BIRTH OPTIONS IN NSW - MUDGEE
So you are thinking of starting a family or extending your current family, but what are your options when it comes to care?
Do you know all the ins and outs of the care you will be offered?
You have Private Health Cover so isn’t that automatically the better option for you?
Depending on where you are located in New South Wales changes the answers to all these questions.
In this blog, I will touch lightly on what you can be offered within NSW and go into more depth about Mudgee specifically.
New South Wales has a few different care options available but again this all depends on where you are located let us start with the care options available.
Firstly we have Routine Public Care, this care takes place in your selected hospital and you will be seen by several doctors and midwives. This care is free for Medicare-eligible women.
Secondly, we have Midwifery Group Practice; with this type of care, you are seen right through your pregnancy, labour and postnatally by a small group of midwives. This care is also free for Medicare-eligible women.
Next is AMIHS (Aboriginal Maternal Infant Health Service); this care option is for Aboriginal women expecting babies. Your pregnancy and postnatal care are provided by a midwife and Aboriginal Health worker but your labour and hospital stay is the same as Public Care.
GP Shared Care is your next option within NSW; with this care, some of your antenatal appointments are done through your GP and some are done through the Public Care option. This option is mostly free for Medicare-eligible women but there may be some out of pocket expenses with your GP.
Private Obstetric Care is another option; with this your care is with a Dr who specialises in pregnancy, labour and antenatal. This care style often has out of pocket expenses that vary from Dr to Dr, this is something you would have to discuss with your chosen obstetrician.
The final care option is Private Midwifery Care; with this, your care will be provided by a privately practising midwife. This care style also has out of pocket expenses that you would need to discuss with your selected midwife.
There is also the option of having a Doula at any of the above settings. This can be a huge benefit for birthing mothers and their partner's. Doulas are birth coaches, they are there to inform, support, empower and ensure the woman is aware of all her/their options. They are trained in the anatomy and physiology of the pregnant body, so understand what your body is going through and can offer alternate methods to relieve pressure or encourage the baby to move into an optimal position for birth. A Doula can offer a variety of packages that suit their clients and more often than not will be a calming and encouraging voice on the day you birth your baby. A Doula is non medically trained birth attendant and will not be able to conduct any clinical performances such as vaginal exams or heart rate monitoring. They will not give medical advice, they will only offer you options to discuss with your birthing partner for you to make an informed decision. Recent studies have shown mothers who had a Doula present at their birth were more relaxed, had fewer unnecessary interventions, C-section rates were lower, bonding with their babies increased and are more than likely to rate their birth as “Good”.
Now we have covered the different types of care let's look at the birth options as these can affect the care option you choose.
Public Hospital Care is the option most Australian women use, in public hospitals if you are a low risk you will be looked after by midwives, with obstetricians available in medical emergencies. Women having a high-risk pregnancy will see one or more of the hospital obstetricians during their pregnancy, and also when they give birth. In the public hospital system, there are several ways maternity care might be offered to low-risk women these include; midwifery group practice, a birthing centre or shared care.
Private Hospital care is another option available. In Australia, if you have private health insurance you can choose private obstetric care for pregnancy and birth. This means an obstetrician will look after you during pregnancy and you will give birth in a private hospital. Obstetricians are affiliated with certain hospitals, so you can’t choose any hospital or any obstetrician – they need to be affiliated. You can either choose an obstetrician and then one of the private hospitals they attend (usually they are affiliated with 2-3 hospitals), or you can book into a private hospital first and choose from a list of obstetricians who attend that hospital. If you don’t have private health insurance, you can still attend a private hospital and be under the care of an obstetrician. However, you will need to cover the entire cost yourself, which will amount to many thousands of dollars and will vary according to what’s needed during the birth and what consumables you use.
Birthing Centres are also another option for birthing in NSW, these are attached to hospitals. Birth centres have a philosophy that birth is a natural and normal event in a woman’s life. Centres have a home-like environment and are staffed by teams of midwives. They have strict criteria for eligibility; only low-risk women are accepted.
Home Birthing is also an option, only about 2% of women in Australia will choose this, with the support of a private practice midwife. Private midwives work in groups, with a backup midwife, or alone. There are many public-funded home birth programs available and accessed through public hospitals. These programs are very similar to the birth centre experience, except you can remain at home to have your baby. Your pregnancy, birth, and postnatal care will be provided by your chosen midwife. This is called ‘continuity of care’. Throughout your pregnancy, you will develop a strong relationship with your midwife, and she will know how best to support you during labour. Private practice midwives are trained professionals, who focus on birth as a natural and normal process. While they are keen to help you achieve a wonderful home birth, they will refer you to specialist care if complications arise during pregnancy. During labour, they also watch for anything which might signal a transfer to the hospital. They have medical supplies and special equipment for resuscitation that can be used at home, if necessary. If you need to transfer to the hospital during the birth, your midwife will come with you.
Now let's get down to your options in Mudgee, unfortunately, we do not have access to all the options above but you do still have a choice.
We have 5 to 6 Obstertrians for you to choose from seeing them being spread around both the Medical Center and Southside Medical Center so there is a great chance for you to find a doctor who you feel is the right fit for you and your pregnancy. We only have one public hospital that both private and public patients use, our hospital has great maternity facilities but due to its size can only accommodate low-risk full-term pregnancies, high-risk pregnancies and births or premature births are required to travel to Dubbo.
Excitingly, after getting in touch with some private midwives from Dubbo they are willing to travel to Mudgee for women who would like to consider a home birth. This is a very good thing for our locals as we now have more options and have a better chance of achieving a birth they really want.