Comments on: Fees for Private Midwifery

By: Melissa Maimann

Melissa Maimann — Wed, 10 Jun 2009 22:07:31 +0000

Joy,
I forgot to ask, when you mentioned that if women are unsure of place of birth, they see the hospital and IM, do they have the option to only see their IM and just go to hospital for a booking visit? The IM is able to provide all the info and history if the woman decides to birth in hospital.

By: Melissa Maimann

Melissa Maimann — Wed, 10 Jun 2009 12:18:23 +0000

Hi Joy,

thanks for that insight into midwifery in Melbourne. We don’t have any practices here in Sydney where the midwives are employed and are paid a wage. There are no GPs who attend home births.

Like you, I also work alone and arrange back up if needed by whomever is available at the time. I cover a large area – covering a 2-hour radius around my home, so I wouldn’t be able to arrange back up from just 1 midwife.

Most women book in, but procedures for this vary. Most hospitals require the women to come in for a visit. I always go with them.

We have 2 public homebirth programs in NSW, soon to be 3 or 4. Satisfaction with the services is high provided the woman has met all inclusion criteria. For women who are excluded from the program, bitterness is a common emotion and they usually go and book with an IM.

By: Joy Johnston

Joy Johnston — Wed, 10 Jun 2009 07:00:12 +0000

Women in Melbourne have several choices of homebirth ‘models’. There are a couple of group practices which work as businesses and have clear protocols such as two midwives to attend each birth, and pay the midwives a wage. There is one GP who attends homebirth with a midwife. He will do Ventouse if needed. I am one of the few who will be the only midwife in attendance for a birth.
We can make backup bookings at the Women’s hospital by faxing the details in – no visit required. Monash asks the women to come for a checkup at 36 weeks. If women want bookings at other hospitals, or aren’t sure whether they want to give birth at home or hospital they do their checkups with the hospital as well as having visits with their midwife – a shared care arrangement. Occasionally a woman plannning homebirth will make a booking at a private hospital, but no obstetricians are officially giving backup to homebirth, so if the baby is born at home the booking isn’t used.
As a general rule I do prenatal checks in my office approx 6 weekly until 24 weeks, then 28 and 32 weeks, and a home visit at 36 weeks, office visits at 38 and 40 weeks, then weekly until the birth. Postnatally I do 3-5 visits in the first 5 days, then more as arranged with the woman. The total cost is usually $2200-2500.

By: Melissa Maimann

Melissa Maimann — Mon, 08 Jun 2009 23:46:04 +0000

Hi there,
We don’t have PI insurance in NSW … privately practising midwives don’t have PI insurance anywhere in the world, as far as I know. That will cahnge post 2010 when eligible midwives will have insurance, but that insurance will only cover hospital birth. Down the track, it may cover home birth too.

By: infomidwife.paulinerose

infomidwife.paulinerose — Mon, 08 Jun 2009 13:37:04 +0000

Hi Melissa,

This will be very interesting to watch and see how things eventuate. How does indeminty insurance work for you in NSW, are you covered? I am not totally sure of the costs of a private birth in Perth I think it is between $3000 – $4000 per birth all inclusive.

By: Melissa Maimann

Melissa Maimann — Sun, 07 Jun 2009 07:37:11 +0000

Dear Joy,
It will be interesting to see how midwives charge for private services after Nov next year – I am not sure how much the medicare rebate will be. Most likely, there’ll be a rebate for antenatal care and postnatal care, but homebirth will not be covered do midwives will have to charge a fee for the actual homebirth. Hospital births will be covered but I’m not sure what the rebate will be. I’ve heard conflicting info – one source said that the rebates will not be more than what a GP would be paid (I think that’s about $30), so in that case we would charge over and above that amount. The other source I spoke to said that the total fee would be around $5000 …. which I can’t see happening.

$4000 -$5000 is the going rate in Sydney …. some women have told me that their midwife charges $6000. I think it relates to the high cost of living in Sydney.

The fee covers visits that are monthly to 28/40, 2-weekly to 36/40 and weekly thereafter (all 2 hours long, all in the woman’s home), attending all hospital / doctor visits and scans with the client, labour and birth (1 midwife …. most midwives work alone), 3-4 hours after the birth, 6-7 postnatal visits (more if needed), care to 6 weeks postnatally, access to books and DVDs etc. I believe Adelaide is the cheapest State for home births, QLD and VIC are in the middle, and NSW is the most expensive …
How does your service work in Melbourne?

By: Joy Johnston

Joy Johnston — Sun, 07 Jun 2009 04:21:37 +0000

Hi Melissa
It will be interesting to see how midwives charge for private services for attending births after November next year, when Medicare rebates will apply. Will we start charging a (small) recommended fee for prenatal and postnatal visits, and put most of the charge into the booking fee, which is what obstetricians do so that most of their fee is covered in the Safety Net?

I would assume that $4000 -$5000 covers approx 10 prenatal checks, two midwives being booked to attend in labour for as long as needed, and the birth plus 3-4 hours post birth, as well as about 5 postnatal home visits and a follow up 6 week visit. Midwives usually charge for the service rather than per hour. Some women will want only one midwife; some will want fewer prenatal checks and postnatal visits.