We look at how the public and private healthcare systems differ when it comes to some aspects of pregnancy and childbirth.

Public or private: which is better for you?

A total of 311,104 babies were born Australia in 2016(1), up from 305,377 the previous year.

New data from the Medibank Better Health Index has found that of those who were pregnant in 2016-17, more than 1 in 4 (27.8%) were affected by stress, showing -- unsurprisingly -- those nine months can be a stressful time for expectant mothers.

There are many unknowns during the pregnancy and birth experience, but making a decision as to which health system you’ll go through -- be it public or private – and understanding how it works may help put your mind at ease to some extent. Read on to find out how the two systems differ when it comes to choice, continuity of care and costs, and why health insurance might be right for you.

Sarah went through the private system with an obstetrician for her pregnancy. Karuna went through a group midwifery program in the public system. Watch their stories.

Choosing your specialist

One of the key benefits of the private system is having the freedom to choose your own obstetrician. This means you can do your own research and make an informed decision about who provides your obstetric care during this very personal experience.

The type of care you receive in the public system depends on a number of factors, including the options at your hospital and your level of risk. Some common options include:

  • Antenatal clinic care: Appointments take place in your maternity hospital’s outpatient or community clinic, you won’t be able to choose which midwives or obstetricians you see.
  • GP shared care: Your care is shared between your GP and your maternity hospital. You will have some level of choice about your GP, but they must have special training, and have an agreement with the hospital you plan to give birth in.
  • Midwifery-led care: You will be assigned a midwife, or team of midwives to care for you throughout pregnancy. If you’re leaning more towards midwifery-led care, it’s best to speak to your GP about this early on as there can be waiting lists. Additionally, some hospitals only accept low risk pregnancies into their midwifery programs.

Continuity of care

Continuity of care, or seeing the same person throughout pregnancy, is an important factor for many women. As a private patient, the specialist you choose at the beginning of your pregnancy is generally the same person who sees you throughout. This can be particularly comforting for those who are nervous about labour and birth, and would prefer to have someone that they know and trust oversee their pregnancy journey.

With antenatal clinic care in the public system, it is likely that you will see a number of different staff from the clinic throughout your care. There are options however, such as midwifery-led care and GP-shared care that allow for some level of continuity of care.

Medibank Clinical Director, Dr Sue Abhary, says: “Here in Australia, we’re lucky to have a public health system which provides outstanding comprehensive healthcare. However, for those who wish to choose their obstetrician and see that same specialist throughout their pregnancy and birth, the private system may provide a more appropriate option.”

Can I have my own room?

While private rooms are always dependent on bed availability and clinical need, you’re more likely to have your own room if you’ve got health insurance.

Out-of-pocket costs

In Australia, we’re lucky enough to have a universal healthcare system. It means those who receive their pregnancy care as a public patient in the public system generally face little or no out-of-pocket costs. Those who choose to go through the private system with an obstetrician face higher out-of-pocket costs, including the cost of seeing an obstetrician for appointments outside hospital. You may also have to pay out-of-pocket costs for the birth of your baby, depending on your excess and how much your obstetrician and hospital charge. However, many feel the extra cost is worth it for their peace of mind and the choice it gives them.

It’s important to remember that every health insurance product is different, so if you’re likely to use your health insurance for childbirth, check obstetrics services are included in your policy. A 12-month waiting period applies, so make sure you have the appropriate level of cover at least a year before your baby is born.

1 Australian Bureau of Statistics, December 2017, September the most common month for babies born in Australia, http://www.abs.gov.au/ausstats%5Cabs@.nsf/0/8668A9A0D4B0156CCA25792F0016186A?Opendocument