Midwives who do not work in the public system are called private midwives and can be self employed or work for a private business. Midwives who are in private practice may choose to offer full care from pregnancy to after birth and some specialise in particular areas – for example, antenatal education only.
Midwives in private practise have the same qualifications as those employed in hospitals and they have met and maintain the same registration requirements with the Nursing and Midwifery of Board Australia. Some have also completed further endorsement, allowing them to prescribe certain medicines, which you can claim on Medicare. Private midwives care for pregnant women with the same competence and expertise as hospital employed midwives.
All private midwives are always supported by an interprofessional collaborative team. This means that, if at any time medical advice or assistance is required (from pregnancy to postnatal), your midwife will consult with – and refer you to – the appropriate health care specialists. You will also be required to see a doctor for at least one of your appointments while pregnant, your midwife can refer you to one.
Private practising midwives are often in high demand and it is a good idea to contact your local private midwife as soon as you discover that you are pregnant as they fully book very quickly. Private midwives most closely follow the midwifery philosophy of being ‘with woman’ and usually provide a more holistic approach to pregnancy and birth, making them a popular alternative to clinic midwives who are limited by hospital policies. Private midwives also tend to spend more time at antenatal and postnatal appointments, allowing more time for questions and planning individualised care.
Where private midwives work:
Generally private midwives will come to your home for antenatal and postnatal check-ups and attend births planned outside of the hospital system – in private birth centres or at home. There is a lot of research to show that planned birth at home is a safe option for low-risk women who access midwifery-led care, and that women who birth at home have a much smaller chance of having intervention during their labour and birth compared to birth in a hospital. This is the same for births planned in a birth centre.
Some private practising midwives have hospital visiting rights to a particular hospital. This means you can be admitted to the hospital as a private patient and your chosen midwife can be your primary care provider. If you choose this option, private fees will be charged, so it a good idea to check that your private health insurance will cover this.
Most private midwives don’t have visiting rights. This means that if you want a private midwife and to birth in hospital, your midwife would provide your antenatal and postnatal care, but the public hospital staff would provide your labour and birth care. In this situation, some private midwives may not attend the birth, or they may agree to be present but only as a birth support.
Charges for full pregnancy, birth and postnatal care with a private midwife can range from $4000 – $6000+. This may or may not include the fee of a second midwife (required at birth) or for additional items such as hire of a birth pool, so it is a good idea to discuss these with your midwife. Many private midwives offer a payment plan.
Rebates are available through Medicare if your private midwife has a Medicare provider number. You may be eligible for rebates on the cost of antenatal, birth and postnatal care with a private midwife if you birth in a hospital. Or, if you birth at home, you may be eligible for a rebate on antenatal and postnatal care only. If you have private health cover, it is worth checking if your insurance will also cover any of the costs. Despite rebates, there are still out of pocket expenses and this may be a barrier for some people.
NOTICE: All health professionals require indemnity insurance to meet their legal practise requirements. Midwives in private practise across Australia cannot currently purchase indemnity insurance to cover birth care, as this insurance product is not presently available. The Australian federal government has provided an exemption until December 2021. It is currently unknown if this exemption will be extended, or if an insurance product will become available to private practising midwives. This may impact private midwives offering a homebirth service at this time, and women with an estimated due date of December 2021 (or later), who are planning to birth at home.