The cost of antenatal classes should be means-tested and made uniform across all hospitals, according to the Australian College of Midwives.
Increasingly, NSW hospitals are using private contractors to run antenatal classes because of tight budgets, which means women are being charged hundreds of dollars to attend at some hospitals, said Hannah Dahlen, an executive member of the NSW branch of the college.
The problem is that the women who potentially need classes, women who may not read a lot of books … are the ones that are least likely to get it.
The cost varies by up to five times between hospitals.
Ms Dahlen, who is also an associate professor of midwifery at the University of Western Sydney, said increasing fees were shutting some women out and the system was unfair.
''We've seen an increasing trend of, rather than employing staff to do antenatal classes, getting private contractors to come in and do the class and using women's incomes to pay for that,'' Ms Dahlen said.
''Antenatal education is not seen so much as core business any more so I think that's a real problem.''
Ms Dahlen said classes must be means-tested because too many women were missing out.
''The problem is that the women who potentially need classes, women who may not read a lot of books … are the ones that are least likely to get it.''
A spokesman for NSW Health said ''there are no standard fees, and costs vary from service to service'' for antenatal classes.
''Women who hold Commonwealth Health Care Cards have access to free or reduced-cost antenatal classes in many services. This decision is made on a case-by-case basis after referral from midwives, obstetricians and social workers,'' he said.
The opposition health spokeswoman, Jillian Skinner, criticised the high cost of some classes.
''The care and decisions made during these early months can impact on the rest of the child's life, and funding these programs should be a priority, not a luxury,'' Mrs Skinner said.
Sarah Monch, 31, of Surry Hills, attended antenatal classes at Royal Hospital for Women, which charges $270 for a six-week evening course.
Mrs Monch, an occupational therapist, thought it was not expensive and had already paid $475 for a private birth class weekend in Bowral.
''I think I got value out of both the classes and I'm glad I did them,'' Mrs Monch said.
By contrast, Nicole Harris, 20, paid $55 for intensive classes over a weekend at Campbelltown. ''There was so much that you learn that you don't know.
''I wouldn't have had a clue about anything, I would have been lost if I didn't do that class.''
Nadia Jones, a 29-year-old nurse, said the classes she attended at Campbelltown were invaluable but she would have baulked if the price was higher.
Royal Hospital for Women $270
St George, Sutherland $156
Royal North Shore $230
Nepean, Westmead $150
Campbelltown, Camden $55-$100
Canterbury No cost
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