Let me tell you a story I often tell to the couples who come to my HypnoBirthing couples.

 

Before I became a midwife, I was a nurse and I worked in Neonatal ICU (I still do, but that is another story).  ‘Growing up’ as a nurse there I would often have senior nurses saying how dangerous birth was, and that homebirth especially was bad.  Being a ‘good girl’ I would nod along and think ‘well, they have so much experience, they must know what they are talking about’.  Had I got pregnant in this time I would have gone to a private hospital with a private obstetrician.

 

Then I went to do my midwifery training, and within 2 weeks of starting I had cancelled my private health insurance, because I realised that I would never go to a private obstetrician  The lecturers, midwives with over 20yrs experience each, had made me realise that pregnancy in itself isn’t a medical condition and why would you go to a doctor if you are not sick?  And if something happened during the pregnancy that required a doctor then I would go to the tertiary public hospital, where they dealt with the worst of the worst, and so have very good knowledge and skills.

 

Now, before we go any further and you start to think that I am against doctors – I am not.  Or that I am going to push home births – I am not.  

 

I have great respect for the skills and knowledge doctors have, and I respect that not everyone will be comfortable giving birth outside of a hospital. 

 

What we need to keep in mind is that midwife means ‘with woman’ and obstetrician means ‘to stand by’.  Midwives are the experts in physiologcal pregnancy and birth, doctors are the experts in pregnancies and/or births that require medical management.

 

Giving birth is not just about getting a healthy baby at the end.  It is a very important outcome, but not the only one.  Giving birth is also about the creation of mothers, and fathers, and families.  How they are made to feel during the birth can have lifelong consequences.  Having one outcome does not have to the detriment of the other - you can have both

 

So I would strongly encourage you to ask ‘which caregiver will be best for us’, ‘who is going to keep us safe and help us become parents to this new child’.  (And safe means emotionally and physically.)

 

What are your choices?  In a nutshell they are:

Private midwife for a home or hospital birth

• They will usually do all antenatal appointments with you in your home, or their clinic

• They will usually be with you for most of your labour and your birth (the things that might prevent them from being there is sickness, or attending someone else at the same time, but they will usually send a back up midwife and this is a very rare occurrence)

• They will also do your postnatal care, usually in your home

• Can be pricey (a few thousand dollars out of pocket) as Medicare won’t cover the whole cost, and private health insurances rarely cover private midwives

 

Publicly funded midwife for hospital, birth centre, or home birth

• There may be some ‘heavy’ restrictions on who can access this model of care, but it never hurts to ask

• The midwife will usually do all of your antenatal appointments either in your home or at the hospital/clinic

• They attend you during your labour and birth.  Again, sickness or work restrictions may mean that they cannot come, but a back up midwife will usually be sent.   This is slightly more likely to occur than with a private midwife as a publicly funded midwife may be assigned more families to care for

• Your midwife will usually do your postnatal care in your home, or maybe at the birth centre/hospital  

• These programs are usually free, as they are fully funded by Medicare, but there might be incidental costs such as for scans or other tests

 

In both of the above options you may see a doctor or two at different times in your pregnancy.  If a medical issue becomes a problem during the pregnancy then you may be referred to a doctor to be part of your team as well

 

Public hospital midwives/obstetricians

• You are booked in to your local public hospital 

• You see whoever is on duty when you attend the antenatal clinic – this may be a midwife or a doctor, or both, depending on your situation

• When you go into labour and are admitted to the birth suite you are assigned a midwife to care for you.  You may see two or more midwives depending on how long you are in labour and/or what time of day you are there

• Obstetricians and junior doctors (‘registrars’ and ‘RMOs’ or ‘JMOs’) are on duty if they are needed

• This is usually free as it mostly covered by Medicare.  There may be some out of pocket costs for scans and/or other tests

 

Some public hospitals have started ‘Midwifery Group Practice’.  This is where you are assigned to a group of midwives (or sometimes a primary midwife), and they will take turns to do your appointments, and then who ever is on duty when you go into labour will be assigned to care for you.  Again, it never hurts to ask if this option is available

 

Private obstetrician for a hospital birth

• You choose a private obstetrician to see, and choose the private hospital to give birth at (some also have admitting rights in public hospitals).  They may have a midwife working with them

• They do your antenatal appointments in their clinic

• When you go into labour a midwife working at the hospital will be assigned to you (again you may see a few depending on how long you are there), your doctor may come to see you during your labour, and then will usually be there at the birth (although, again sickness, holidays, or them attending other patients may prevent them from being present)

• Your postnatal care will usually be done by the midwives working at the hospital, and you may go to your obstetrician for 1 or more postnatal appointments in their rooms

• This can be quite costly as not all the costs will be covered by Medicare or private health insurance (I’ve heard of figures up to $10,000)

 

Before you settle on an option, I would encourage you to do some reading – read some books, look at some websites, don’t just take my word for it.  The ones I most recommend are – anything by Ina May Gaskin, ‘Gentle Birth, Gentle Mothering’ by Sarah Buckley (and her website, just search her name), ‘Birth with Confidence’ by Rhea Dempsey, ‘HypnoBirthing’ by Marie Mongan, www.evidencebasedbirth.com, www.midwifethinking.com, and www.sarahwickham.com.  There are of course numerous others, but these will hopefully give you a good start

 

If you have already chosen a care provider and are maybe starting to think that they are not the best option for you then do not despair.  You may have the option of changing care providers.  But if that isn’t an option then remember what I said in my first email – knowledge is power!

 

You can learn more about options, and how to have a positive and empowering experience by attending a 5 week HypnoBirthing course.  I run new sessions every second month from January (private classes may be available, and extra sessions may be put on if there is high demand).  They are best attended between 20 and 30 weeks (but don’t despair if you are slightly further along – we may be able to work something out).  Click the picture below for more information