Australia's fertility rate has dropped again, this time because of the GFC.

Pregnancy and birth

If you are a member of a private health fund (or if you want to pay for private care), you will be able to make your own choices about who will be your care giver and the private hospital in which you will deliver your baby. (Check with your healthfund to determine whether or not they cover Private Midwife Care).

When you select your caregiver (obstetrician, general practitioner or independent midwife), they will be able to tell you which hospitals they have admitting rights to. Hospitals will also be able to provide you with information about admitting rights for your chosen obstetrician, doctor or midwife. If you choose your hospital first they will be able to give you advice about an obstetrician.

Why choose a private hospital? 
One of the attractions of private hospital care is the high standard of comfort and quality of food, however it is important to look beyond the frilly curtains - there is more to a hospital than plush single rooms, gourmet meals and a bar fridge. The main disadvantage of private hospital care is the expense and if you do choose this option, it is beneficial to have private health cover, which must be taken out before you are pregnant (12 months before giving birth).

Private hospital care can also include some hidden expenses, and even with private hospital cover there can be additional "gap" payments to be made.

Obstetrician/GP
Your birth choices in a private hospital include include the Obstetrician/GP (providing they have visiting rights at the hospital you have chosen, this will be one of the questions you want to ask them). 

If you choose an obstetrician or GP as your caregiver, he / she will provide all of your care throughout your pregnancy and delivery. You will usually attend the doctor's private consulting rooms for each antenatal visit.

Theoretically, an obstetrician offers the most knowledge and skill, though in practice most of their training is focused on problem deliveries. An obstetrician is a good choice if you have had a previous difficult pregnancy / delivery or a medical condition eg. high blood pressure or diabetes.

If this is your first pregnancy the decision is not so easy. Some people will choose an obstetrician for peace of mind; however, most women do not require such a high level of care for a normal and uncomplicated delivery. If you decide you want to see an obstetrician, your GP can refer you to one, or you can ask at the hospital of your choice.

You should check that the obstetrician / GP you choose has visiting rights to the hospital of your choice, and that if a serious obstetric emergency was to arise, the chosen hospital has the appropriate staff to handle the situation.

When you deliver your baby you will be admitted to either a private hospital, or a public hospital as a private patient (most obstetricians and doctors also have access to public hospitals). Throughout your labour you will be looked after by a midwife who will notify your doctor or obstetrician when to come for the birth, or if any difficulties have arisen. If your obstetrician or doctor can be present at the delivery, he / she will usually be assisted by other members of the hospital staff.

While private care with an obstetrician or GP gives you the advantage of seeing the same person throughout your pregnancy, unfortunately there is no absolute guarantee that your obstetrician / GP will be there for your birth, particularly if the delivery is quick.

Also, some doctors have a share agreement with other obstetricians to cover them while on holiday's etc. Who you get may depend on who is on call. While most obstetricians will endeavour to be there for your birth, it is always possible they will be unavailable when you go into labour - they do have a life and other patients.

If you are a privately insured patient in a public hospital and a single room is available, you will be given the room. Postnatal care is given during your stay in hospital (usually about 2-3 days). If all goes well, you may even be able to schedule an early homecoming!

Private shared care 
With Private shared care you can arrange to have all your care shared between more than one care giver, eg: your obstetrician, doctor, or midwife can share your antenatal care, delivery and postnatal care. This option may enable you to consider a greater range of delivery options, such as a labour ward, a birthing centre or a homebirth. You will receive the same treatment as a private patient (and the same bill!).

Private care with an independent midwife
Some health insurance companies offer health cover for private midwifery services and others do not. If you already have health insurance and this is your preferred care option, you will need to check your cover before making any firm plans.

Some midwives provide antenatal care at your home. Private care with a midwife gives you the option of having your delivery at a hospital delivery suite (wherever the midwife of your choice has admitting rights), a birthing centre, or at your home.

Compare private hospital care with public hospital care or talk to EB members about birth experiences.