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Public vs private pregnancy
Pregnancy care and childbirth can be either private (with out of pocket costs) or public (completely free). Let's dive into the pros and cons – and costs – of each.
Childbirth and maternity care in Australia is available in both the private and public hospital system. You and your baby will be in good hands with either option, but there are big differences in the services available to you, and the overall cost.
Maternity: Public versus private overview
In Australia, you can choose between a virtually free delivery using Medicare or a private delivery, which will have out of pocket costs. Private delivery costs extra but offer more choice, comfort and help toward your out-of-hospital treatments. Higher-tier private health insurance policies include benefits for private childbirth and pregnancy, so many of these costs can be partially covered, but you will always be out of pocket. For a private birth experience, you can expect to be out of pocket to the tune of $5,000 to $10,000.
In terms of the essentials, like how many appointments you go to, what test you need to take and how you choose to deliver, you won't find much difference between the public and private systems. The big differences are the professionals you'll be interacting with and continuity of care with the same providers; where you'll be staying when you deliver; how long you'll have to recover in hospital; and what additional benefits are available to you.
Pregnancy cover can be found in a top (or gold tier) policy. As an example, the following table shows finder.com.au partners. They all have a 12-month waiting period, meaning you have to take out cover at least 3 months before you get pregnant, in order to be eligible for cover when the baby is born. All prices are based on a single individual with less than $97,000 income and living in Sydney.
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Pregnancy: Public versus private for your prenatal care
Your prenatal care starts the day you first see a medical professional to confirm your pregnancy, all the way to the day you give birth. You’ll be in and out of appointments with GPs, obstetricians (OB), midwives, radiologists (for ultrasounds) and other clinicians for blood work and genetic testing. There are a few differences you should be aware of between public and private prenatal care. These are:
Who you see first. In the public system, you will first see your GP who will refer you to the nearest public hospital or birthing centre to see a midwife. In the private system, you can go straight to your chosen OB in either a private clinic or private hospital.
Where you go for regular appointments. In the public system, you’ll go to a public hospital for your appointments at a time allocated to you. In the private system, you’ll go to your OBs private offices and you can arrange appointments for times and dates that best suit you.
Who you see at your appointments. In the public system, you’ll see a group of midwives with the opportunity to see whatever OB is on duty when necessary. In the private system, you’ll see the same OB at your appointments.
Other than that, your appointment schedule will be about the same, and you’ll most likely have access to educational and fitness courses through both systems.
Choice of carer and continuity of care didn't matter much to me, and I'd heard really good things about the midwife care system at RPAH. The only hang up was the private room situation. Admittedly, we haven't had to live through that part yet, but RPAH does share rooms with 1 other woman which doesn't seem too bad, and the at-home midwife care program means they come out and visit you for check-ins for the first 2 weeks. We are lucky to have access to RPAH; if not, and I didn't have access to the same programs and quality of care, I likely would have opted for private.
Regardless of whether you go public or private, you can deliver naturally, via c-section, with or without pain relief and even via waterbirth if that’s what you choose. Some of the major differences are:
Accommodation. In the public system, you'll be in a public room, which means you may be sharing with other mothers after the birth, though if you book early enough and there aren't any foreseen complications, you may be able to book yourself into a birthing centre. In the private system, you will get your own private room with the opportunity to upgrade to a premium delivery suite.
Time in hospital. You'll usually go home within 24 hours of giving birth in the public system (longer for a c-section). As a private patient, you'll generally stay a minimum of 4 nights.
Who delivers your baby. In the public system, the team on duty at the time will be delivering your bub. When you go private, you can consult with the obstetrician of your choice. They'll come to the birth if they're available and if your obstetrician can't be there, they'll arrange another one.
I had all three of my children at public hospitals and all were good experiences, except that my first two I had to share a room with another new mum. It was a nightmare because of the noise, the visitors and the lack of privacy, and my husband couldn't stay overnight to help me. My last birth was at GCUH, which was fabulous. 5 Star treatment for $0.
After: Public versus private for your postnatal care
Your postnatal care refers to your immediate recovery period in the hospital, as well as a period of time post-birth when you’re nursing yourself and your baby into good health. Whether you use public or private, you’ll receive the same number of basic check-ins, where doctors and midwives will make sure everyone is healthy. The big difference is that the private system offers much more in the way of counselling, education and therapeutic services. Here are the differences you’ll notice:
The length of your stay in the hospital. For an uncomplicated birth in a public hospital, you could be discharged as early as 4 hours after your birth. In a private setting, you will get to stay at least 3-4 nights. If you have a c-section, you’d be looking at around 5 nights in a public hospital or 7 nights in a private one.
Consultations. Apart from the two standard consultations everyone gets, your private cover may offer speciality lactation consultation. You may also still have access to private classes run by your OB.
Natural therapies. Medicare won’t cover you for physio or massage, but a private extras policy will rebate some of these costs. For instance, of your physio appointment is $95, you will get between $30-$85 back on each appointment, depending on your policy.
Exercise classes. If your public hospital offers complimentary exercise classes, you may be able to attend for a certain amount of time post-baby. A private extras policy may also include cover for exercise classes of your choice.
How much does it cost to have a private pregnancy in Australia?
A major difference between delivering publicly and privately is cost. A Medicare-covered public birth is generally free. With a private birth, your insurer and Medicare will pay a majority of the costs, but you’ll still have out-of-pocket expenses and they usually amount to thousands of dollars.
Here’s what you’ll pay for:
A portion of procedures. For every procedure covered by Medicare and your private cover, there may be an additional amount that you have to pay. That’s because private doctors set their own prices, and these can go above what is covered. The exact amount depends on what kind of gap cover arrangement your doctor has with the insurer, but you can expect to have a gap of between $1,000 and $5,000 for your OB's deliver fee alone.
Tests. Medicare largely won’t cover tests performed in a private clinic, like bloodwork, ultrasounds and genetic testing, although you will get a rebate for things like your 18-week morphology scan. The rebate won't cover the full case , but it will be up to you to pay the remainder. Your OB may be able to refer you to bulk-billing clinics if one is available. You can expect to pay between $150
Fees. Medicare largely won’t cover any additional fees like accommodation fees, theatre fees or your doctor’s admin fees. Again, you private cover will take care of some of this, but there may be a portion you’ll need to pay out-of-pocket.
Medications. If you need medication that is not part of the Pharmaceutical Benefits Scheme, you will have to pay for it whether you use public or private.
Key statistics
On average, Australians spent $726 for childbirth in the public system, according to our parenting report.
Those with private health insurance had an average of $2,400 in out-of-pocket expenses.
Almost 2 in 5 (38%) people surveyed said the quality of treatment and care in public is just as good as it is in private.
Although, the number 1 reason parents say they would go private for their next birth is for better quality of treatment or care, closely followed by the ability to choose their own OB.
You can get health insurance for pregnancy from $216 a month. You'll need to hold a policy for 12 months before you are covered.
The average bronze hospital cover premium is $98.84 a month for a single policy (without pregnancy cover) compared to the average gold hospital cover premium of $219.35 a month for a single policy (includes pregnancy cover).
Is it worth going private?
This really comes down to a few important factors around cost, privacy and your preference with doctors. There are a few questions you can ask yourself to make the decision:
How important is privacy? Going private, you are almost guaranteed to have a private room for several days after giving birth. In the public system you will be recovering in a shared space.
Do you want more time in hospital to recover? The public system won’t kick you out before you’re ready, but the focus is on getting you home sooner than later. The private system gives you a few extra days to recover.
Do you value consistency with the same health providers? With a private birth, you will see the same OB or midwives throughout your pregnancy. In the public system, a team of midwives will look after you during the birth with the on duty OB.
Is there a particular OB you prefer? If the closest hospital is a private one and being close to home is important, private health insurance could be worth it. Or if there is a private OB you would like to see, private health insurance will give you more choice.
Do you have a specific hospital in mind? This could determine whether you go private or public, as OBs work with specific hospitals.
Is it worth the cost to you? You'll be out of pocket a minimum of $5,000 for a private pregnancy and childbirth, with private health insurance. This cost jumps to $12,000 to $20,000 without private health insurance. You can weigh up the cost of cover to see how much more you pay in premiums and in out of pocket costs, to see what the likely cost is going to be and whether it's affordable to you. This guide explains all the costs in detail.
At the end of the day, it’s a personal choice and it's often helpful to reach out to friends to family and find out what their experiences have been like. Hop onto some online forums and FB groups to hear from women there, many of whom will be from your local area offering local advice.
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As an authority on all things personal finance, Sarah Megginson is passionate about helping you save money and make money. She is an editor and money expert with 20 years’ experience and an extensive background in property and finance journalism. Sarah holds ASIC RG146-compliant Tier 1 Generic Knowledge certification, and she's a regular media commentator, appearing weekly on TV (Sunrise, Channel 7 news, Nine news), radio (KIIS FM, Triple M, 3AW, 2GB, 6PR) and in digital and print media. See full bio
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You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
