Having a baby in the public system

Hi all,

Just wondering what the public system is like for maternity? How does it work and Is it comparable to NHS?

If anyone knows any specific info about this in regards to Perth that would be great too.

Thanks in advance!

Hi Alycat,

I'm not familiar with the NHS (I'm Irish) but my daughter was born through the public system in Australia. Had great care throughout. Most of the pre-natal scans and tests were done in the RPA in Sydney. You can do share care with your GP (if they are part of the system), they do most of the regular checkups and you only go into hospital occasionaly. My daughter was born in Bentley hospital in Perth. Care was superb from start to finish. My ex was in a room with only 1 other mother and had plenty of room. There was always plenty of midwives available for anything that was needed. My mother travelled over from Ireland for the birth and was very impressed by the level of care received.

I know a few people who went private and said that it wasn't worth the money. In some cases, their consultant wasn't available when the baby decided to come and the doctor on duty delivered their child.

In short, our experience of the Australian health system was very positive and I'd recommend it.

Hope this helps.

It's over 30 years since I had my two in Osborne Park Hospital in Perth not long after Medicare was introduced. I was very lucky because our GP was also an obstetrician so he looked after me throughout my pregnancies and delivered my babies then he was their GP for check-ups/ailments/immunisations which was great. I was actually kept in hospital with my first baby for a week as they knew I had no extended family here!!! Can't see that happening now. I was in a 2 bed room and the care was first class.

I had both mine through the public system but in Adelaide.

First time I went through a midwife group practice, which is where you get your own midwife and see her for all of your appointments. She ended up being off shift at the birth, so we had a backup, but then saw her again for appointments at home until 6 weeks. I stayed in two nights there in a room of my own that my partner could stay in too. At one point in my pregnancy I had issues with my kidneys. The ob phoned the renal department at another hospital and one of the renal doctors drove straight over to see me and was there half an hour later. I even overheard some midwives saying how bloody impressive that was (it wasn't urgent).

For our second I did shared care so most of my appointments were at my GP who has done extra training in pregnancy. That way you get whoever happens to be on to deliver the baby. That went well too. At the end her heart beat dropped as the cord was wrapped around her neck. They pressed a button and the room was full of people instantly. They were all so professional that I stayed totally calm and trusted everything they were doing.

All went well and I was wanting to leave pretty much straight away. I had told them all along I wanted to go home. So she was born at 11am. I was ready to go at 1pm. They had to wait for Drs to sign me off, sign the baby off etc. As they were MEGA busy I couldn't leave until 6pm which I was very frustrated with at the time lol. I'm sure they got fed up with me keep buzzing them and wondering out if my (private) room to ask where the people were to do the tests so we could go lol.

For scans make sure you look for bulk billing places. They are covered by Medicare at those places, although lots of people are told by other places that they aren't. I paid nothing for any of my scans for either. I know people who have paid up to $300 per scan. So shop around.

Good luck. :-)

Compared to the NHS, birthing is much more medicalized in Australia than the UK. Australia has some of the highest Caesarean section rates in the world.

Midwives are still actively involved in "routine" deliveries in Australia.

Obstetricians have successfully lobbied to essentially outlaw home births in Australia.

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One diff here I think is the doctors are very nervous about being sued so they will do a caesarian if there are even slight risks.

One diff here I think is the doctors are very nervous about being sued so they will do a caesarian if there are even slight risks.

x3 babies in RPAH Sydney, 1 natural, x2 caesar, same midwife for all, private health but in a public hospital, same obstetrician for all private.

Advice from our obstrician was private (room) facilities in a public hospital, otherwise the people, drugs, care is all the same, it benefits the hospital financially as they can recover from the private health fund.

woman nearby us in Syd had a home birth, went horribly wrong and had to be ambo'd to hospital.

Why take risks when you can avoid them ?

Two emergency c-sections, both through the public system, both single rooms (not a ward). First pregnancy was through GP and in last four weeks, midwife and obstetrician appointments. Second pregnancy, again public, care of obstetrician all the way through. Second baby spent months on life support and survived due to the amazing care, love and expertise given. I have a lot to thank the public system for.

Whilst I was in the intensive care unit a number of babies were transferred there from private hospitals as they simply did not have the state of the art facilities that the NICU had.

The NICUs are absolutely fantastic in Melbourne. Couldn't be better. My granddaughter was a 27 weeker and the level of care for her and her mum- brilliant. She spent 10 weeks in hospital, 8 in NICU then special care.

The NICUs are absolutely fantastic in Melbourne. Couldn't be better. My granddaughter was a 27 weeker and the level of care for her and her mum- brilliant. She spent 10 weeks in hospital, 8 in NICU then special care.

I would like your comment if the like button was still there:) I owe the Royal Flying Doctors and the NICU everything.

x3 babies in RPAH Sydney, 1 natural, x2 caesar, same midwife for all, private health but in a public hospital, same obstetrician for all private.

 

Advice from our obstrician was private (room) facilities in a public hospital, otherwise the people, drugs, care is all the same, it benefits the hospital financially as they can recover from the private health fund.

 

woman nearby us in Syd had a home birth, went horribly wrong and had to be ambo'd to hospital.

 

Why take risks when you can avoid them ?

20% of births in the Netherlands are at home, 0.4% in Australia (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399594/#!po=5.69620). Same neonatal survival figures in Australia and the Netherlands (http://data.worldbank.org/indicator/SH.DYN.NMRT).

For every anecdotal report of adverse outcome during home birth, there is at least one similar in hospital report.

I am not advocating home birth as a practice (all three of my children were born in hospital, and had obstetric emergencies). But I would suggest not getting too carried away with the interested parties rhetoric proposing a single system over all others, without looking a little more closely at why such a system developed.

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Where I live in NSW, you can be managed by a midwife in one of 3 ways: group midwifery (a small group of midwives are in a team, you're assigned to one midwife, and see her for your appointments, but if she's not available when you go into labour you see another team member), community midwives (you see whoever is there on the day you attend the community clinic), or hospital midwives' clinic (you see whoever is there at the hospital). If you want an obstetrician, you have to go private. You can also be managed by your GP, as long as they are accredited in the local hospital's program, and you are transferred to the hospital midwives at 36 weeks.

I had both my boys and a missed miscarriage here in Australia, at the local public hospital. Most of my friends had theirs in the private system - main difference was that they all had obstetrician-led care from the outset, whereas I was only transferred to the ob when I developed gestational diabetes; otherwise I'd have had a midwife-led birth. With my first, the ob I was under was willing to try to deliver my breech baby vaginally, which surprised me; though for a combination of reasons that didn't work out.

My youngest was an elective C section, and it was a lovely experience - I had one-to-one care in recovery, and the midwives went out of their way to make it as 'natural' as possible. With him, I elected for GP management, in the knowledge that I had a very high chance of developing diabetes again (my GP is right next to where I work so I went for the most convenient option knowing I was probably only going to be in her care until around 26 weeks).

In terms of cost, the only things I paid for were my diabetes supplies (NDS subsidises some of it, but it's not free if you don't have a concession card) and some fancy scans (only necessary because of the diabetes, and again, wouldn't have had to pay if we were low income).

Overall, I'm happy with my choice, because having diabetes meant I had to see two medical specialties, an educator, a dietitian; and I was also able to see the lactation consultant (who was awesome!) and one of the anesthetics doctors too - all in the one clinic.

Yes the maternity care is very good here, I would say the public hospitals are much preferable than the private ones though. Your chance of a Caesarean section will triple if you have a private obstetrician.

As a midwife who works in both public and private areas I honestly struggle with the differentiation in the system here.

Privately you get a single room and afew extra material ‘perks’. The care (which is what it’s all about, not whether you get a Coffee machine on your room or not) is the same, arguably better in the public system because practice has to be evidence based instead of going with some private obstetricians personal preference which is sometimes ridiculous and not founded as best practice. 

Depending on who you choose privately can cost you $1000s out of pocket and that’s not including the need for a CS and all the associated costs in that eventuality. 

You will still get charged by that obstetrician if they miss the birth, and the intervention rates (medicalisation of birth) is massively increased privately. 

The midwives who provide care are not trained any differently to work in private areas and many rotate round between all areas anyway. 

For continuity purposes look into a midwife led group practice model of care. Not only will you get to know your midwife or group of midwives, they will be on call for your birth and see you postnatally for a good number of weeks which is when you really need the support IMO. In a non- MGP model you can expect 1 or 2 home visits, and privately none of you stay your full length of allocated time in hospital usually 3-5 days max depending on birth.

I had my babies publicly (as do many of the midwives I work with) and the care was excellent. But equally many women will stand by their decision for private.

It’s your choice at the end of the day.

we went private but at a "public" hospital in sydney, did it for all three (now 9, 13, 15), same midwife for all, same obstetrician for all,  more pricey sure, if I had our time again I think my wife would probably have gone public, but needed C section after 1st so hmmmmmm