Written by Jacqueline O’Neill
Where did you give birth? Did you know all your options? Did you feel like you chose the best place for you? Did you even know you had options, or did you think going to hospital was the only choice you had?
I wasn’t aware of the different choices I had when we were trying to conceive our first, and automatically thought having maternity as part of our “Private Health Insurance” would be the best option for us.
What I wasn’t aware of was that even though we were paying a monthly payment for “Private Health Insurance” once I did get pregnant and choose an OB, we would still have a lot of out of pocket expenses. Appointments, scans, the OB maintenance fee (anywhere from $1500 to $3500).
This is all well and good, but when you aren’t aware of this from the beginning, financially it can be a bit of a stinger.
In saying that, I would like to tell you what your options are so you can be fully informed and choose what you feel best suits you and your growing family.
I will be covering;
- The different midwifery care options
- Hospital Options
So, sit back, relax and enjoy the read.
MIDWIFERY CARE PROGRAMS
COMMUNITY MIDWIFE PRACTICE (CMP)
The Community Midwife Program is a program which facilitates home-births / Family Birthing Centres / or Domino Hospital births.
The CMP philosophy is to protect and support natural birth and to provide clients with evidence based, holistic care from known midwives throughout the continuum of pregnancy, labour, birth and the postnatal period.
You will be allocated a midwife, who will be ”YOUR” midwife from start to finish. Keeping in mind, midwives can’t be on call 24/7, 365 days a year – so if you go into labour when your midwife is on her day off, you will have her back up midwife, who you would’ve met and possibly had some antenatal care with through your pregnancy too.
They will be familiar with your birth plan and help support you in whichever setting you choose to birth in.
CMP books out quickly, so as soon as you find out you are pregnant you need to fill in the form and send it off as quickly as possible to secure your spot. The locations CMP cover are below;
- Family Birth Centre
For more information on CMP see links below;
MIDWIFERY GROUP PRACTICE (MGP)
Midwifery Group Practice (MGP) offers one on one care with a known midwife through your whole pregnancy, birth and beyond.
MGP offer their services at the below hospitals only:
- King Edwards Memorial Hospital
Care can start from 14-16 weeks – and the antenatal appointments can be done in your home or at the chosen hospital you will be birthing at.
INDEPENDENT / PRIVATE MIDWIFE
You can choose a private midwife who will be with you through your antenatal appointments (in the comfort of your own home), at your birth and most offer an extensive postnatal program too. Private Midwives primarily attend homebirths, but some can attend Public Hospitals they have admitting rights with, so in the event you may require a transfer they will still be your caregiver.
Private Midwives are very women-centred and believe in our bodies ability to birth – they believe in physiological births.
Most are required to do additional training, so they can order tests or prescribe some medication if required.
Going down this route isn’t cheap, but I have only ever heard mothers say, “My midwife was worth her weight in gold” and “I would’ve paid double the asking price to have the experience I did.” The current rates for independent midwives varies from $4000 – $8000. In some circumstances Medicare can and will cover some of this cost, if they are Medicare endorsed.
You can choose to have a home birth – this can either be facilitated through the CMP or with Private Midwives.
A common misconception about homebirths is that they unsafe. There have been many studies done about homebirths with the largest study being done in the Netherlands. This study was done in the Netherlands because it has the highest rate of home births with 30% of Dutch women giving birth in their home.
“This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system. (2009)”
You can birth in the comfort of your own home, surrounded by people who you know will support the choices you make. If you want a home water birth, you can hire or buy birth pools.
Think homebirth, without any medically trained personnel to assist you. Just yourself, your birthing partner and the baby/babies that are ready to be birthed.
Having a Doula at any of the above settings, can be a huge benefit for birthing mothers and their partners.
Doula’s are birth coaches, they are there to inform, support, empower and ensure the woman is aware of all her options.
They are trained in the anatomy and physiology of the pregnant body, so understand what your body is going through and can offer alternate methods to relieve pressure or encourage baby to move into an optimal position for birth.
Doula’s can offer a variety of packages that suit their individual clients and often will be a calming and encouraging voice on the day you birth your baby.
Doula’s are non-medically trained birth attendants and will not be able to conduct any clinical performances such as vaginal exams or heart rate monitoring. They will not give medical advice, they will only offer you options to discuss with your birthing partner for you to make an informed decision.
Recent studies have shown mothers who had a Doula present at their birth were more relaxed, had less unnecessary interventions, C section rates were lower, bonding with their babies increased, and are more than likely to rate their birth as “Good.”
There are 9 Maternity Hospitals within Perth Metropolitan area. See the list below.
- SJOG Midland (Public Section)
- Joondalup Public Hospital
- Armadale / Kelmscott Memorial Hospital
- Bentley Hospital
- King Edward Memorial Hospital
- Family Birthing Centre (more about this under next header)
- Osborne Park Hospital
- Rockingham General Hospital
- Fiona Stanley
To find out which Hospital your catchment falls under refer to the website below. Please note that the catchment areas are constantly changing so it is important to check this yourself rather than rely on what someone tells you.
When you have confirmed your pregnancy with your GP, all antenatal appointments will be at your local hospital. The antenatal appointments will be completed by midwives.
All costs for your care and birth are covered by Medicare.
GP SHARED CARE
This could be quite convenient for those who have been seeing their family GP for years and feel incredibly safe and comfortable with their GP.
In short this is where you have all your antenatal appointments with your GP up until approximately 20 weeks pregnant where you will have an initial appointment at the share care hospital of choice. If there are no complications in your pregnancy your antenatal care will still be with your GP until 36 weeks.
From 36 weeks onwards, all appointments will be at the hospital until you birth your baby or babies.
Not all GP’s offer shared care, so this could be a problem if your current family GP doesn’t offer this service.
To find out your local GP’s who offer GP shared care, call your antenatal clinic at your hospital of choice.
FAMILY BIRTHING CENTRE (FBC)
The Family Birthing Centre is located next to King Edward Memorial Hospital in Subiaco.
The best part of the FBC is it is like a home away from home setting – they offer water births – not just “water labour” where you are able to labour and birth in the bath or pool. In most hospital settings, if they offer a bath for labour, you will be required to get out of the bath when you are close to birthing your baby,
The FBC is run by midwives, who are highly trained to help you birth your baby.
Being close to KEMH (King Edward Memorial Hospital), any birthing woman can be safely transferred if the midwives feel that the birth is not progressing or complications arise.
One of the major downfalls to FBC is they only have 4 birthing suites, and they book out quickly – so as soon as you know you are pregnant, get on it and book yourself in. The other downfall is, they only accept what they deem to be “low risk” mothers, so there are a few hoops you need to jump through to get in.
For more information on the FBC click the link below
When you chose Private care, you must be sure you have added “Maternity” to your chosen health insurance provider for at least a year before birth. So, if you have just added Maternity to your health insurance, and the next month you fall pregnant, you won’t be covered. You could still choose to go to a Private Hospital but would have to pay all costs.
Once you suspect you are pregnant, you need your GP to confirm your pregnancy. They should then cover all the options available to you and ask whether you have private health insurance. Most GP’s can refer you to an Obstetrician if you wish.
Obstetricians are highly trained in managing complications in pregnancy and birth – they are surgically trained. It is important to be aware that women birthing in private hospitals are more likely to have interventions during their births. It is also interesting to know that Perth is known as the Caesarean Capital of Australia (see table below from Birth Savvy).
When choosing an Obstetrician, make sure you shop around. Meet at least 3 Obstetricians and have a list of questions for them to ensure they are willing to support your birth choice.
Once you have chosen your Obstetrician and private hospital you will have antenatal meetings with your Obstetrician from approximately 12 – 13 weeks until birth.
There will be a management fee for the Obstetrician, which can range from $1500 to $3000 or more. Your antenatal appointments will also incur a fee, which your private health insurance doesn’t cover. Medicare may cover part of these fees.
Your private health insurance covers some of the hospital stay, but not necessarily all of it and if you have an excess you will need to pay that as well.
You will get your own private room, you will be able to stay in hospital for up to 3 days for a vaginal birth or 5-7 days for caesarean section.
Some great options for you to think about. Do you feel like you have more knowledge about where you can give birth now? Were you surprised at any of your options?
My name is Jackie O’Neill and I am a Doula who has trained at the Doula Training Academy. If you would like to talk more about your birthing options, please contact me:
Business Name: Live Love and Birth
Business Email: [email protected]
Phone: 0400 247 857
Facebook Link: https://m.facebook.com/Jacqueline-ONeill-Live-Love-and-Birth-221201888466916/
Instagram Link: https://www.instagram.com/liveloveandbirth