Types of Birth Care in Adelaide
I remember walking into the doctors office, 6 weeks pregnant with the most hectic brain fog I have ever experienced, ready to go in and be told exactly where I should give birth.
Instead, I walked out more confused then before. Private? Public? Shared GP care? Eh?
Photo by RODNAE Productions from Pexels
I had NO idea about pregnancy or birth and was totally lost about what I should do. So, after navigating through my journey I have put this together to help you be more prepared then me! A doula is able to be present at your birth no matter where you birth and statistics show that women who have a doula as part of their birth support team leave their birth feeling more fulfilled and satisfied with their birth so if you have any questions about how I can help you further, please contact me through the ‘CONTACT’ tab.
PRIVATE CARE
Private Hospitals in Adelaide:
Burnside Hospital
Calvary Hospital
Ashford Hospital
North Eastern Community Centre
Sometimes, when we start thinking about having children our minds go straight to ramping up our private health not realising this may not actually be our ideal care. If you chose to go down the private path, you will choose out of a team obstetricians who will follow you through your pregnancy and birth. Private comes with a fee, as you are charged directly for each service provided, including a fee for the obstetrician, which is up to the individual on what they charge and in order to get this subsidised you will need to make sure your private cover covers maternity. Services you will be charged for include but not limited to - ultrasounds, birth classes, health checks for baby and hospital stay. If you let your GP know which hospital you are wishing to birth at, you will be given a list of obstetricians, if you do not already know which one you are wanting to go with. It’s worth chatting with a few to see which one you gel with if you don’t have one in mind already.
Private hospitals offer a comfortable and high quality environment for labour and birth with generally large rooms that are not shared with other guests so this can be a good option if things like space, privacy and some little luxury extras are important to you such as food menu options, double beds and at times, baths! It’s just that little bit fancyyyyy.
Private can also be a desirable option due to the continuity of care however they may not always be an option for high-risk pregnancies or complications due to lack of NICU/special care facilities at some private hospitals. Through your appointments, you will see your obstetrician in a consulting room for appointments and ultrasounds alongside a midwife which they work with and at times, you
may see a different obstetrician as they work in small teams. You will also have birth classes at some stage through your pregnancy.
PROS:
- Continuity of care
- Spacious, private rooms
- Generally better food
- Not pressured to discharge before you feel ready - Partner can stay with you comfortably
CONS:
- Statistically higher levels of intervention
- Potential chance of being induced goes up due to to obstetricians schedule - May end up in public anyway if complications occur
- Not always as open to physiological/water birth
- More out of pocket costs
PUBLIC HOSPITALS:
Public Hospitals in Adelaide:
Flinders Medical Centre Women’s and Children’s Lyell McEwin Hospital
The public system is there for a more affordable option for pregnancy care and birth. If you chose to go public, you will find yourself having your prenatal appointments with midwives rather then an obstetrician however it will be the one who is on shift and may not be the same one each time.
Medicare covers most if not all of your pregnancy appointments at birth, making it a very cost friendly option. Personally, this is the route I went and while it was not perfect, I can say hand on heart that the midwives and special care nurses I interacted with were amazing. Sadly, at times, the system can be underfunded and overworked so it’s important to note this if you feel that continuity of care is very important to you as well as understanding that at times you may need to remind the midwives of certain things incase the previous midwife didn’t put it on your notes. Public hospitals are generally more on board with physiological birth and will not let you opt for a caesarean even if it’s your wish. You will be dealing with only midwives for your appointments and birth unless there are complications when an obstetrician is on call to help.
You will have approx. 4 appointments here for a straight forward pregnancy and all ultrasounds will be conducted externally and not at the hospital. These will need to be paid for however Medicare does cover some of the ultrasound fees.
In terms of comfort, every hospital is different but as you can imagine, it is a free service so if you are expecting a hotel I would scroll up a bit to the PRIVATE part! It is comfortable, however the birthing suite will not always have the option for a bath at times the beds can be quite uncomfortable with only a single chair for your partner to sit on. This can vary from hospital to hospital but be aware that most times the rooms are kept quite simple. The maternity rooms can be shared, so you may be bunking in with other mamas which can be hard if one or more of the babies decide it’s time to party. Other times, you may be lucky to get your own room with a bed, a fold out bed for your parter and a small ensuite. The food is.. hospital food.. but did I mention it’s free?!
If all goes well, you can go home as soon as 24 hours. At times, if baby is in special care, you may need to get discharged on your own due to scarce beds.
PROS:
- Pretty much free!
- Less appointments for time poor women
- Midwife led, at times less intervention is offered
- NICU/special care is close if god forbid it is needed
- Access to other services such as lactation consultants, physiotherapists
CONS:
- Can feel a bit ‘lost in the system’ at times
- No option to stay longer if you feel you would like to
- Partner may not always be able to stay
- Food is... not always the best
- Can be very busy at times, and may take a while to be seen to
MIDWIFERY GROUP PRACTICE (MGP)
Midwifery Group Practice enables women to be cared for by a small team of midwifes through your pregnancy, child birth and the first 6 weeks at home with your baby. It is a free, continuity of care programme allowing women and the midwives to form a trusted relationship throughout the pregnancy journey. This may seem like a desirable option - and it is - so much so it can feel impossible to get in. I would recommend calling as soon as you are pregnant to try and give you the best possible chance. This programme is also known for a more natural approach to pregnancy and birth and generally try and avoid any pain relief or intervention. Keeping in mind this option is only available if you are deemed ‘low risk’.
Public Hospitals that offer MGP:
- Flinders Medical Centre
- Women’s and Children’s Hospital - Lyell McEwin
- Bridge Clinic
Your appointments will be generally be at the hospital with the option of one home visit, which occur monthly up until 36 weeks. You will then have more frequent appointments up til you deliver. When you are in labour, the midwife on duty will be informed and once in active labour you will be cared for by this midwife for the duration of your labour and birth. Once baby is born and all goes well you can be discharged from around 4 hours post birth providing you, the baby and the midwife are all comfortable with this. You will then receive home visits from the midwife who will check in on you and baby, normally on the first, third, fifth day. They will then visit between the seventh and tenth day and between the tenth and fourteenth day. Finally, they will check in around the three week period and the fourth week! Keeping in mind all these visits will be at your home.
PROS:
- Free
- Continuity of care
- Midwife led, with a natural birth philosophy
- NICU/special care is close if god forbid it is needed
- Less interference from obstetricians
- Option to have a water birth -
CONS:
- Hard to get into
- May not feel ready to go home after a short amount of time
- Pain relief is not readily available if you are wanting it, however not impossible
HOME BIRTH
5 years ago, if someone said home birth you would have thought ‘’hippie’’ right?! These days home birth is becoming more and more popular as an option and for good reason. Women are wanting to be in the comfort of their own home with the continuity of care.
Home birth can be an option through Midwifery Group Practice or you can hire your own private midwife. I recommend getting in touch with either of these options as SOON as you are pregnant to avoid disappointment. Currently in SA, there are double the amount of clients wanting home births then the midwives available.
Home birth is around the $2000-$4000 mark if going with a private midwife. All of your appointments will be based at home which is a wonderful option for those who already have children or just wish to enjoy the comfort of their own home whilst baby is getting checked. Midwifes will make postnatal visits at the home so you basically do not need to leave your house for any antenatal or postnatal visits - amazing! Again, you are only eligible for home birth if you are deemed low risk.
PROS:
- Continuity of care
- Very natural birth focussed
- In your own environment, set up the way you would like
- Can have as many people as you would like with you, for however long you would like
- Option to have a water birth if desired
- Not ‘on the clock’ the same way as a hospital
- No pressure to get induced
- Generally, home birth midwives will have the same philosophies around birth as you as home birth
is a big commitment albeit an amazing one
CONS:
- Private midwives are often heavily booked out
- Midwifery Group Practice is hard to get into
- If something does go wrong, there is time pressure to get to the hospital - May need to go to hospital if placenta is having issues being delivered
GP SHARED CARE
Shared care is an arrangement between a GP, the birthing woman and a birthing hospital. You can see your GP for some appointments and the rest (and the birth!) in the hospital. Shared care can be a desirable option due to the relationship and history you may have with your GP as well as it may be an easier location to attend. Be mindful, that not every GP offers this so you will need to check with your individual care provider.
If your GP bulk bills and you eligible for Medicare, these appointments won’t cost you anything, however if your GP doesn’t bulk bill then you will be out of pocket for the gap.
Once you are 36 weeks pregnant, your appointments will move to the designated public hospital.
PROS:
- Continuity of care
- GP has your history
- May be closer to home - Convenient
CONS:
- May be more expensive then just going to the hospital
- Appointments MAY not be as thorough, if GP is running late
- GP may not be able to answer your questions the same way a midwife can
I hope this is helpful! Just remember that it’s your birth, your way. Ask questions, educate yourself and BELIEVE in yourself and your baby.
