What birthing options are available in Canberra?
Congratulations on your pregnancy!
What an exciting time lays ahead of you with so many options and decisions to be made. The two most important decision you will make is where you will give birth, perhaps a home birth or natural birth in hospital sounds like something you want, and who will be on your birth team, maybe a doula, private midwife, photographer.
No one will be more effected by your birth experience than you so its essential that you make decisions with yourself at the fore and really dig into what you feel you want and need during pregnancy and birth.
In order to make an informed decision you will need to understand what options are available to you. I’ve put together this list of options available to you here in Canberra so you have an easy to digest document with everything all in the one place.
There are 9 birthing options available to women in Canberra, however not all will be applicable to you. Read the options below and once you’ve honed in on a couple of options feel free to reach out to discus further.
GP Shared Care
What/Who: You have your pregnancy reconfirmed by your GP and referrals are made by them to a public hospital for all your scheduled hospital appointments. You will see your GP throughout pregnancy unless either of you decide this is not necessary, you will also see the Midwives at your scheduled appointments, the midwife may be different each time.
Where: In one of the public hospitals (Centenary Hospital for Women and Children or North Canberra Hospital) with midwifery and obstetric services available.
Why: This type of care is for you if you have a trusted family GP that you have known for many years or you have had ongoing medical conditions that they have been helping you with and you feel their knowledge of your medical background will help in pregnancy, birth and aftercare.
How much: You will need to pay your doctor fees unless they bulk bill.
Continuity of Midwifery Care
What/Who: If you’re considering a low intervention, natural and active pregnancy and birth, continuity of care through the Continuity of Midwifery Care Program at the birth centre may be for you. You’ll get to build up a relationship with a known small team of midwives who will take care of you during your pregnancy, labour, birth and after you’ve had your baby.
Where: Early discharge is encouraged for well women and their babies. Following discharge from the hospital, a midwife will visit you at home. Available at Centenary Hospital for Women and Children.
Why: This is a wonderful option for most women especially low risk, first time mothers. Its proven that having continuity of care during pregnancy and birth brings better outcomes for everyone. Birthing in the birth centre can bring a separation from the hospital for unnecessary involvement but close enough to surgical assistance if absolutely necessary.
How much: This is covered by Medicare.
Maternity Care Team
What/Who: Very similar to the Continuity of Midwifery Care option, Midwives will be available to take care of you during your pregnancy, labour and birth, working collaboratively with medical and allied health staff if required. Uncomplicated births are attended by midwives in the Birth Suite and medical staff are available when the need arises. Postnatal care is provided in the postnatal ward for those women and babies requiring a longer stay.
Where: the real difference is in where you birth, being hospital (North Canberra Hospital and Centenary Hospital for Women and Children) rather than birthing centre. If you live in the ACT, Queanbeyan or Jerrabomberra, you’ll receive home visits from a midwife following your discharge from hospital.
Why: This is a good option for those who feel safe in hospitals and would like others to have control of the birthing process.
How much: This is covered by Medicare.
Private Midwife
What/Who: A private midwife is a registered and self-employed midwife. They can provide continuity of care throughout pregnancy, labour, birth and the postnatal period.
Where: Antenatal and postnatal care are generally provided in your home. Labour and birth care are provided at your home with midwives having admission rights to public hospitals.
Why: Having a person hired by you, for you is a huge advantage in having your wants and needs met, having someone in your corner to advocate for you rather than having to follow hospital policy will give you and baby better outcomes.
How much: There are Medicare rebates for eligible people. You will need to check with your private health insurance if they cover costs for private midwifery. If you are not eligible you can expect to pay out of pocket between $6,000 and $8,000 depending on where you birth, how many antenatal appointments, what blood tests, scans or additional services you decide on.
Private Obstetrician
What/Who: A private obstetrician is a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Some obstetricians employ a midwife who may also be involved in your antenatal care. You will be cared for in labour by midwives employed by the hospital. Your doctor will be closely involved and will normally be present at the birth of your baby.
Where: Antenatal care will be provided at their offices. The private obstetric birthing unit is located at Calvary John James Hospital, although you also have the choice to birth at Centenary Hospital for Women and Children or North Canberra Hospital, depending on where the obstetrician has admitting rights. Postnatal care is provided in the postnatal ward of the hospital where you birth. Follow up care is provided in the obstetricians’ offices.
Why: If you know you want to have an assisted or surgical birth this will be the option for you.
How much: There are generally out of pocket charges for private obstetric and hospital care that can range from $7,000 to $14,000.
Home Birth
What/Who: Home Birth Service is available through the Centenary Hospital for Women and Children’s continuity midwifery program. This service now gives women in the ACT an option to birth in the comfort and familiarity of their own home. The service is available to women who meet the eligibility criteria. You must meet over 10 eligibility requirements in order to be considered. Eligibility screening continues up until and including when you go into labour. If any issues are identified, you may need to be transferred to Centenary Hospital for Women and Children, in Garran, or North Canberra Hospital, in Bruce, to give birth.
Where: This service is offered by Centenary Hospital for Women and Children in Garran to eligible women.
Why: This option would be good if you know you will meet the eligibility requirements and feel confident that you will stay within the parameters of those requirements. They can be found here: https://www.canberrahealthservices.act.gov.au/before,-during-and-after-your-care/having-a-baby/before-you-arrive/pregnancy-care-and-birthing-options/homebirth/homebirth-information
How much: Covered by Medicare.
Fetal Medicine Unit
What/Who: The Fetal Medicine Unit provides care for women with complex or high-risk pregnancies who require specialised care for either them or their baby. Only women with identified risk factors in their pregnancy or those who have had complications in a previous pregnancy will be referred to this service. You will be cared for by specialist doctors, sonographers and a designated midwife who will provide continuity of care during your pregnancy.
Where:During your labour and birth, you will be cared for by a team of midwives and medical staff within the Birthing Suite at Centenary Hospital for Women and Children. If you live in the ACT, Queanbeyan or Jerrabomberra, you’ll receive home visits from a midwife following your discharge from hospital.
Why: Various reasons.
How much: May vary.
Free Birth
What/Who: Birthing without trained medical or midwifery presence.
Where: wherever you like.
Why: If you feel completely educated, informed and trust birth, your body and your baby then this might be an option for you.
How much: from $0 to however much you want to spend depending on if you want a photographer, doula or other support people present.
Specialist Care Team
What/Who: During your pregnancy and labour you will be cared for by a team of midwives, medical staff and allied health professionals in a hospital. Your labour and birth will occur in the Birth Suite supported by a midwife, working collaboratively with medical staff.
Where: North Canberra Hospital and Centenary Hospital for Women and Children. If you live in the ACT, Queanbeyan or Jerrabomberra, you’ll receive home visits from a midwife following your discharge from hospital.
Why: Your midwife, doctor or GP may refer you to this service if necessary.
How much: This is covered by Medicare.
Birthing on Country
Birthing on country or within community is available if you’re Aboriginal or Torres Strait Islander, or pregnant with an Aboriginal or Torres Strait Islander child. You can choose to receive your care through Winnunga Nimmityjah Aboriginal Health and Community Services or Canberra’s public or private maternity system.
To join the program, you need to:
- be a first time mum or this be the first time mothering your baby
- be between weeks 16 and 28 of your pregnancy
This is a free service and is a voluntary program. You can join the program and opt out at any stage if you want to. The program involves home visits during pregnancy, infancy and toddlerhood and gives mums the opportunity to improve pregnancy outcomes through the practice of good health related behaviour and improve outcomes in child health and development.
Birth With B: doula to support your home birth or natural birth at hospita
Asking these questions and more will help make sure you find the right fit for your birth team.
1. How do you feel about physiological birth and how many have you witnessed?
If your care provider is comfortable and confident around physiological birth you have more of a chance that they will support your wish for a natural birth. If they have actually witnessed any completely physiological births then this is an even better sign they they support woman and their wants and needs
.
2. Who will make the decisions around what happens during our birth?
If at any stage they suggest anyone other than you will make decisions around what happens during your birth this is a red flag.
3. What is your policy on going past 40 weeks?
You are not overdue until you’re past 42 weeks and this should not effect they way you birth if you are well and healthy.
4. What is your policy on big babies and what do you consider a big baby?
We can birth big babies, our bodies grow the baby we are meant to birth. The size of your baby should not effect your chances of birthing the way you want to. Inducing big babies does not prevent shoulder dystocia or reduce newborn morbidity but does increase the chance of Caesarean Section.
5. Under what circumstances would you suggest an induction?
In those circumstances are there alternatives to try before induction? What is the threshold for a preferred induction over an emergency induction?
6. What is your preferred method of induction?
There are many different ways you can be induced and its important to know what those options are along with all the details so you can make an informed decision about which option you will allow your care provider to use.
7. Do you attend vaginal breech births?
Although rare breech birth are still a variation of normal and you could fall into the 3-4% of those giving breech birth. Its worth knowing if your care provider feels confident they can handle this type of delivery.
8. What are your preferred methods of monitoring?
What are the risks and benefits of their preferred type of monitoring and how do they feel about you denying constant monitoring? CTG can cause unnecessary interference.
9. What is your policy around release of membranes for 24 hours or more?
Some care providers see this as extremely risky for mum and bub to be exposed to infection, if this is believed to be the case there are antibiotics and induction options that could be considered before a Caesarean Section.
10. Do you have a time limit on how long labour can go on before Caesarean Section is offered?
If mum and bub are well and healthy they should be able to continue their dance for as long as is required and given space, support, darkness, music, water to help them along the way. Perhaps you could ask about birth suite conditions at this point.
11. How many Caesarean Sections have you and/or this hospital recorded this year?
Although elective Caesarean Sections are on the rise we can still consider that only 10% really need a Caesarean Section so if their number is way above this then it worth having a deeper conversation around why this is happening in their practice.
12. In what circumstance would you remove my baby from me after birth?
This gives you the opportunity to let you care provider know that any tests needing to be done on baby should be done so while on or next to you. This will prompt for discussion around any need for amniotic fluid to be removed from bub or even a NICU visit.
13. How regularly do you read the latest research and what source do you use?
If your care provider is interested in what is happening in their industry, their communities and for women and babies they will keep their finger on the pulse and stay up to date with new findings or techniques while understanding what is a credible resource is and being able to think critically about findings and resources alike.
