Private obstetricians offer medical care for high risk and low risk pregnancies and can work in private and public hospitals. They also offer a form of continuity of carer. It is a good idea to do some research before deciding which obstetrician you wish to use, as some may meet your needs better than others. For example, if you have previously had a caesarean section and wish to have a VBAC (vaginal birth after caesarean) next time, some obstetricians will be more comfortable with this than others.
Your antenatal care is likely to be provided in the private hospital they practise in and you may also get to meet one or two of the midwives who work with your chosen doctor. Having ‘your own’ doctor means that they will learn what your needs and wants are, an important aspect of continuity of carer.
During labour you will initially be looked after by the hospital midwives, who you may or may not know. The midwives will regularly update your obstetrician with your progress, and they will be advised of appropriate care over the phone. Your obstetrician will come to hospital at a time when your baby is likely to be born soon, or earlier if medical assistance is required.
After birth, you will be moved to a private room where you and your partner can get to know your baby over the next few days. Check with your obstetrician how long the hospital allows you to stay, it may be up to five days. During this time, your baby can have all the recommended checks completed before you go home and you will be well supported in learning to care for your new baby.
If you prefer to have private care in a public hospital you will need to check if your preferred obstetrician provides this, as not all private doctors work in public hospitals. In a public hospital, your antenatal, labour and birth care will be similar to the care in a private hospital, however you cannot be guaranteed a private room for postnatal care. Your length of stay after birth may also be shorter in a public hospital.
Private obstetric care is available to anyone. If you have private health insurance (with maternity cover), it is important to check what your health insurance covers before finding an obstetrician as costs for things like ultrasounds and some blood tests may be charged to you at different rates. Any family without private health insurance can choose private obstetric care but will need to pay all fees out-of-pocket.
Some people are concerned that obstetricians have a higher intervention rate than midwives, but this is to be expected as they are the experts in higher risk pregnancies and birth. However, private obstetricians tend to have higher intervention rates than public obstetricians. The average caesarean section rate for private obstetricians in 2017 was 39.9% but the public obstetrician caesarean rate is 26.6%. The World Health Organisation recommends a caesarean section rate of 10-15%. This increased caesarean section rate has been recognised by RANZCOG, Australia’s obstetric profession, as an ‘appropriate rate’ for ‘Australian women’.