Did you know that where you choose to have your baby can have a huge influence on how you have your baby? One Australian study on Maternal and perinatal outcomes by planned place of birth found that low-risk, health women were twice as likely to have a “normal labour and birth” in a birth centre than they were in a hospital setting, and six times more likely for a planned home birth, all with no significant statistical difference in stillbirths or neonatal deaths. 


Now, before we get into your different care options and pathways I want to share some recent statistics with you from the Australia Mothers and Babies Report 2023 relevant to Western Australia. In 2021:


  • 96.4% of women gave birth in hospital (75% of these were public hospital births)
  • 2.1% gave birth in a birth center
  • 0.9% of women gave birth at home
  • 0.6% gave birth elsewhere, such as while enroute to the hospital, or on country. 


There is no one-right place to have a baby, luckily we have many different options to choose from. The most important thing in deciding where to have your baby is that you choose a team and an environment that makes you feel safe and respected. For some women this is with an obstetrician in a private hospital and for others this is a homebirth with a private midwife.


Public Hospital

This is where around 70% of Western Australian women choose to give birth. As long as you have a Medicare card you will not experience any out of pocket costs no matter what type of birth you have. If you choose to birth in a public hospital, you will be referred to one of the following birthing hospitals based on your postcode. You can choose to have your prenatal care with the hospital midwives and obstetricians, GP shared care, midwifery group practice, or you can even have a private obstetrician and birth in a public hospital. This is a list of public maternity hospitals between Perth and Mandurah. 

Midwifery Group Practice (MGP)/Caseload midwifery is where women are designated a primary midwife for all of their pre and postnatal care and are supported by a group or team of secondary midwives. MGP is offered at the following hospitals: 


Birth Center (Public Hospital)

Low-risk women can apply to birth at the family birth centres at either Fiona Stanley or King Edward Memorial. These centres offer a more non-clinical atmosphere and promote physiological births. The birth suites are equipped with baths. Birth centres have tight eligibility criteria so many women are excluded. 


Private Hospital

You can self refer to a private obstetrician at your selected hospital at any point in your pregnancy. Many women choose a private hospital birth for the different benefits offered such as a private room, a chosen care provider, room service, or to allow their partner to stay overnight. Most women who give birth in a private hospital have top tier health insurance which covers a large portion of the incurred costs but even with health insurance you can still expect to be at least $2,500 out of pocket. 


At Home

You can birth your baby at home and there are a few ways of doing so. 

  • With a privately practising midwife (list of midwives here). Privately practising midwives (PPMs) are highly sought after so they tend to book up very quickly. They care for you from early in your pregnancy, during labour and birth and up until 6 weeks postpartum. Medicare will cover a portion of your pre and postnatal appointments but will not reimburse you for the birth. Some PPMs have admitting rights which means they can care for you during your labour and birth within a hospital setting if you wish or should the need arise. PPMs set their own eligibility criteria and have a much wider acceptance of women who would generally be excluded from other programs. PPMs vary in price but usually cost between $5,000 - $7,000 out of pocket (after your Medicare rebate). PPMs are able to prescribe medicines, refer you for blood tests and scans and they bring emergency resuscitation equipment and haemorrhage management medication to every birth, although this is very rarely needed. 
  • With the Community Midwifery Program (CMP). The CMP offers publicly funded (free) home births for low-risk women who live within the designated catchment area. The CMP has very tight eligibility criteria and you can be excluded at any point during your pregnancy should you fall outside the criteria. The CMP has clinic locations at the following sites:
  • King Edward Hospital: Subiaco, WA
  • Kalamunda District Hospital, Kalamunda, WA
  • Atwell: 9 Lanao Way, Atwell, WA
  • Without any medical support (freebirth). Some women may choose to freebirth. This is usually a birth at home with only family-based support. Many of these women are well educated in labour and birth, and complete neonatal resuscitation and other first aid programs. These women will generally transfer themselves to hospital via ambulance should the need arise.



My name is Sarah Del Borrello,

I am a Doula who services Perth to Mandurah, Western Australia. I support clients birthing at Fiona Stanley Hospital, King Edward Memorial Hospital, Rockingham General Hospital, Armadale Health Service, St John of God Murdoch Hospital, and the Peel Health Campus in Mandurah. As well as those birthing at home between Perth and Mandurah. 

If you would like to know more about my services, please get in touch, I’d love to hear from you.


Sarah Del Borrello

Mother Mother Doula

hey@mothermotherdoula.com

mothermotherdoula.com


References

Homer, Caroline SE, et al. "Maternal and perinatal outcomes by planned place of birth in Australia 2000–2012: a linked population data study." BMJ open 9.10 (2019): e029192.

Australia's mothers and babies. Australian Institute of Health and Welfare, 29 June 2023, https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies


Links to Helpful Resources

Your maternity care options (healthywa.wa.gov.au)

Choosing where to give birth | Pregnancy Birth and Baby (pregnancybirthbaby.org.au)

Privately Practising Midwives in Western Australia | Back to Basics Birthing (vickihobbs.com)