What is public and private care?

If you are pregnant or planning a pregnancy, you might be wondering about the options for your care.

Australians have access to a variety of high-quality maternity services and models of care. You can choose which model of care is best for you and your pregnancy.

Take your time to decide the best care model for you. It's a good idea to explore all options, to find the care that is right for you and your pregnancy.

What is public healthcare?

Medicare is Australia's public health insurance scheme funded by the government. If you are eligible, you may be able to access certain types of medical care and hospital services at low or no cost.

Learn more about Medicare and its benefits.

During your pregnancy, Medicare may help with the costs of:

• appointments with midwives and obstetricians in the public healthcare system
• telehealth and telephone consults
• routine ultrasound scans
• blood tests
• some immunisations covered by the National Immunisation Program
• 3 pregnancy support counselling session per patient per pregnancy
• your stay in hospital

Learn more about Medicare during pregnancy.

What is private healthcare?

The private healthcare system allows you to be treated in a private hospital.

Choosing private care may:

• give you a single hospital room
• allow you to choose your own healthcare providers

If you choose treatment in the private system, you are responsible for the costs of your care. Private health insurance may help cover some of the costs.

Private health insurance may:

• cover part or all of your hospital stay in a private hospital
• cover some out-of-pocket fees for private doctors or midwives
• cover some antenatal tests that aren't covered by Medicare
• allow you to choose your specific health care providers and the hospital you will give birth in

If you have private health insurance, you may also choose to be treated as a private patient in a public hospital. You will not be guaranteed a single room and will still be responsible for hospital, medical and diagnostic costs.

Private health funds usually require membership for at least one year before they will cover you for maternity services. Make sure to check what your private insurance covers.

The Royal Women's Hospital explains the various hidden costs of having a baby.

Who are my care providers during pregnancy?

There are 3 main types of health professionals who may look after you during your pregnancy, depending on your health needs and where you plan to have your baby:

• midwives
• obstetricians
• your GP

Learn more about the roles that these health professionals can play during your pregnancy.

Midwives

A midwife is a registered healthcare professional who works in partnership with women before conception and during pregnancy, labour, birth and the first few weeks after birth.

Midwives support natural birth and can identify complications and provide emergency care for you and your baby if necessary. Midwives also work with other healthcare professionals and may refer you to medical care if needed.

Midwives make sure that you're fully informed about the care you and your baby will receive. They are your advocate, and they can help you to have the birth experience you want.

An endorsed midwife is a midwife with an extra postgraduate qualification. They can prescribe some medicines and order certain tests relating to pregnancy, birth and the newborn period.

If you are a public patient, you may not have the same midwife throughout your pregnancy and birth, but instead be care for by a team of midwives. Additionally, you can choose to give birth with a midwife at a birth centre, in a maternity group practice or case load model, or through a planned home birth.

If you are a private patient, you can choose to be seen by a midwife for all of your pregnancy birth and postnatal care . You may also choose to give birth in different settings, including at home with a private midwife.

Obstetricians

Obstetricians are doctors and registered healthcare professionals, who specialise in caring for you during pregnancy, birth and after birth. Obstetricians work in both public and private hospitals.

If you choose to see a private obstetrician, you will need to find out where they practice and book in as a patient at that hospital. It is sometimes possible to have your private obstetrician attend your birth in a public hospital.

If you are a public patient having your baby in a public hospital, or midwifery led models of care, you might only see an obstetrician if there is a medical need.

General practitioners (GP)

Your doctor might offer pregnancy care alongside other health professionals at a hospital or birth centre. This is called shared care. If you live in a rural or remote area, your GP might provide all your pregnancy care and assist at your baby's birth.

If you are a public patient and your doctor bulk bills, the costs of your appointments will be covered by Medicare.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Where can I choose to give birth?

You can choose where you want to give birth.

The options available to you may also depend on if you have pregnancy complications and where you live. It is important that you are well-informed and understand the advantages and disadvantages of different birthing options, so you can make a decision that aligns with your preferences for pregnancy, labour and birth.

Find out more about where you can give birth and how to choose which option is best for you.

Public hospital

Most public hospitals in Australia offer a range of care options. Options you may be able to access through a public hospital include:

• a hospital birth with team midwifery care
• midwifery group practice or case load (pregnancy, birth and postnatal care with a known primary midwife)
• birth at a public birth centre
• homebirth

If you need to be seen by an obstetrician during your labour and birth, you will see the doctor who is working in the hospital at that time.

If you book into a public hospital for your pregnancy, you will usually attend the public hospital antenatal clinic and may see a doctor or midwife during your visits. It may not always be the same person.

You can ask your GP, midwife of doctor, at your first antenatal visit, for more information on the models of care available in your local area and maternity hospital.

Private hospitals

Private care will usually be through a private obstetrician of your choice. They may also have a midwife that works with them. Most private hospitals will be able to give you a list of obstetricians who practice there.

Antenatal care is often provided in your doctor's clinics. You will usually be care for by a midwife during labour and your obstetrician will attend and assist you around the time of birth, usually at a private hospital.

Learn more about having your baby in a hospital.

Birth centres

Birth centres offer care for women who have a low-risk pregnancy and would like minimal medical intervention. They often have a more home-like feel than hospitals. Your pregnancy, birth and postnatal care is generally all provided by a known primary midwife or small team of midwives.

Learn more about having your baby at a birth centre.

Planned homebirth

Homebirth offers care for women who have a low-risk pregnancy and would like minimal medical intervention. Your pregnancy, birth and postnatal care is generally all provided by a known primary midwife and small team of “backup” or secondary midwives.

If any pregnancy, labour or birth complications arise, you may need to see an obstetrician or be transferred to a maternity hospital.

If you plan to have a homebirth, you can choose to have your antenatal care through a private midwife or through a public hospital that offers homebirths.

If you are booking directly with a private midwife, you don't usually need a referral from a GP. However, you will still need a referral from your GP for a public homebirth service.

You can find a private midwife on the Homebirth Australia website. Speak to your midwife about their arrangements with local maternity hospitals. They may suggest that you book in to your local maternity hospital as well, in case complications arise, and you need to be transferred to hospital.

What are the costs?

The cost of having a baby will vary depending on whether you give birth in the public or private system. There are advantages and disadvantages to both.

Public care

If you have a Medicare card and choose to have your baby at a public hospital, birth centre or public homebirth program, most of your pregnancy care costs are covered by Medicare. Sometimes, you may have to pay an out-of-pocket cost if the complete cost of the service is not covered. Private health insurance may cover some of these gap payments.

Find out more about bulk-billing and out-of-pocket costs.

Private care

If you choose to be looked after by a private healthcare provider, Medicare will only cover part of your costs. Private health insurance might cover some or all of the costs. You should check with your doctor, midwife, hospital, birth centre and health fund what to expect in out-of-pocket costs.

It can be hard to understand the costs of different care options. Talk to your midwife, doctor, hospital or health fund if you are unsure, or call Pregnancy, Birth and Baby on 1800 882 436.

How do I decide what type of care is best for me?

There are some important questions that you may want to ask before deciding on public or private care such as:

• Who would I like to care for me — a midwife, your doctor, an obstetrician or a combination of these healthcare professionals?
• Where do I want to give birth — at hospital, in a birth centre or at home?
• What kind of birth experience do I want?
• Which type of care is better for me, my baby and my individual circumstances?
• Do I want private care, and can I afford it?

Make sure that you explore all your options. Your options may depend on your health, where you live and what is available in your area.

You have the right to respectful maternity care that is culturally appropriate and helps you to make informed choices.

It's OK to change your mind and find the care that's right for you. It's important to have a positive, trusting relationship with your care provider, so you can make decisions together about the best way for your baby to be born.

Resources and support

For information, advice and support during your pregnancy:

• Talk to your doctor or midwife.
• To speak to a registered nurse, call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria).
• NSW Health's Having a Baby outlines choices for care during pregnancy and birth.
• PrivateHealth provides a comparison of public and private care.
• Learn more about Medicare during pregnancy, Private health insurance and pregnancy on the Pregnancy, Birth and Baby website.
• Read more about Maternity care in Australia on the healthdirect website.
• Find out how you can receive maternity care if you are in Australia on a visa on the Pregnancy, Birth and Baby website.
• The Royal Women's Hospital further explains pregnancy care and birthing options, as well as shared care and money matters.

Looking for more information on maternity care in rural or regional Australia?

You can get more information on the maternity care available to you in rural NSW / Qld / SA / Vic / WA / Tas / the NT on the Pregnancy, Birth and Baby website.

Do you prefer to read in languages other than English?

healthdirect has developed translated health information to help people who speak various community languages navigate the health system.

Looking for information on maternity care options for Aboriginal and/or Torres Strait Islander people?

Different states have their own programs to meet the maternity care needs of Aboriginal and Torres Strait Islander people. These programs are centred on involving you in decisions surrounding your pregnancy.

• The Strong Women Strong Babies Pregnancy Diary promotes healthy pregnancies and breastfeeding.
• NSW Health's Aboriginal Maternal Infant Health Service (AMIHS) provides information about local Aboriginal and Torres Strait Islander services during pregnancy.
• The Victoria Department of Health — Aboriginal maternity services advises where to find culturally appropriate maternity care for Aboriginal women or women having Aboriginal babies.
• In Victoria, Koori Maternity Service (KMS) offers inclusive and culturally appropriate pregnancy and postnatal care to Aboriginal or Torres Strait Islander people.
• Queensland's Charles Darwin University offers resources and information about Birthing on Country.
• Aboriginal families having their baby at the Women's and Children's Hospital have access to South Australia's first ever purpose-built unit for the Aboriginal Family Birthing Program.