Mother duck sitting with ducklings

Primary Care Providers

Many people think that if they have private health insurance then they should have a private obstetrician. Or if they don’t have insurance, then they will have fractured midwifery-led care in the public system. But there are so many more options than this. From high-risk care with a public obstetrician, to low-risk care with a private midwife, there are a range of options for you to consider. You could even choose to have some of your antenatal visits with your local obstetric GP.

Below we have made a potential pros and cons summary of the different care providers available across Australia. As you read through, you’ll see that we often refer the term ‘continuity of care/carer’, as this has been proven to have great outcomes for mothers and babies. Read our continuity of care article to learn the different types of continuity and how they can benefit you.

As well as choosing your preferred care provider, you also need to decide where you would like to birth, so make sure to look at our birth places article for a summary of your options. You can check out this model of care page to quickly see the birth places different care providers work in.

Pros Cons

Provide full continuity of carer. Your chosen midwife will be familiar with your needs and wants

Ongoing support at home through the postnatal period, up to 6 weeks

You may birth at home, in a private birth centre or public hospital (varies between midwives)

They have the lowest intervention rate, with excellent health outcomes

Are in high demand - access may be limited by availability and location

Many do not have ‘hospital admitting rights for birth in a hospital

Cost may be prohibitive

Midwife may need to cancel antenatal appointments at late notice if attending another birth

Pros Cons

Specialised care for higher risk pregnancies

Can provide care in private hospital or public hospital (not all obstetricians do this)

No need to change care provider if unexpected medical intervention is required during birth

Provides continuity of carer

Gap fees and additional services may be charged to you (blood testing, ultrasounds, nutritionist etc)

Potential change of obstetrician if a transfer to a public tertiary hospital is required (in some rare circumstances)

Postnatal care varies and may include appointments at the hospital with midwives or referral to a child health service.

Obstetrician may need to cancel antenatal appointments at late notice due to attending a birth

Pros Cons

Provides midwifery continuity of carer. They will be familiar with your needs and wants

You may birth at home if you have a 'low risk' pregnancy, or in hospital

Use of a birth centre rather than the ‘labour/delivery unit (if available)

Ongoing support through the postnatal period, for least 2 weeks

In high demand and some hospitals have a ‘low risk’ criteria, which limits access

You are provided a midwife by the hospital (cannot choose)

Midwife is bound by hospital policy

Midwife may need to cancel antenatal appointments at late notice due to attending a birth

Pros Cons

Most antenatal appointments at your familiar/chosen (accredited) GP

GP may already know your current health needs/concerns

Provides a version of continuity of carer before and after birth

More flexible appointment times (late and weekend times available)

Still need to attend some appointments at hospital

Documents from tests/screenings are sometimes not forwarded to the hospital (time consuming at hospital appointments)

GP may not be able to answer all your questions

You will not have met your birth care providers during pregnancy

Pros Cons

Specialised care for higher risk pregnancies in the public system

Some public hospitals offer this care to any woman who requests it

May be based on the continuity of care model

Cost covered by Medicare

Some public hospitals only provide obstetric care to higher risk pregnancies

Potential to see different obstetricians throughout pregnancy

Unknown midwives during labour

Likely a different obstetrician at birth (if one is needed)

Pros Cons

Obstetric care available at the same place and time for higher risk pregnancies

Appointment times do not get cancelled

Tests and screenings can also be done at the hospital

Maternity care in a public hospital is covered by medicare

Likely a different midwife at each antenatal appointment

Unknown midwife at birth

A different midwife for postnatal care

Potential need for repetition due to seeing a number of different midwives (lack of continuity of care)

For more information on care providers, please use these links:

*Womb does not promote any particular birth place. Womb advocates for women to have options and believes that a woman’s pregnancy and birth decisions are her own – to be made with information, guidance and support from her care provider/s and family.

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