PROS AND CONS OF PUBLIC VS PRIVATE HOSPITALS FOR PREGNANCY

Updated December 2022 | 5 min read
Words by Karen Burge

Learn about the differences between public and private hospitals for pregnancy care, and how birth experiences can differ based on hospital, cover and personal preference.

The decision to have your baby at either a private or public hospital is something you’ll need to consider before you start trying to fall pregnant because it can impact your pregnancy and birth experience.

If you want to go private, you’ll need to have private hospital cover that includes pregnancy and birth-related services 12 months before the birth of your baby to be able to claim for the services listed on your policy. If you go public, your care will be free.

Weighing up your options can be challenging, particularly if it’s your first pregnancy. You’ll need to consider what kind of medical professional you’d like to lead your care and the type of facility you’d like to give birth in, whether that’s a hospital, birthing centre or at home.

Your choice can help create a pregnancy experience that matches your expectations. For example, when it comes to facilities, you might believe labour should have minimal intervention and prefer the home-like feel of a birthing centre. Or maybe you prefer having pain relief options more easily accessible in a hospital setting.

Birth experiences: public vs private hospital for pregnancy

For HCF member Monique, a smooth first pregnancy led her to choose public care the second time around.

“I hadn’t chosen an obstetrician for my second baby and decided to go to a midwifery clinic,” she explains. “Coming up to the end of term the baby hadn’t turned and he would have had to be a breach birth. It was recommended that I have a C-section.

“I had to go into hospital not knowing an obstetrician and having to have a procedure [without] knowing the doctor that was doing it.”

Hear about other HCF members' experiences.

For Sydney mum Jessica, falling pregnant before upgrading her policy meant she had little choice but to proceed as a public patient. She’d had great care through a private obstetrician during her first pregnancy and was initially concerned about not having that for her second.

However, her public hospital experience was very positive, and she felt a warm connection to her small team of midwives throughout pregnancy. Her only downside was sharing a room post-birth, which she found to be uncomfortable, noisy and a little chaotic with the flow of visitors to her roommate.

Know your options

When deciding on the pregnancy and birth experience you’re after, it’s important to do your research. Find out what local maternity services are on offer, speak to family and friends, and discuss your options with your GP. It’s also a good idea to consider the following questions:

• Do I want a dedicated obstetrician?
• Would I prefer midwifery care?
• Where would I like to give birth (hospital, birth centre, home)?
• Does my local hospital offer a midwifery model of care or will I see different faces each visit?
• How important is it to have my own room after delivery?
• If complications arise, am I comfortable being looked after by doctors who I might not have a relationship with?
• What pain relief options do I want access to?
• How important is having close access to medical intervention or neonatal units?
• Do I want minimal intervention (if possible)?
• What kind of labour do I want (i.e. access to baths, birth pools etc)?
• How much contact would I like to have with my regular GP?
• What can I afford?
• How close to home will my appointments be?

The pros of going to a private hospital for pregnancy

Going through private health insurance for your pregnancy and birth allows you to:

• choose your doctor and where you give birth: you might take a recommendation from your GP
• select a doctor first then your hospital based on where that doctor delivers; or choose a hospital first then a doctor from its list.

Some expecting mothers prefer to have their own obstetrician because it can be reassuring. Having the same obstetrician means:

• you’ll see the same person each visit at their private rooms
• they’ll get to know you and your pregnancy
• you may be able to contact them directly if you have any questions or concerns throughout your pregnancy
• they’ll usually be present for the birth.

Your selected obstetrician will provide ongoing care for up to six weeks after you give birth. In some cases, they’ll also have a midwife on hand, who may be involved in some of your appointments and postnatal care, as well as lactation consultants and physios.

If you decide to choose your own obstetrician, ask for a detailed breakdown of all costs they can foresee for your pregnancy, birth and postnatal care. This will help you understand what your private health insurance will cover, what Medicare rebates you can expect and what your out-of-pocket costs are likely to be.

HCF has agreements in place with many private hospitals and has negotiated ‘known-gap or no-gap’ services with doctors across Australia to help minimise your out-of-pocket costs for hospital services.

To be covered for pregnancy and birth, HCF members need to have an appropriate level of cover, like  My Family Silver Plus, My Family Advanced Silver Plus packages, or Hospital Premium Gold, and have served a 12 month waiting period. If you have extras cover you may be able to claim for a range of support services, including childbirth education classes, physio and pregnancy compression garments^*.

What isn’t covered when going private?

It’s important to be clear on what your private health insurance doesn’t cover. Health funds aren’t able to cover outpatient services like consultations, scans and your obstetrician’s management fee, for example.

Even when pregnancy and birth services are covered, assisted reproduction like IVF may not be, so it’s important to know what your cover includes from the start. HCF members on Hospital Premium Gold cover can claim for assisted reproduction services but members on My Family Silver Plus and My Family Advanced Silver Plus cannot claim for IVF services.

Pros and cons of going to a public hospital for pregnancy

Using the public system certainly doesn’t mean you lack choice. There may be many models of care and birth philosophies (depending on your location) to choose from.

When deciding how you want to give birth, you might like to tour the hospital’s delivery unit or birth centre. Some public hospitals provide for homebirth services as well.

In the public system, your pregnancy care is likely to be at:

• an antenatal clinic (at the hospital)
• a midwifery clinic (at the hospital, birth centre or within the community)
• both your GP rooms and midwifery service as part of a shared care arrangement.

If your pregnancy becomes high risk or requires more intensive monitoring, you’ll also have the care of hospital doctors.

Though, there are some pros and cons to being a public patient that you might want to consider.

Advantages include:

• various models of care to choose from within the hospital
• you can have care with little intervention but still have medical back-up if needed
• out-of-hours clinics are often available
• facilities for high-risk pregnancies and very sick babies are usually available in major public hospitals.

Disadvantages include:

• you’re more likely to share a room after you give birth
• you don’t always see the same doctor or midwife.

The best way to make a decision is to be informed, be prepared with appropriate health cover and be ready for an exciting journey ahead.

Learn more about childbirth with our Preparing for hospital tool.

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