Choosing Your Maternity Model of Care

When you find out you’re pregnant, one of the first things you’ll need to think about is who will care for you during your pregnancy and birth.

There are several different models of maternity care available, and it can be a little overwhelming trying to work out which one is right for you.

The good news is that there isn’t one “best” option for everyone.

The right model of care will depend on your pregnancy, your individual circumstances, your preferences, where you would like to give birth and, importantly, what feels right for you.

Let’s take a look at some of the options available.

Public Hospital – GP Shared Care or Midwifery Shared Care

For many women, shared care within the public system is one of the most familiar options.

GP Shared Care

With GP shared care, your GP provides most of your antenatal appointments, with a few appointments at the hospital, usually with a midwife. You will generally have around 3–4 hospital appointments during your pregnancy.

When the time comes to have your baby, you’ll be cared for by the midwife on duty in the birth suite. Your care is generally midwifery-led, with an obstetrician becoming involved if there are complications or additional medical needs.

Midwifery Shared Care

Some public hospitals also offer midwifery shared care, sometimes through a program such as Your Midwives.

Instead of seeing your GP for your routine pregnancy appointments, you have these appointments with a midwife at a community centre or maternity service close to your home.

This can offer a lovely middle ground — you remain within the public hospital system, while having the opportunity to build a relationship with a midwife during your pregnancy.

Your midwife provides your antenatal care in the community, and you continue to have access to the hospital maternity services for your birth and any additional care you may need.

For some women, being able to see a midwife close to home, rather than travelling into the hospital for every appointment, is a real benefit. It also provides an opportunity to ask questions, talk through your preferences and receive midwifery education and support throughout your pregnancy.

When you go into labour, you will generally be cared for by the midwife on duty in the birth suite, rather than necessarily the midwife you have seen during pregnancy.

If you are interested in midwifery shared care, it’s worth asking your local hospital what programs are available and whether you are eligible.

Midwifery Group Practice (MGP)

Another option available through many public hospitals is Midwifery Group Practice (MGP).

One of the beautiful things about MGP is the opportunity for continuity of care.

Rather than seeing lots of different people throughout your pregnancy, you have an allocated midwife who gets to know you, your pregnancy and your preferences.

Your midwife provides care throughout your pregnancy and, where possible, will be there to support you during labour and birth. They can then continue caring for you and your baby after birth, usually for up to six weeks.

Of course, babies don’t always arrive according to our carefully made plans! If your midwife isn’t available when you go into labour, another midwife from the MGP may care for you.

Research from Australia and around the world has found that continuity of midwifery care leads to positive outcomes for women and babies.

For many women, simply knowing “someone I know will be there” can also make a big difference to how they feel about their birth.

Private Hospital – Obstetrician-Led Care

If you choose to have your baby in the private system, you will choose an obstetrician to oversee your pregnancy and birth.

You’ll have regular appointments with your obstetrician throughout your pregnancy. When you are in labour, you will be cared for by the hospital midwife on duty, with your obstetrician attending for the birth.

Private hospitals also have midwives available 24/7, and these midwives are an important part of your care during labour.

Some private hospitals also offer midwifery programs, where you can have regular appointments with a midwife alongside your obstetrician.

This can be a lovely option if you value having extra time for education, asking questions and discussing your individual preferences, while still having obstetric care.

Private Midwifery and Homebirth

Another option is care from a private practising midwife (Endorsed Midwife).

Private midwives provide care throughout pregnancy, labour, birth and the postnatal period. Depending on the midwife and the model of care they offer, appointments may take place in your home, their clinic or another setting.

Some private midwives also support women who are planning to birth in hospital, rather than at home.

One of the advantages of private midwifery care is the opportunity to build a strong relationship with your midwife over the course of your pregnancy and beyond.

Birth Centre

A birth centre can offer another option for women who are looking for a midwifery-led, birth-centre environment.

The Gold Coast also has a private birthing centre where you can choose your care provider and plan to birth in a dedicated birth-centre setting with midwifery support.

Birth centres can appeal to women who are looking for a space that feels less clinical while still having access to professional maternity care.

So… which model of care is right for you?

There is no single answer to this question.

Some women feel most comfortable knowing they have an obstetrician overseeing their pregnancy. Others value the continuity and relationship that can come with midwifery care. Some prefer the familiarity of their GP, while others are drawn to a birth centre or homebirth.

And your preferences may change along the way.

What matters most is that you understand what your options are and feel comfortable asking questions about the care you are being offered.

Ask questions. Lots of them!

Your maternity care provider should be willing to listen to you, explain your options and support you to make decisions about your own care.

You might like to ask:

• What are all of my options?
• What are your policies around birth and intervention?
• Why are you recommending this for me?
• What happens if my circumstances change?
• Who is likely to care for me when I’m in labour?
• How much continuity of care will I have?
• What choices will I have during labour and birth?
• What happens after my baby is born?

You don’t need to know all the answers before you choose your model of care.

And you certainly don’t need to choose the same model as your friend, your sister or the person next door.

Your pregnancy. Your baby. Your choices.

Understanding your options is an important part of preparing for birth. The more you know about your choices, the more confidently you can participate in decisions about your pregnancy, birth and postnatal care. And don’t forget about the post natal period. Private midwives and lactation consultants can give you support in your own home after the birth, regardless of where you have your baby. 

And remember — asking questions isn’t being difficult.

It’s being informed.