Your Birthing Options in Perth -
Congratulations on your pregnancy! I hope you’re feeling well.
You may already have an idea of your dream birth, or you may have never considered it. If you have never really thought about it, now is a great time to start considering what your ideal birth would look like, where it will take place and who you’ll have on your birth team.
Choosing a model of care that works for you, and aligns with your vision and values could single handedly lead to most amazing experience of your life.
When I was pregnant with my first, I had no clue there were any other options besides public or private hospital. I wish I knew what was out there so I could have considered what was right for me and decide on a model of care that suited me better. I hope this article can help you see how many different options there are, and help you make a decision that leads to your best birth.
First lets look at where you want to birth, these are your options;
- Home
- Private Hospital
Let us delve;
Home Birth
Birthing at your own home, or somewhere you feel very comfortable can be a transformative experience. Feeling safe is a massive part of a calm, relaxed birth and your safe space may just give you all these feelings. Birthing at home can mean a lot of internal work and fear release may be needed before your birth, this can sometimes be hard work, but very much worth it. If you wish, you can hire a private midwife to attend your home birth who are medically trained so you can still have that peace of mind. You can't have an epidural or any form of augmentation at home.
Pros:
1. You can have as many people as you like in attendance, even your kids!
2. You have all of the comforts of your own home and set up the space exactly how you like
3. You won’t be interrupted by medical staff busting into your zone
4. You won’t be separated from your partner after birth
5. Medical intervention and trauma is dramatically less evident if you birth at home
Cons:
1. You may need to provide your own materials like hiring a birth pool, buying liners, you can borrow towels or ask in the facebook group for spare unused items
2. You may need or want to transfer to hospital during labour or after your birth (you will have discussed with your midwife and birth team prior to labour in which cases you may want or need to transfer and everyone should be on board with your plans and back up plans)
Home birth is very much making a "come-back" (as in we did it for all of eternity until like a hundred years ago) and you will find some great resources online. Check out Perth Homebirth Group on Facebook.
Cost: Home birth materials from $0 - $ 400 (birth pool hire, towels, fairy lights etc.) plus see below Private Practicing Midwife for their costs
Hospital – Public
Hospital birth these days is the “norm” and is where you will be referred to when you visit your GP if you don’t have private insurance. You will visit the hospital for each check up (after around 20 weeks) and for your birth. You will see a different midwife and/or obstetrician (OB) at each appointment and whoever is working while you’re in labour will be at your birth. It is pure luck if you receive care providers/ a medical team that is on board with your wants and needs. You will stay anywhere from a few hours after birth, to a few days.
Pros:
1. You may be more comfortable in a hospital setting
2. If anything goes wrong, the appropriate care is very close by
3. More variety of pain relief
Cons:
1. Much higher risk of being induced or having medical intervention (compared to planned home birth)
2. Higher chance of caesarean section and birth trauma
3. Less chance of those warm, fuzzy, safe, loving feelings
4. You’re only allowed a small birth team to accompany you and they will have to leave soon after you give birth (they can’t stay the night with you)
5. Not having continuity of care (the same midwife/ OB throughout pregnancy, birth and post partum) can negatively affect your overall birth outcome and experience
Cost: Free (you can choose to hire a private midwife or a doula and still birth in hospital so those services would come at a cost to you)
Public hospitals in Perth Metro area:
Hospital – Private
Private hospital birth will include you choosing a Private Obstetrician to work with. They will be based out of a private hospital where you will birth and generally stay for 3 days post birth. You will have all of your prenatal appointments with your OB.
Pros:
1. You may feel safer with a private OB, especially if they have deemed you high risk
2. The hospital facilities may be nicer than public i.e. guaranteed private room, able to choose food from a menu at any time of the day
3. You have “continuity of care” – refer Private OB for more info below
4. Your partner can generally stay with you the whole time after baby is born (they may need to pay to stay in the room but they can sleep there)
Cons:
1. You have a higher chance of caesarean section no matter your health status or birth preferences *
2. You have a higher chance of intervention** and being induced
3. You need to have had private health insurance for a year before you are able to claim costs
4. They have the right to turn you away if your birth plan doesn’t suit their policies or preferences (see more below Private OB )
5. Water births are not available
Cost: Cost for Private OB and private hospital stay $3,500 - $7,500
Private maternity hospitals in Perth Metro area:
Somewhere in between Home and Hospital – Family Birth Centre
Family birth centers are designed to be like a home birth setting but they are attached to a hospital. They are midwife-run with birth pools and other things that promote physiological birth. They only accept low risk births and there are limited spots. You are sent home soon after your birth.
Pros:
1. Continuity of care – you see a team of midwives throughout pregnancy, some of that team will be there for your birth and you’ll see the same team after birth.
2. Midwife led care promotes physiological birth
3. You have more leeway to set up your birth space, and birth how you like
4. Water birth is available
5. If there is a medical emergency you are very close to the main hospital
Cons:
1. Have to transfer to main hospital for epidural
2. Limited spots available and only qualify if you’re low risk throughout your entire pregnancy i.e. if you go over 42 weeks you can’t birth there
3. If you want to stay in the hospital for an extended time this is not the option for you
The two birthing centers in Perth are located at Fiona Stanley Hospital and King Edward Memorial Hospital.
Cost: Free
Ok, so you know where you’d like to birth but now you need to choose your care provider. Or maybe your care provider will depict where you birth.. When choosing a care provider, you really need to ask yourself what kind of care you would like to receive. This can depend on your values and visions, along with what you’re comfortable with.
Your options are:
- Doula
Okay that’s a lot of options! It is important when choosing a care provider that you interview them to ensure they are right for you, and will support your wants and needs, and the vision you have of your perfect birth. Let us divulge..
Private practicing midwife
Private Midwives (PM) are women centered and physiological birth focused. In my opinion they provide the gold standard in maternity care. PM can attend home births and some have admitting rights to some hospitals meaning they can attend public hospitals with you if you wish to birth there. You can choose your own midwife and she will visit your home for your antenatal appointments, be present for your labour and birth, stay with you for some time after and visit you for up to six weeks postpartum. Private Midwives are very sought after and can get booked up very fast, you should contact your preferred midwife as soon as you are pregnant to secure her.
Cost: Approx. $6,000 - $8,000, some of that may be covered by Medicare though
Public midwives and OBs:
As mentioned above in Hospital – Public, you will see a different midwife and/or OB at each appointment and during your birth. There are often long waits at each antenatal appointment to see the midwife. If your file states anything beside the “norm” your risks will recited to you at every appointment which is not fun. Inductions, intervention and caesarean rates are high in this model of care. The midwives and OBs in the public system don't often see undisturbed physiological birth and intervention is their norm.
Cost: Free
Private Obstetricians
Private OB’s are specialized in managing high risk births and complications during birth, therefore view birth as a very medicalized event. Some OBs encourage physiological birth but statistically you are far more likely to be induced and have a caesarean section with Private OB care.
As mentioned above OBs provide a level of continuity of care, where you see the same person throughout, however the appointments are often quick and to the point (a lack of emotional support has been reported) and your OB will generally only attend your birth when you are admitted to hospital and when you are ready to start pushing, they won’t be with you during labour however the midwives will report to them during this time. OBs are also not required to let you know when they have holidays booked so you may employ them being unaware they will be away at your due date. Private OB’s can be more strict with their policies and it is important you discuss your wants and needs for your birth, along with your back up plan prior to paying their fees, as some OBs will leave it til 38 weeks to let you know they don’t support your preferences and you may feel it is too late to change by that stage.
Cost: As above cost for Private OB and private hospital stay $3,500 - $7,500
Community Midwifery Program (CMP)
CMP is a continuity of care model available to women with low-risk pregnancies. You will be assigned a team of midwives, with one specific midwife seeing you commonly. They can attend prenatal appointments in your home and some will be based at their clinic. You will need to see an OB (from the hospital) at 38 weeks as protocol. CMP can support you birthing at home, the family birth center or in a public hospital (KEMH). Your midwife will attend your birth, stay with you afterwards and attend your home to visit for up to four weeks postnatally. If your midwife is unavailable when you’re in labour another midwife from your team will attend and stay with you. There are reasonably strict intake criteria and very limited spots. You should apply as early as possible if you wish to go through CMP mode of care.
Cost: Free
Midwifery Group Practice
Similar to CMP but specific to specific hospital, it can be found at the Family Birthing Centre, KEMH, Armadale Hospital, Broome Hospital and Northam Hospital. Designed for women birthing in hospital, you will be assigned a midwife (who is in a small group allocated to you) who will see you during pregnancy birth and postnatally.
For more information contact the hospital you wish to birth at.
Cost: Free
Midwifery Clinic
There are two midwifery clinics in Perth that provide some level of continuity of care. You attend their clinic for your prenatal check ups instead of the hospital. You will birth at the hospital with the hospital staff (not with your midwife from the clinic). Your midwife will see you postnatally however some clinics do not do home visits so you need to go to them. This option is great if you are close to one of the clinics and you are comfortable with this level of continuity of care. Not having to wait at the hospital to see a different midwife at each appointment is a big win. There are currently two clinics in Perth Perth Pregnant Centre in Clarkson and Perth Maternity in Success.
Cost: Free
GP Shared Care
Similar to the Midwifery Clinic, if you prefer to see your GP for your antenatal check ups you can. You will still attend some check ups with your public hospital and you will birth there, with the Hospital staff.
Cost: You may need to pay gap fees to your GP but birthing in the public hospital will be free
Free Birth
You have the option, of course, to not use any medical model of care, and just birth your baby however you like. Most free births will be at home, with some planned in nature. You can have your own birth team of non-medically trained support people like your family and/ or a Doula. Despite what you may have heard, you are well within your rights to free birth, it’s completely legal and very much gaining in popularity. You will be able to find more information on google or facebook groups.
Doula
A Doula is a birth support person and coach, able to provide emotional, physical, mental and spiritual support as well as education around birthing options, rights, practices, physiology of birth and more. A Doula is a non-medical support person and you can hire a Doula to attend any type of birth. You will choose the Doula that feels right to you and similarly you want your Doula to get the same feeling about you. You will work together to prepare for your ideal birth, and she will support you through the ups and downs of pregnancy, birth and postpartum. Doulas provide a range of packages, if you don’t want her at your birth but throughout pregnancy and postpartum for support, she can do that too. One study shows that women who have a Doula, are more likely to be satisfied with their birth, less likely to have epidurals, synthetic oxytocin, instrumental births and/ or caesareans, and were reported to be more likely have a spontaneous and shorter labour***.
“If a doula were a drug, it would be unethical not to use it” – Dr John Kennell MD
As you can see, *deep breath* there are A LOT of options to consider. Only consider the options that feel right for you, don’t be confused by options that don’t align with you, or that you feel pressured into by anyone else. This is your birth, your choice and at the end of the day, you are the one that needs to own your decisions and live with your experience.
Feel free to get in contact with me if you have any queries on the above, or on how we can work together. I would love to hear from you!
My name is Nikola, from Illuminate with Nikola and I’m a pregnancy, birth and postpartum Doula in Perth (Boorloo). You can contact me below;
Email: illuminatewithnikola@outlook.com
Phone: 0447 177 975
References:
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