Not sure whether you should go public or private for childbirth? We've broken down the pros and cons of each option.
Before having a child, every parent-to-be has to make an important decision. Will you be one of the 73% of Australian women that gives birth in a public hospital, or will you join the remaining 27% in the private system?
To find the right choice for you, let’s take a closer look at the differences between having a baby in a public hospital and a private hospital.
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Having a child in a private hospital
If you choose to give birth in a private hospital, you have the freedom to choose your own obstetrician to help you from start to finish. You can also choose the hospital where you give birth and may be able to access a private room instead of a shared ward. However, even if you have a high level of private health insurance cover, you will have to meet a certain amount of out-of-pocket costs.
Let’s take a closer look at the pros and cons of having a child in a private hospital:
Pros
- Choose your obstetrician. You can choose your obstetrician, and that obstetrician will look after antenatal care during your pregnancy. This will ensure that you and your baby get the level of care you want during pregnancy and labour.
- Choose your hospital. You can review your options and decide on the hospital where you would like to have your baby.
- Get a private room. You can have a single room if available. In many cases, your partner will also be able to stay in the room with you.
- Staff attention. A midwife will be present throughout the birth and your obstetrician will be on hand to offer assistance if required.
- Private health insurance cover. Private health insurance will cover your hospital accommodation costs, some or maybe all of the fees for your obstetrician and paediatrician, and possibly some of the fees if you engage the services of a private midwife. Check with your health fund for full details regarding which services are covered and to what level.
- Longer stays. Private hospitals commonly allow mothers stays of up to five days in hospital after giving birth.
Cons
- Out-of-pocket costs. Even with a high level of private hospital cover, you will still be responsible for some up-front costs. Out-of-hospital care such as obstetrician appointments, anaesthetist fees and tests/scans during your pregnancy won’t be covered by your private health insurance. As a result, you could end up with medical bills ranging from around $2,000 up to around $8,000.
- Hospital choice may be limited. Your choice of private hospitals may be limited to the ones your private health fund has an agreement with. This may also impact your choice of obstetrician as they will only have visiting arrangements with specific hospitals.
- Need to check the fine print. If you choose the private health system, ask your health fund to confirm exactly what will be covered if unexpected complications arise, for example, if your baby has to be admitted to hospital. If not covered by your health fund, this could add a significant amount to your total bill.
Having a child in a public hospital
If you give birth in a public hospital as a public patient, you will typically not have any out-of-pocket costs. You can also receive antenatal care at the public clinic of your local hospital, or opt for GP shared care. However, you will usually have a shared room and may not receive the same continuity of care as you would in a private hospital.
Pros
- No out-of-pocket costs for childbirth. As a public patient in a public hospital, you receive free accommodation and treatment under the Medicare system. This means that the cost of the anaesthetist, paediatrician and a range of other health professionals will be covered. You can also save money if your antenatal appointments are arranged via shared care with a bulk-billing GP. Ultrasounds and other tests will also usually be covered.
- Convenient. Antenatal care appointments can be managed through the public clinic of your local hospital or perhaps arranged through shared care with your GP.
- Birthing centres. In some areas of Australia, you may be able to access birthing centres, which take a natural approach to labour. These centres typically only accept low-risk patients and employ a team of midwives to care for you during pregnancy. They are part of the public system, so you shouldn’t have any out-of-pocket expenses.
Cons
- Shared room accommodation. You will most likely be given a shared room.
- Can’t choose your obstetrician. You do not have the freedom to choose your own obstetrician.
- Less continuity of care. You may see different midwives and doctors each time you have an appointment. However, some public hospitals are working to introduce greater continuity of care.
- Shorter stays. Public hospital stays following childbirth tend to be shorter. After a normal vaginal birth, stays typically range from 6 to 48 hours.
How to choose between private and public
The choice between the private and public hospital systems comes down to what you think is best for you and your baby. Is a private room important or the chance to choose your obstetrician? Or is the cost of giving birth in a private hospital too much for you to handle?
If you have any questions about how the public and private hospital systems work and which choice is right for you, ask your chosen caregiver. You can also check with a hospital for its policies on positions you can use during labour, on intervention during childbirth, and on the rate of caesarean sections. In short, consider all the issues that are important to you before making a decision.
If you’re considering going private, ask your obstetrician for an “informed financial consent”. This will ensure that you have a full understanding of how much pregnancy and childbirth will cost you, and how much you will have to pay in advance.
Finally, ask your friends and family for their recommendations. While everyone’s experience is different, getting advice from people you trust can help you find the right answer to this difficult but very important question.
Different types of birth
According to the Australian Institute of Health and Welfare, in 2014, 307,844 women gave birth in Australia, and 98% of them had their child in hospital. Of those women giving birth, 73% of women gave birth in public hospitals while the remaining 27% gave birth in private hospitals.
In 2014, 205,927 of women (67%) had a vaginal birth and the other 33% (101,896) had a caesarean section. The majority (81%) of vaginal births were non-instrumental, but if instrumental delivery was required, vacuum extraction (11%) was used more commonly than forceps (8%).
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