Womxn who plan to birth in a public hospital, and their pregnancies have been identified as higher risk, will be given care by a public obstetrician. In some situations, it may also be possible to chose obstetric-led care if you have a low-risk pregnancy. Most or all of this care is covered by Medicare if you have a Medicare card. Obstetric care may provide continuity of carer in some public hospitals for pregnancy, but often not for labour, birth and postpartum. Some antenatal appointments may still be with a midwife.
During labour you will most likely have midwifery-led care, the midwives will know from your hospital records what extra care you may need during labour. Also, the doctors on shift (who may not be the obstetrician you met in pregnancy) will keep track of your labour and will help if medical assistance is needed at any time. Depending on why your pregnancy was identified as higher risk and the progress of your labour, you may or may not have an obstetrician present at your birth.
After the birth of your baby, and routine checks have been done, the midwives will help you get ready to move to the postnatal ward, where different midwives will take over your care. Your length of stay in hospital after birth will depend on your health and your baby’s health. If everyone is healthy you may be discharged the same day, or the next. If there is a health concern your stay maybe longer. If you already know that you don’t want to stay in the postnatal ward, make sure to tell your care providers during pregnancy, so they can support you in leaving early.
Some womxn 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 it is worth noting that Australia’s caesarean section rate of 35% is higher than the World Health Organisation recommendation of 10-15%. This increased caesarean section rate has been recognised by RANZCOG, Australia’s obstetric profession, as an ‘appropriate rate’ for ‘Australian women’.