Deciding to have a baby is exciting yet the unfamiliar territory can be overwhelming too. It is beneficial to both you and your partner that you have an understanding around your birthing choices. Through the medical system once you connect with your health care provider to discuss your positive pregnancy test, it can become a process in automatic motion and sometimes, you may get caught up in this whirl-wide of appointments. Before you know it, you are being told what tests to attend and when, and which hospital you will be birthing at.
Before your birthing plan is unknowingly whisked away from you, take a moment to consider your birthing options in your state. In South Australia, you have the right to a range of birthing options and these include:
Most Australian women give birth in a public or private hospital maternity unit Whether you birth in a public hospital or a private hospital will be determined if you have private health insurance. If you are a private patient, your GP will often take the liberty of processing your pregnancy and delivery plans through the private system. However, knowing your rights and understanding research around birthing options, you can make an informed choice and conclude on the preferred option for you and your partner, based on your birth vision.
Just because you have private health, does not meant that you need to birth your baby in the private hospital under the care of a direct Obstetrician. There are benefits to birthing in a private hospital, such as being able to choose your own obstetrician who will follow your care through your pregnancy and birthing progress, having your own room and probable longer postpartum care at hospital. An Obstetrician will also have a deeper understanding of your medical history, your pregnancy health and any potential risks involved.
Of note, Obstetricians are highly trained in the surgical procedures component or pregnancy, labour and birth and are not well educated or trained in normal physiological births. If you’re seeking a more natural birth, a private hospital birth may not be your best option.
Research show that across Australia,
“The rate of women giving birth by caesarean section, or C-section, has risen to 33% of births,” according to a report done in 208 by the Australian Institute of Health and Welfare’s (AIHW).”
Additionally, “Out of the 309,000 births covered in the report, 101,370 were C-sections. In New South Wales, the latest numbers are slightly higher at 33.8%, while Western Australia is much higher at 37.8%, according to each state’s respective health departments. Interestingly, the numbers for C-sections are higher in private hospitals compared to public hospitals”
Furthermore, according to the latest statistics, “29% of women in a public hospital give birth by caesarean and 43% of women in a private hospital have a caesarean section”
In South Australia, there are 5 private hospitals where you can opt to birth your baby, and these are:
Birthing at the private hospital will incur out of pocket expenses, so it can be useful for you to check your private health coverage, and what all your out of pockets costs will be if you do decide to birth at the private hospital. Even with private health cover, the costs of birthing privately can be quite significant.
Once you have been to your GP to confirm your pregnancy and if you choose to proceed with a hospital birth, then all your antenatal appointments will be at your local hospital, and this will also be where you attend when you go into labour. At each appointment and during your birth, a midwife will be present with the exception of any medical concerns at which a Doctor will assist.
When your pregnancy care begins, you will be advised as to which hospital you will be under the care of based on your location and proximity to the nearest hospital.
All costs for your care and birth are covered by Medicare.
The public hospital which provide maternity and obstetric services are:
Further information on public health services can be found here:
If birthing through the public system is your preferred choice, then you should be aware that you do not have the option of choosing your health care team and continuity of care may lack as your care provider will likely be different at each pregnancy appointments and your birth.
Public hospital care for your labour in South Australia is free and there should be no out of pocket costs.
Midwives are highly trained professionals when it comes to normal, physiological birth. Connecting with a Midwife is becoming an increasingly popular choice due to the diversity in care. In South Australia, there are 2 platforms in which you can be cared for by a Midwife:
Midwifery Group Practice:
Midwifery Group Practice is a “midwifery-led maternity services model of care. It consists of a group of midwives who promote normal birth when working in partnership with women to provide evidenced-based care, identifying the need for referral as required”.
If you choose to fall into the Midwifery Group Practice, you will be assigned a primary and a backup midwife. The request from Mother’s to have continuity of care through the Midwifery Group Practice has increased due to its safety, lower intervention and increased satisfaction with birth. Additionally, some of the midwifery group practice services offer homebirth as an option.
In Adelaide, there are 4 public MGP services at the following hospital:
Independent (Private) Midwifery Care
Independent midwives choose to work privately, rather than be employed by a hospital or other health organisation. A key benefit to birthing with an independent midwife is that they offer continuity of care through you pregnancy and right through the first few weeks of the postpartum period. This is a great option for women who are low risk or have a ‘normal’ pregnancy.
Each midwife provides slightly different services, so it's always best to ask your midwife about the services they offer. Understanding whether they will arrange or refer you for appointments, offer services in home or only at hospitals and also asking about any unexpected out of pocket costs for their services that you may incur.
All privately practicing midwives are required by their regulatory body, the Nursing and Midwifery Board of Australia, to work within specified guidelines. They are bound to ask other health care professions for further medical advice if deemed necessary.
If you decide to connect with an independent midwife, this will be done privately and the midwife must be registered with AHPRA.
A list of private midwives in South Australia can be found here:
If you have a straightforward pregnancy and both you and the baby are healthy, you may have the option to birth at home.
A planned home birth means you’ll give birth at home instead of at a hospital or birthing centre. In South Australia, if you give birth at home, you must be supported by a registered midwife, doctor or obstetrician who will be with you while you’re in labour. As of 1 February 2014 it is an offence for any person in South Australia to conduct a home birth if they are not medically registered. You can learn more about this legislation under section 123A of the Health Practitioner Regulation National Law (South Australia) Act 2010 (https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/legislation/restricted+birthing+practices)
You may find that obtaining support from your medical professional to birth at home in South Australia quite difficult, The choice to birth at home with a qualified midwife is not fully supported in Australia . It is believed that a lack of funding, insurance and experience is responsible. In 2015, out of the 28,211 registered midwives who were employed in midwifery only 241 attended birth at home nationwide. (https://researchdirect.westernsydney.edu.au › PDF)
However, women are now considering the option to have a home birth due to:
familiar, comfortable setting
no pressure to use medications/interventions
religious or cultural considerations
choosing own labour positions
In South Australia, approximately one hundred and twenty women birth their babies at home each year.
Also on the rise, is the number of women who are preferring a ‘free birth’, which is where birth occurs at home without a regulated birth worker. A quantative study was conducted to explore the reasons why this was on the rise. As shown in the image below, a study in Australia, showcases the desire for a free birth at home:
In South Australia, whilst home births are certainly possible they cannot fall into the category of a ‘free birth’ and you must have a trained and registered provider to support your birth. Further explained terminology to help you determine what is an appropriate provider can be read at the link:
If you opt to have a planned birth at home in South Australia, you can read the policy which supports adequate and appropriate care from the health care team:
There are a range of options and things to consider when deciding on your preferred support through your pregnancy, birth and postpartum period.
To help you further support your thoughts, you should consider the following:
The advantages of giving birth in hospital include:
You will have good access to obstetricians, anaesthetists (who give epidurals and general anaesthetic) and neonatologists (specialists in newborn care).
You can access other specialist services.
You can have a c-section immediately, if required.
Your baby can be transferred easily to a neonatal care unit straight away, if necessary.
The advantages of Midwife care:
Continuity of care
Home care or hospital care
Can refer for any further tests required
Has back up support from other midwifes or health care professionals
The advantages of a home birth
Reduced hospital intervention
Options for heightened birth support, such as aromatherapy
Birth partner can be with you the whole time
In a familiar and comfortable environment
Further information about pregnancy services in South Australia can be found on the website:
My name is Shereen Nielsen and I am a certified infant and child sleep coach and a Doula, training at the Doula Training Academy. I am also a lecturer and mentor for students on their journey towards becoming a Sleep Consultant, through my on-line internationally recognised sleep consultants course.
If you would like more information about my services, please contact me: