WHERE CAN I GIVE BIRTH? Choosing your care provider & birthplace
You are pregnant. Congratulations.
You hold your positive pregnancy test in your hand and you wonder what happens next? Depending on where you live you can choose between different care providers and places to give birth. Keep reading for your maternity care options in Sydney, Australia.
I wrote this blog post because I talk to many pregnant couples who in their late pregnancy say something like: “I wished I knew I had options at the beginning of my pregnancy.”
I just recently had a birth planning session with a couple who will give birth in the hospital nearby. They found out that they were pregnant, went to their GP and started shared care with the closest hospital. No questions were asked. No information was given.
Later on, in their pregnancy, they found out that the hospital has a midwifery group practice that offers continuity of care through one midwife caring for you during pregnancy, birth and postpartum. But spaces for this very personal care are limited and have been taken already.
I get many calls from pregnant mums looking for a home birth midwife in their third trimester because after educating themselves and learning about birth they felt homebirth would be the best option for them but so close to the birth of their baby it’s hard to find a homebirth midwife who is still available.
So, I am writing this, especially for those who aren’t pregnant yet and I want to encourage you, once you start “trying” or thinking about having a baby, also start reading and learning about what kind of care and birth you would like to have. Because depending on where you live you have a few options. Technically you can choose and change your care provider until the end of your pregnancy but in practice that isn’t always possible.
Where can I give birth?
The most common place to give birth in Australia is a public hospital. In 2020, 96% of women gave birth in the hospital, with the majority birthing in a public birthing suit. (1)
Most public hospitals have a birthing suit and a birthing centre. That said you can also give birth in a private hospital or at home.
Homebirth
If you want to give birth at home with a midwife present, the most common way is to engage a private midwife. For Australia, you can find a homebirth midwife on Homebirth Australia and for Sydney and surroundings on Homebirth NSW. When choosing a homebirth with a private midwife you contact and engage the midwife directly. You will be cared for by the same midwife throughout your pregnancy, birth and postpartum. Private midwives are not covered by medicare and need to be payed privately.
There are also a few homebirth programs through public hospitals. Ask your local hospital if they offer one. These programs are publicly funded through medicare. I know that the Royal Hospital for Women in Randwick has such a program.
If you want to give birth at home it’s best to start the process as early as possible in your pregnancy. Due to the personal and continuous care that this option offers, midwives can only care for a small number of women and are quickly booked out.
Public Hospital
As mentioned, this is the most common birth place. Your GP will give you a referral to a hospital in your area. Midwives from the hospital will look after you in your pregnancy and during birth. You most likely will be cared for by different midwives throughout your pregnancy and birth . Depending on the length of your birth and the shift of the midwife you will see different midwives.
A doctor will see you if there are complications in your pregnancy or during birth.
Usually, women go to the hospital closest to them but know, that you have the option to choose any hospital you like. Most hospitals take on outpatients. Only note that when you choose a hospital that is not in your area you won’t get postpartum visits through that hospital.
Most hospitals have a birthing suit and a birth center. Additionally to that, some hospitals have a midwifery group practice.
After a vaginal birth, mum and baby stay for a day or so in the hospital before going home to receive a few postpartum visits from one of the hospital midwives.
Giving birth in a public hospital is covered by medicare.
Birth Center
A birth center is usually attached to the hospital and offers a more home-like feeling. It is for women who have a low-risk pregnancy and would like to have a natural birth without interventions. You can express your interest for the birthing center when you book in the hospital.
During your pregnancy, you will be cared for by a group of midwives. When you come to the birth center for birth, the midwife who is on shift will support you.
If you and your baby are well, you can go home after a few hours and a midwife will come to your home for a postpartum visit.
Midwifery Group Practice
A midwifery group practice is a team of midwives attached to a hospital. In this model, you will be allocated to a midwife who will look after you throughout your pregnancy, birth and postpartum. This is called continuity of care and has the great benefit that you get to know your midwife throughout your pregnancy and you know who will be with you during birth. You can read more about the evidence on continuous support here.
Depending on the group model you will be able to give birth with your allocated midwife in the birthing suit or birthing center of the hospital or at your home.
If you had an uncomplicated birth and you and your baby are fine, you will go home a few hours after birth and will receive postpartum visits from your midwife back home.
Ask your hospital if they have such a program and express your interest as soon as possible. Places are limited due to the continuity of care through one midwife.
Private Hospital
In a private hospital, you will be looked after by an obstetrician and midwives. You will be cared for by the same obstetrician throughout your pregnancy. During your labour and birth, you will be supported by the midwife who is on shift and your obstetrician will be there for the birth of your baby and when complications arise.
After birth, mum and baby usually stay in the hospital for a few days.
The cost will need to be covered privately or through a private health cover.
If that is the care you would like, your GP will give you a referral to an obstetrician who will book you into a private hospital.
What is shared care?
Shared care means that your care during pregnancy is shared between your GP and the hospital. Usually, this shared care is between your GP and the public hospital in your area. Ask your GP in which hospitals she/her is registered for shared care.
What to do next?
When you find out that you are pregnant through a pregnancy test at home, you can go to your GP to have your pregnancy confirmed. Your GP will talk to you about your next steps.
If you consider a homebirth or the midwifery group program you should get in contact with a private midwife or the midwifery group as soon as possible to get the ball rolling and secure your spot if you want.
You don’t really know what is right for you?
Once you know that you have options, it can be a little bit overwhelming especially when you haven’t dealt with any of this yet.
Get in touch for a Clarity Call with me where we explore your options and get clear on what is important to you. There is no one best or safest option. It comes down to your individual pregnancy and health situation and your values and wishes for your birth.
One-hour clarity call plus one week of email support to answer any questions that pop up after or to give more information/resources on certain topics - $100
Source:
(1) Australia’s Mothers and Babies
Pregnancy, Birth and Baby: Maternity care in Australia
Homebirth:
Midwifery Group Pratices:
Royal Hospital for Women, Randwick
Northern Beaches Hospital, Frenchs Forest