choosing the right care provider

Most of us don’t really look into our options when it comes to birthing, not until the second time around. You only know what you know, and it’s all too simple to be told by your GP how it’s going to go, or by your sister-in-law who went through XYZ. It’s not until we have experienced birth ourselves that we realise that things didn’t have to be that way the first time around, that we actually have options as birthing women and that we have control over how we wish to birth.

Choosing the right care provider is the single most important thing that we can do as birthing mothers to ensure that we feel safe and heard. There is no bad choice, but finding the right choice for you is critical in ensuring that you receive tailored care during your pregnancy, birth and postpartum journey.

Finding the right care provider is not always easy and there will be times when you feel as though there is no perfect choice at all. Like anything, it’s possible that you will need to compromise, but start by jotting down what is most important to you and go from there.

So, what options do we have in WA when choosing a care provider?

GP SHARED CARE

Your pregnancy care will be shared between your GP and the midwifery/obstetric team at your local public hospital. Your GP will provide your antenatal appointments until 20 weeks of pregnancy when you will also meet with the midwifery team at the hospital. If you have an uncomplicated pregnancy, you will see your GP up until approximately 36 weeks of pregnancy after which you will attend all appointments with a hospital midwife/obstetrician.

PROS - Mostly covered by Medicare (out of pocket expenses through the GP clinic may apply), you will see the same person for each appointment, possibly less travel involved for antenatal appointments.
CONS - Not able to choose your hospital as you will be in a catchment area, you may not have met the midwives/obstetrician on duty when you birth your child.

PUBLIC HOSPITAL CARE

An option for women who do not require ongoing specialist supervision. General hospital care is provided by the midwifery/obstetric team at your local public hospital.

PROS - Fully covered by Medicare, possibly less travel involved for antenatal appointments.
CONS - Not able to choose your hospital as you will be in a catchment area, you may see a different staff member at each appointment (no continuity of care), staff are bound by hospital policy.

PRIVATE OBSTETRICIAN

If you have maternity cover on your private health insurance policy then you have the option of choosing your obstetrician and hospital that you would prefer to birth through. Your private health insurance will cover part or all hospital costs, however your antenatal appointments are not covered. Part may be covered by Medicare. Non-private patients also have this option at their own expense.

PROS - Continuity of care and a high chance that you will have your obstetrician there on the day of birth, you can typically stay in a private hospital room for longer if you wish, obstetricians are specialists in managing pregnancy and birth complications.
CONS - You typically will not meet the midwifery team at the hospital until the day that you give birth, water births are not available in private hospitals, obstetricians often have a medical approach to birth (higher chance of intervention), staff are bound by hospital policy.

FAMILY BIRTH CENTRES

Family Birth Centres provide midwifery led care with a known midwife and is available to both public and private patients. Typically attached to a hospital.

PROS - Continuity of care, easily transported to a hospital should complications arise, water births available, fully covered by Medicare.
CONS - Low risk women only, limited number of applications accepted.

COMMUNITY MIDWIFERY PROGRAM

The Community Midwifery Program (CMP) is a model of care available to Perth women who are interested in home birth. Antenatal midwifery led care in your home and community based clinics.

PROS - Continuity of care, fully covered by Medicare.
CONS - Low risk women only, limited number of applications accepted.

MIDWIFERY GROUP PRACTICE

Midwifery Group Practice is available to women who are wanting a low intervention birth, offering both public hospital and home births. An allocated midwife provides your prenatal, labour, birth and postnatal care.

PROS - Continuity of care, fully covered by Medicare, can choose a home or hospital birth.
CONS - Low risk women only, limited number of applications accepted, bound by hospital policies.

PRIVATE PRACTICE MIDWIFERY CARE

Private Midwives are practising midwives who are not linked to a hospital. They offer woman centred prenatal, labour, birth and postnatal care for women wanting a home birth. As midwives are not bound by hospital policies, you typically have a lot more flexibility in terms of your birth preferences. If your midwife is an Endorsed Midwife, you may be able to claim some of the cost by Medicare.

PROS - Continuity of care, flexible birthing options.
CONS - Low risk women only, large out of pocket expense (from $5000), limited availability.

MIDWIFERY STUDENT PROGRAM

As part of their midwifery studies, university students are required to be involved in multiple women’s pregnancy, labour, birth and postnatal journey. You may choose to have a midwifery student follow your journey if you are less than 35 weeks pregnant from the start of the program. Students are always under the supervision of a qualified care provider.

PROS - Familiar face throughout your entire journey, additional support for no additional cost.
CONS - One extra person in the birthing suite.

Edith Cowan University
Mothers Adopting Midwifery Students (MAMS) Program
http://www.ecu.edu.au/schools/nursing-and-midwifery/community-activity/mothers-adopting-midwifery-students-mams-program

Curtin University
Continuity of Care Experience
midwifery.cce@curtin.edu.au

Notre Dame University
School of Nursing and Midwifery

Call the Student Midwife South West Facebook Page
https://www.facebook.com/groups/1083371685597377

We are fortunate to have so many birthing options available to us, and each come with their pros and cons. Talk to other women about where they birthed and how they found their care provider, listen to podcasts, read books. Should you find yourself midway through your pregnancy and having doubts about your chosen care provider, listen to your gut and make the change. No matter which pathway you take to birth your baby, the most important thing is that the decision is yours, the entire way through your pregnancy.