Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448. 2010 cost of home birth

The current cost of homebirth in Sydney is somewhere between $3000 and $6000 but the cost may come down after November 2010 if Medicare benefits are extended to antenatal and postnatal care.

Birthing hospital expenses

Good question! If you are going through the public system and you have a Medicare card, it is free. If you have a private midwife, the cost can be anywhere between $3000 and $6000 (some private health funds will provide benefits for private midwifery and you may claim the cost via the net medical expenses tax off-set). If you are birthing in a private hospital, many people assume that their private health insurance covers all of the costs and are very surprised when the bills continue to come after the baby has been born. You can expect to pay for a private obstetrician (anywhere between $2000 and $10000 in Sydney), the private health fund excess or co-payment, ultrasounds and tests, paediatrician and anaesthetist fees. As well as incidentals such as parking at the hospital, TV, phone etc.

Difference in childbirth with midwife and childbirth in a hospital

Midwives attend all births in hospitals, even if you have an obstetrician.

First time mothers and homebirth

What a great decision! Discuss your situation with your midwife for more advice. Generally, first babies are ideal for home births. Why? Many first-time mums have caesareans in the hospital system. It’s about one in three. The rate with homebirth? A mere 5%. Why does this matter? Well, these days it’s very difficult to have a vaginal birth after a caesarean in the hospital system as the hospital system generally does not support VBAC, either covertly or overtly. So it’s really important that you optimise your chance of a natural birth with your first baby. Transfer can be more likely in a first labour, partly for reasons such as a long labour and the woman’s request to transfer for pain relief, or for other reasons such as high blood pressure. Your midwife will guide you as to whether transfer is necessary.

Hospital midwife compared to private midwives

A private midwife is bound by the same regulatory mechanisms as a hospital midwife is/ w e are all bound my a code of ethics, code of conduct, competency standards, we are all registered and are bound to comply with the various Acts such as the Poisons Act, coronial law, civil law, criminal law and the nurses and midwives act etc. the main differences between a private midwife and a hospital employed midwife, for you as a pregnant and birthing woman is as follows:

- hospital midwives have the additional requirement of having to follow hospital policy. What is wrong with this/ some policies are not based on evidence, and some may be out-of-date. This of course creates safety issues for women. the other problem is that people generally don’t like to be treated “routinely”, they like individual care. this is where a private midwife is a real advantage: women can access evidence-based care and are treated as an individual. - the other benefit to having a private midwife – the main benefit – is access to continuity of care. private midwives birth with women at home or in hospital, either as a planned hospital birth, or as part of a homebirth transfer. continuity of care is beneficial to women and babies and has advantages such as enhanced breastfeeding rates, increased satisfaction from women with the service, fewer interventions in labour and birth, fewer admissions to the nursery and so on.

Which is safer for baby repeat c section or vbac?

This is a good one to discuss with your care provider. For a balanced appraisal, it would be worth seeking a consultation with a private midwife as well. generally speaking, repeat caesarean has risks for the baby in terms of breathing difficulties and later asthma, allergies and diabetes. VBAC on the other hand has a very small – 0.5% - risk of uterine rupture. When this statistic is put into the perspective of other risks with having a baby, it is a very small risk.

Melissa Maimann, Essential Birth Consulting 0400 418 448