisations below:
- Australian College of Midwives
- Having a baby in NSW
- Queensland Centre for Mothers and Babies
- Pregnancy and birth care in SA
- Having a Baby in Victoria
- Advocacy and support groups for maternity and childbirth care
want to know more?
For more articles, local directories of shops and services, checklists, calculators and more visit our...:: pregnancy & birth info hub