In 2010 a total of 294,814, women gave birth in Australia.* It is often said that giving birth is the one event you will remember for the rest of your life. So how do you choose where is the best place for you to have your baby?
When you find out you are pregnant you are often referred by your GP to an Obstetrician if you have private health cover or if you do not have private health cover you would be referred to your local public hospital. Both options are completely fine but it is vitally important to consider which environment best supports your birthing needs? It is critical that you choose a model of care that shares a birthing philosophy that you are aligned with. Your carers also need to be willing to support you in what you believe is important for you during your pregnancy, birth and post natal care. It is helpful to understand the difference between Midwifery based care and Obstetric care.
Midwifery Model of Care
Midwifery based care is for women who are healthy throughout their pregnancy and are considered ‘low risk’ at the time of birthing. A Midwife is a healthcare professional who provides care for women during pregnancy, birth and the post natal period. They can work independently or within the public or private hospital system. They generally come with a more natural approach to birth however they have the expertise to detect complications and would then refer to an Obstetrician.
Independent Midwives are qualified to provide your care during pregnancy, labour and birth. Having a private midwife ensures continuity of care throughout your pregnancy and birth. They offer, ‘a woman and family’ centred approach and very much regard your pregnancy and birth as a normal physiological process not an illness. They trust in the woman and her ability to birth naturally. You can choose to have an Independent midwife for your antenatal and postnatal care no matter where you choose to birth. Independent Midwives can assist you during your birth if you are having a home birth however they are unable to support you medically during labour in a hospital setting.
Obstetric Based Care
An Obstetrician is a medical doctor who has been educated in obstetric care. They are specialists in caring for women with complicated pregnancies, women who choose to have medical pain relief in labour or women who are in need of medical intervention during their birth. You can choose your own Obstetrician in the private hospital system. However in the public system if you are ‘low risk’ you will have Midwifery based care, but if needed, you will have access to a resident Obstetrician known as the registrar.
We are very blessed in Australia with our high level of Obstetric care. When high-risk care is needed we have some of the best doctors and facilities in the world. However in our birthing culture in Australia, many low risk women choose obstetric care as their primary care and therefore have higher interventionist births than the midwifery model of care, as by nature Obstetricians focus more on risk. This is a contributing factor to our high caesarean rate which in the private system is 43.1% and in the public system is 28.4%, overall in Australia our caesarean rate is 31.6% which is one of the highest in the world.
The next decision in choosing what birth options are right for you is to look at ‘where’ you will give birth.
Understanding the different birth environments available to you is extremely helpful when contemplating your birth. Here are your four main birthing options
– Family Birth Centre
– Public Hospital
– Private Hospital
– Homebirth
Family Birth Centre
A family birth centre is a home-like setting within a public hospital. It is for women who have had a healthy pregnancy and are considered to be medically ‘low risk’. For your prenatal care, labour and birth you can be attended by the hospital midwives and a hospital registrar if required. You can also choose to have your antenatal care with a private midwife or have shared care with a private obstetrician or GP. Pregnancy and birth is regarded as a normal physiological process. Medical pain relief is limited and not encouraged; a Birth Centre allows women the space and time to birth naturally. On the day of your birth you will be cared for by the midwives you have seen as part of your pre natal care.
2.2% of women birth in Birth Centres in Australia*
Public Hospital
Your antenatal care takes place in a clinic within the hospital with the hospital staff. You could also choose to have shared care with the hospital team and either a GP, a private obstetrician, or an independent midwife.
You will labour and birth in the hospital labour ward attended by the hospital team of midwives and the hospital registrar if needed. On the day of your birth, you will be cared for by the midwifery team on that day and if necessary the hospital registrar.
Private Hospital
A private obstetrician of your choice would manage your pregnancy, labour and birth. Antenatal care will be at the private rooms of the obstetrician. During labour and birth you will be attended by the hospital midwives which will be unknown to you and your obstetrician can be involved in your labour and will plan to be present for the birth, which is only usually for the last 30mins to hour of your labour.
96.9% Of women birth in either the public or private hospital system*
Home Birth
Naturally birthing at home you will be attended by a private midwife of your choice. You may also choose to have a supportive doctor present. Being able to choose your carers in this way enables you to develop a relationship throughout your pregnancy, ensuring continuity of care with someone you know and trust during your labour and birth. Antenatal care takes place at your home or at your midwives or doctor’s practice.
0.5% of Women Birth at home in Australia*
0.5% of Women BBA (born before arrival) which is unplanned home births or babies born on the way to hospital!*
Understanding your options for care is helpful when planning your birth.
Here are your four main birthing options
– Public Hospital
– Family Birth Centre
– Private Hospital
– Homebirth
Sometimes women choose where and with whom to give birth based on what their friend, sister or GP suggests instead of researching how they would like to give birth and whether the model of care best suits them. There are various considerations when choosing what is right for you and your baby and like many things in life knowledge is very powerful and can move you towards an empowering parenting journey.
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From the desk of…
Jules Brooks
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*Stats are from Australian Peri Natal Data 2010
Jules and her co director Lael Stone offer Calmbirth workshops for couples to prepare themselves with the tools needed to have an empowered and positive birth experience. They also offer doula support for couples who are looking for support during their pregnancy and birth. The next Calmbirth workshop will be held in Malvern.
Date: Saturday 5th and 6th October 2013
Time: 9.30 to 3.30pm
To book please visit www.aboutbirth.com.au
