Expert tips by Caroline May (midwife)
When it comes to choosing where to birth your baby there are many things to think about and it can be quite overwhelming, but choosing the right place for you can have an enormous impact on your pregnancy, birthing and post partum experience and it is not quite as simple as public vs private.
What to consider
Some things to think about are what type of birth do you want? Do you have a high risk pregnancy that is going to require high tech support? Is continuity of carer important to you or are you not too fussed as long as they know what they are doing! Do you want pain relief? Follow up at home after your baby is born? So many things to think about!
Public hospitals for birthing
The majority of Australian women birth in public hospitals. They are free and usually have significantly higher vaginal birth rates than private hospitals. Your care will predominately be carried out by Midwives in collaboration with Doctors if a need arises. Some hospitals offer team midwifery to make your care more personalised. Many offer water births and home visiting after you have had the baby. Breastfeeding rates are also significantly higher in women who have birthed in public hospitals than in private hospitals. However you may not get a choice of who provides your care and you may be required to share a room post natally, though this is not always a bad thing.
Private hospital for birthing
If you choose to birth in a private hospital you will be booked in with a named Obstetrician who will provide all of your ante natal care and will be called for the delivery. The plus side of this is that you will usually have built up a relationship with this person and so hopefully trust them, however they are not always present during your labour and will usually only attend for the actual birth. You will also usually get a room to yourself post natally. Generally speaking, private hospitals have significantly higher caesarean section rates than public hospitals. It is worth remembering that the World Health Organisation recommends a caesarean section rate of 15% and most hospitals, public and private sit higher than this recommendation. The question to ask is by how much? If you plan on booking with an individual Obstetrician ask what their caesarean rate is, not just that of the hospital.
Birth centres for birthing
Birth Centres can be a great option for women who want to keep intervention to a minimum, but who are not comfortable with home birthing. You will need to have an uncomplicated pregnancy and pharmacological pain relief options are usually limited. If required transfer to the main hospital is usually straightforward.
Home is a great option for women who wish to avoid interventions and pharmacological pain relief and has been proven to be a safe option for women at low risk of complications. Some states offer government funded home birthing programs while in others midwives in private practice or independent midwives provide the services to home birthing families.
Other options for birthing
There are lots of other options including midwifery group practices, care by your GP in collaboration with your local hospital, domino schemes and unassisted birth, but more about these another time.
My birth: birth stats
Caroline May qualified as a Midwife in 1999 and has worked in both community and hospital settings around Australia and in the UK. Currently residing in Perth with her partner and two young children, Caroline is particularly interested in home and waterbirth and is passionate about enabling women to make an informed decision and play an active role in their care. You can find all her articles here.