Primary Care Providers

February 19, 2020

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.

@AuWomb

wombcommunity

Primary Care Providers

Chorionic Villus Sampling

Prenatal screening

The booking visit

Confirming Pregnancy

GP Shared-Care

Private Obstetrician

Navigation

Essentials

First Trimester