Written by Eve White
Pregnancy is a time not only of big changes, but big decisions too. One of the first of these that may seem to be thrust upon you far too soon is who to trust to look after you and your baby for the duration of your pregnancy and during birth. It pays to do your research and start thinking about antenatal care early (even before conceiving) as many private obstetricians’ lists fill up quickly.
Your choice will depend on many variables, including finances, whether you have private hospital cover, previous obstetrics history or complications, your personal values and priorities, and what services are available in your area.
Private or public?
The first decision is whether to see a private obstetrician or use a public hospital.
The main benefit of seeing a private obstetrician is that you can choose your obstetrician and you know that you will see that one doctor for the duration of your pregnancy. This can be extremely reassuring if you’re at all anxious or have health issues or have had pregnancy complications and would like the security and predictability of knowing you will always see the one person.
Scans are likely to be more frequent if you see a private obstetrician, too, which can benefit you if you want the extra reassurance. On the other side of the coin, if you’re concerned about the safety of unnecessary scans, this might be a reason for you to avoid seeing a private obstetrician – or to check their policies on scan frequency before booking.
You’ll also more likely to have your own room in a private hospital and may be able to have a longer hospital stay, if you choose to, than in a public hospital.
One disadvantage of choosing to see a private obstetrician is the cost. Private health funds have a twelve month waiting period for obstetrics services and even with top-level cover, out-of-pocket expenses are likely to run into the thousands. The actual amount will vary depending on which fund you’re with, your level of cover, any required interventions and your obstetrician’s and hospital’s fees.
Another thing to be aware of is that intervention rates are higher in private hospitals, even for low risk pregnancies. If it’s a high priority for you to minimise the chance of intervention, perhaps you should consider using the public system, which means you won’t be able to choose your obstetrician (and most of your appointments will be with midwives rather than an obstetrician), but you will save money and reduce the chance of intervention.
Of course, there are other options too, including birth centres in some large hospitals, which focus on low intervention births, a share care arrangement between your GP and a public hospital or seeing a private midwife to assist you with a home birth.
Choosing a private obstetrician
My husband and I chose to see a private obstetrician, mainly because after many cycles of IVF and one traumatic miscarriage I was anxious about things going wrong and I wanted the security of continuity of care. After paying for IVF, forking out a few thousand more dollars for this peace of mind didn’t seem like a big deal.
Let’s say you’ve decided to take this path too. Now you have another decision to make: which obstetrician? These are some of the factors to consider:
- Your GP is your first point of call when you’re pregnant and will be able to outline your options.
- Do you have a preference for a female doctor or would you be equally happy with a male?
- Word of mouth can be valuable – both friends and local Facebook parenting groups can be a fantastic source of knowledge.
- Some obstetricians deliver babies in public hospitals, so if finances are a factor and you’re not particular about hospitals – or perhaps you prefer a particular public hospital because of its birthing policies – this question is worth asking.
- Obstetricians usually work within particular private hospitals. So, if you have a preference for a certain hospital – perhaps the one closest to you to minimise travel time when in labour! – you need to take this into account.
- Consultation fees, hospital costs and other out of pocket expenses vary. These are important questions to ask early on.
- Intervention rates and policies regarding going past the due date vary between obstetricians and it’s totally reasonable to ask about these before booking an appointment.
- Remember, you can change obstetricians during pregnancy if you feel that you’ve made the wrong decision.
Pregnancy and birth are intense and life-changing experiences like no other, a time of dramatic physical change, emotions driven by hormones, excitement, love, anticipation and sometimes fear and anxiety. Perhaps the most important thing that will help support you through this time is having trust in the professionals that are caring for you. We are extremely fortunate in many parts of Australia to have a range of birthing options and lots of information available, which should make it possible, with just a little forward planning, to find the right fit for you and your circumstances.
References / links:
Possible risks with scans: https://www.newscientist.com/article/dn1670-ultrasound-scans-may-disrupt-fetal-brain-development/
Dahlen HG, Tracy S, Tracy M, et al. Rates of obstetric intervention among low-risk women giving birth in private and public hospitals in NSW: a population-based descriptive study. BMJ Open 2012; 0:e001723. doi:10.1136/bmjopen-2012-001723
Birth choices: https://www.babycenter.com.au/a536330/birth-choices