Birth in Perth…
What are your options?
This is a good place to come if you’re pregnant and looking for a pregnancy care provider in Perth, WA. I’m fairly new in Perth myself, (about four years) so I’ve done some research on care options and this is what I’ve found out.
There are so many different models of care available and if this is your first pregnancy or you’re new to the state (like me) it can be a little tricky trying to decide which option is best for you. So, I’ll give you all the information and you can decide what is the best fit for you.
The first thing you should do is write down your needs and wants for your birth so that you know what qualities you would like your care provider to have and what is negotiable. Also write down what you would like to avoid ~ this is the start of your birth plan which will be developed further during your pregnancy so that your preferences are well known.
Models of Care
Midwifery Led
Midwives are qualified medical professionals and they are trained to provide you with the full range of maternity care if your pregnancy is low-risk. Midwives are trained to care for you throughout your pregnancy, labour and birth. Midwives anticipate that everything will be normal unless their clinical observations show a developing health concern, they prioritise making pregnancy and birth normal. The benefit of having midwifery led care is that there is continuity of care by either the chosen midwife or team of midwives.
There are many benefits to midwifery led care including reduced epidurals, episiotomies, instrumental births and preterm deliveries and higher chances of a spontaneous vaginal birth.
To read more about this follow this link to the Cochrane review on midwifery led care
Here are 4 options for midwifery led care in Perth
Midwifery Group Practice (MGP)
Community Midwifery Practice (CMP)
Family Birthing Centre (FBC)
Midwifery Group Practice (MGP)
This service is covered by Medicare so you will have no out of pocket expenses if you choose this option.
Available to women who are less than 32 weeks pregnant. If you sign up for MGP, you will be allocated a midwife or team of midwives who will give you continuity of care throughout your pregnancy, labour, birth and into the early postnatal period. Even if you develop complications, you may still be able to keep your MGP midwife as your primary caregiver. To be accepted into this program you will have to agree to some ultrasounds and tests.
For more information on MGP, you need to contact one of these hospitals and ask them to put you in touch with the Midwifery Group Practice (MGP)
Armadale Kelmscott Memorial Hospital
King Edward Memorial Hospital (KEMH)
Community Midwifery Practice (CMP)
This service is also covered by Medicare and is available to low-risk women. CMP will allocate you a midwife who will offer you support so that you can have your baby in your own home if you are within the Perth metropolitan area. You can also select a “domino” birth” which means that CMP midwives will take the same care of you but the birth is planned to be in a hospital. The Domino program provides excellent continuity of care for women birthing at KEMH who have risk factors. It is a supportive program for women who would like to have a VBAC (vaginal birth after caesarean)
Currently CMP midwives are able to attend births at the Family Birthing Centre (FBC) King Edward Memorial Hospital (KEMH) Kalamunda Birthing Rooms, Fiona Stanley Hospital, Armadale Kelmscott Memorial Hospital and Rockingham Hospital - you will be assigned a hospital based on your address.
Family Birthing Centre (FBC)
This service is fully covered by medicare. There are two FBC’s in Perth. Both offer midwifery led care but with easy access to hospital care in case of emergency.
King Edward FBC is on the grounds of KEMH in a small building that is set up as a home - it has four birthing rooms that are comfortably furnished with double beds and easy chairs, individual garden courtyards, air conditioning you can control and en-suite shower/toilet. It also includes a shared bathroom with a large bath for water births
Fiona Stanley FBC is on Level 3 of the Fiona Stanley Hospital. It has three birthing rooms that are comfortably furnished with a birthing pool in each room, day beds and chairs, as well as en-suites with shower/toilet. There is a shared family room that has a kitchenette for food preparation and food storage.
You will have all of your antenatal visits at the centre you choose and you will labour and birth in a safe, comfortable room. Water birth option is available.
Independent/Private Midwife
The cost of a private midwife in Perth is $5000-$8000, some of this can be claimed back on Medicare if your midwife is endorsed. Private midwives are fully qualified midwives offering continuity of care and some have admitting rights into public hospitals so you can continue having them as your primary caregiver if you need to be transferred to hospital during the labour.
Private Midwives believe in your body’s ability to give birth and will empower you to believe in yourself, they are generally woman centred.
With an independent midwife you are are able to choose which tests and ultrasounds you have ~ your independent midwife will educate you on this. Because your independent midwife does not overbook themselves it is highly likely that the will be in attendance at the birth of your baby.
You might choose to have an independent midwife for these reasons:
You have a high risk pregnancy (or if you were in a medical system you would be considered high risk) - but you want continuity of care with a midwife (make sure your independent midwife has admitting rights as not all of them do)
You want to make independent decisions about whether you have tests or other interventions during your pregnancy and want to do that autonomously
You want a physiological birth and want to be supported by a midwife who is an expert in that field
You want a relationship built on trust. Confidence in your care provider is a high priority to you and you want the same midwife to oversee your entire pregnancy and postpartum period
Privately practising midwives are available for home births and hospital births if they have admitting rights
For the complete list of privately practising midwives in Greater Perth, please see this link
GP Shared Care
If you feel you have a good connection with your GP and would like them to oversee the majority of your prenatal care, then this could be an option for you. Your GP will be able to provide you with all your antenatal care until you’re about 20 weeks pregnant. Around 20 weeks you will have a consultation with the ‘share care’ hospital of your choice (usually one that you are in the catchment of. If you are low risk, then your GP will continue your care until 36 weeks. From 36 weeks until the birth of your baby, the share care hospital will then take over your antenatal care. Not all GP’s offer this service so you’ll need to do some research to see if your preferred GP offers this care. When it is time to birth your baby you will have whichever midwife is on duty on that day in your hospital.
Hospital Birth
Public Maternity Hospitals
There are nine maternity hospitals in Perth ~ the one you go to depends on the catchment postcode. Your antenatal care will be supported by midwives at the public hospital you attend. All costs associated with the public birthing system are covered by Medicare.
6108 – 6112, 6121 – 6126
Blow up birth pool (water birth available if trained midwives are working) showers, birth balls, throne beds
6100 – 6105, 6107, 6151 – 6152
Showers
6147 – 6150, 6153 – 6160, 6162 – 6164, 6166
Water birth facilities depending on available midwives, showers, birth balls
6020, 6023 – 6028, 6030 – 6038, 6041 – 6044, 6503, 6507, 6511, 6516, 6521, 6064 – 6065, 6077 – 6079
Baths for labouring in only, showers
6000 – 6001, 6003 – 6016, 6050 – 6053, 6062, 6907
Baths available for labouring in only, birth balls, showers
6016 – 6019, 6020 – 6022, 6029, 6050, 6059 – 6052, 6066 – 6067, 6090
Bath available for labouring in only, showers
6165, 6167 – 6176
Showers
6054 – 6058, 6068, 6070 – 6074, 6081 – 6085, 6090, 6500, 6556, 6558
Bath for labouring in only, showers, birth balls and CUBs (comfortable upright birth support)
Private Maternity Hospitals
Private Hospital care is available if you have private health insurance and have Maternity cover. If you do not have this cover then you can still choose a private hospital but you pay all the costs out of pocket to the hospital. Even with private health insurance, there may be some services that are not covered, and you will have to pay out of pocket for these but some of these fees may be covered by Medicare. No private hospitals in Perth currently facilitate water birth, but some do have baths which you are allowed to labour in. All have showers.
If you choose a private hospital you will be allocated a birthing suite which is well equipped. You will be able to stay in your room up to 5 days after a vaginal delivery and up to 7 days post Caesarean and your partner will be able to stay with you as well.
Bath available to labour in only, showers available
Bath available to labour in only, showers available
Bath available to labour in only, showers available
Showers available
Bath available to labour in only, showers available
Showers available
Private Obstetrician
An obstetrician is a specialist doctor who provides medical care to women during pregnancy and after the birth. Obstetricians are skilled at managing complex or high-risk pregnancies and births, and can manage interventions and perform caesareans. When you are in labour, your obstetrician may visit you but you’ll mostly be looked after by midwives in your chosen hospital. Your obstetrician will take over if there are complications.
If you choose to birth in a private hospital you will need to choose a private Obstetrician (OB) to oversee your antenatal care. This begins at about 12-13 weeks and they will follow your pregnancy and be available for consultation during labour, birth and into the postnatal period. Having a private obstetrician involves the payment of a management fee which is in the range $1500 to $3000 plus each of your antenatal appointments will incur a fee which your private health insurance doesn’t cover. Medicare may cover part of these fees.
Choosing your OB requires quite a bit of questioning. To determine if he or she is the right person to support you I suggest you interview them in the same way you would interview someone for a job ~ you take a list of questions with you and you ask them their views on the things that are important to you. This will help you decide whether they will be the right care provider for you (see link here for questions to ask your pregnancy care provider). OB’s are highly trained in surgery and necessary medical intervention, which can be particularly important for complicated or high risk pregnancies. But it is worth noting that research shows that private hospital births are more likely to involve interventions. In Perth there is an unusually high caesarean rate so go back to your birth plan preferences and consider carefully what your birth goals are if you are actively choosing a physiological birth rather than a birth with interventions.
This is a reader generated list of Obstetricians in Perth, but please do your research and go to meet the Obstetrician with your list of questions to be sure they will listen to your personal requests and meet your needs
Doula Care
A Doula is a trained support person who will provide continuous care and coach you through the birthing journey during your pregnancy, labour, birth and into the postpartum period. Doulas are non medical (they don’t perform medical tasks like listening to your baby’s heart rate or taking your blood pressure) but they are there to support you through natural birth, complicated birth or caesarean section birth.
A doula in Perth will cost between $800 (for a student doula) up to $2500 (for an experienced doula) When choosing a doula, go with a list of questions and go with your gut instinct ~ choose one who you connect with as they will walk the whole pregnancy and birth journey with you.
Go here to find a list of trained doulas in Perth
I hope this blog post has been helpful to you as you decide what is the best model of care for you and your partner. Happy pregnancy :)