Choosing where to give birth to your baby

You have lots of choices about where to have your baby and deciding what’s right for you. Like making any other decision,  there are many factors which need to be considered - personal choice, your health during pregnancy, how your baby is growing, previous birth experiences and your budget.

Women in Australia give birth either in a public maternity hospital, private maternity hospital, a birthing centre or have a home birth. Women can also change their minds about what’s right for them after having their first child and choose to go to a different maternity hospital with subsequent babies.  

What to think about

Ultimately, you need to decide what is right for you, your partner and your baby.  It’s important to consider your obstetric history when planning where to give birth. If you are having a ‘high risk’ pregnancy, it’s likely you’ll be referred by your maternity care provider to a larger maternity hospital.

Most women feel that pregnancy and birth are special times in their life.  Birth plans can be a good way to have a say and sense of control over labour and birth.

Choosing your maternity care provider

Many women choose to see their GP for regular antenatal checks. As the expected due date gets closer, their antenatal care is then transferred to the maternity hospital where the baby will be born. Other women go to a private obstetrician who will be present when the baby is born. Most obstetricians have locum arrangements, or work in group practices to cover their absences.   

If you choose to have a private obstetrician and birth your baby in a private hospital, you’ll need private health insurance.  Medicare only covers some of the cost of a private obstetrician, though not the hospital stay.  It’s common to have a fee gap between the obstetrician’s fee for antenatal services and delivery and the Medicare rebate.

Another option during your pregnancy is to go to an antenatal clinic and see a midwife who is employed by the maternity hospital. Many hospitals use a ‘model of care’, conducted by the midwives. Midwives and obstetricians are available for antenatal care and support. When you go into labour, you’ll be  supported by a midwife working in the labour ward.  Medicare covers this option.

Birth centres also use a model of midwifery care where a team of midwives share the care of a number of women.  Once a mother goes into labour, one of the midwives you’ve met antenatally will offer support when you are in labour and when you are birthing your baby. Medicare also covers this option.

Some midwives work independently in private midwifery group practices. Depending on their own arrangements, their services may be rebatable under Medicare and private health insurers.

Where you can have your baby

Most  cities and regional centres in Australia have maternity hospitals. Generally, these are attached to public hospitals.  Some only offer public care, though many offer a combination of both public and private.  If your pregnancy is complicated, or there are likely to be problems with the baby e.g., born prematurely, you’ll be advised to go to a larger maternity hospital.

Birth centres are an option for women having a low-risk pregnancy. Larger maternity hospitals often have a birth centre attached to the labour ward. In birth centres, a group of midwives provide care; however, obstetricians are also available if they’re needed.   

Many birth centres also offer water birth facilities.  Hospitals develop their own protocols around safe management of water births, though not all places provide this option. Check what’s available for you. 

Home birth can be another alternative for healthy women having a low-risk pregnancy. Having their baby at home means that some women feel more relaxed and in control. It’s important to research all your options and make your own informed choice if you’re considering having a home birth.  

Ten top tips to consider when planning where to have your baby

1. Be guided by your maternity care provider who knows you and your individual history.
2. Do a hospital tour antenatally so you’re familiar with what it offers. Ask as many questions as you need to feel reassured and have information which will help you to make an informed decision about where to birth your baby.
3. Speak with your health insurer if you’re planning to have your baby in a private hospital. It’s important you know what level of cover you have. Be mindful that most private health insurers have a ‘waiting period’ from joining until they will cover obstetric care.
4. If you’re being supported by a private obstetrician or midwife, you may be more limited in your hospital choices as they will have visiting rights to specific maternity hospitals.
5. Be open to changing your mind about where to have your baby. What’s important is that you have a safe birth which is right for you, your partner and your baby. Ultimately, you have choices.
6. How long you will need to stay in hospital after your baby’s birth. As a general rule, stays are longer in private maternity hospitals than public ones.
7. The hospital’s philosophy around intervention and supporting ‘natural birthing’. This is very important to many women.
8. Access to the hospital and travelling time.
9. The overall cost of having your baby.
10. The hospital’s approach to birthing and if their model of care fits with your own birthing philosophies.

About the Author:

Written for Nourish Baby by Jane Barry. Jane has qualifications in general, paediatric, immunisation, midwifery and child health nursing. She holds a Bachelor Degree in Applied Science (Nursing) and has almost 35 years specialist experience in child health nursing. She is a member of a number of professionally affiliated organisations including AHPRA, The Australasian Medical Writer’s Association and Australian College of Children and Young People’s Nurses.    

References

Obstetricians: guide for expectant parents | Raising Children Network

Pregnancy care & birth: public hospitals | Raising Children Network

RACGP - Mothers and babies in Australia