Maternity Care In Australia: What The Options Are And How To Decide On A Birth Plan
In Australia, you must register your pregnancy with a GP or midwife as soon as possible after you have received a positive test result. Once you have registered, antenatal (or before birth) care will begin. Antenatal appointments are a vital part of every pregnancy; they allow health professionals to ensure mothers and babies stay healthy by identifying, preventing and reducing potential risks. They are also a great opportunity to ask any questions you may have about your pregnancy.Antenatal care is usually initiated by a GP, after which appointments will be carried out by a midwife or obstetrician. Where the appointments take place will depend on where you intend to give birth. In Australia, you have four options:
• Public hospital
• Birth centre
• Private hospital
• At home
If you are planning to give birth in a public hospital, you will usually see a midwife at your local hospital. For birth centres, you will probably have your appointments onsite with a midwife. If you intend to give birth at a private hospital, antenatal appointments will most likely take place with your obstetrician, at the hospital of your choice. If you choose to have your baby at home, it is likely that you will see a midwife either in your home or at your local hospital.
The number of antenatal appointments you will be given during your pregnancy depends on several factors, including whether you are a first-time mother, and whether there is a high chance of significant risk to you or your baby. Generally, a first-time mother with a straightforward pregnancy will have nine or 10 appointments. A mother who has already had a baby / babies will generally be given seven or eight appointments. If there are any complications or significant risks, the number may rise – this could be due to extra tests and scans.
Antenatal care covers appointments, checks, scans, tests and discussions, including:
• Ascertaining when the baby is due, using the date of your last period as a guide
• Discussing medical and family histories, including details of any previous pregnancies
• Making a note of any medication you are currently taking, and the potential effects this could have during pregnancy
• Ensuring you have had a recent smear test
• Discussing any health concerns you have, and providing support for any mental health worries or conditions
• Checking your blood pressure, weight and urine
• Testing and screening your blood
• Providing advice on health eating, including which foods to avoid during pregnancy
• Listening to the baby’s heartbeat
• Discussing your birth plan
Your first antenatal appointment should take place around the six- to eight-week mark, usually with your GP. During this appointment, the doctor will confirm your pregnancy and discuss your medical history. You will also be given information regarding your pregnancy care. Usually, all subsequent appointments will be with a midwife, until you give birth, and for a few days afterwards. Occasionally, you may see an obstetrician; this will usually only be if a complication arises during pregnancy, or if you opt to give birth in a private hospital.
In Australia, you can choose to give birth in a public or private hospital, at a birthing centre, or at home. Whilst technically the choice is that of the mother, your location may limit your options.
A birth plan is a useful communication tool between expectant mothers, their partners, and midwives and doctors. It helps let those looking after you know what sort of care and intervention you would like during labour and birth.
To best inform your birth plan, particularly if you are pregnant for the first time, you should first research types of birth and the options available. You can do this by:
• Attending antenatal classes
• Asking questions at antenatal appointments
• Reading relevant books and articles
• Talking to other mothers about the choices they made
• Talking to your partner about how you would like your labour and birth to pan out
It is important to remember that, despite your best efforts, things may not go according to plan. You may need unplanned intervention, or you may change your mind about what you want. Remember that your birth plan is merely a guide, so try to stay as flexible as possible.
Your birth plan could include:
• Where you wish to have your baby
• Who you would like with you
• Whether you would like your birth partner to stay with you throughout the entire process
• What kind of environment you would like, including music and lighting etc.
• What birthing aids you might like to try
• Whether you would like pain relief and, if so, what types
• What position(s) you intend to try during labour and/or birth
• What intervention(s) you would be willing to try
• Thoughts on inductions
• Whether your birth partner would like to cut the cord
• Whether you would like an injection to speed up the delivery of the placenta
• Whether you would like to try to breastfeed or not
You may think of other things you would like to include in your birth plan. Before making any decisions on medications and procedures, talk to your health professionals, so that your decision will be informed correctly. Think of your safety and that of your baby, before completely disregarding anything that may help either of you.
It is a good idea to have written your birth plan by the time you are 32 weeks pregnant – this gives you plenty of time to talk through your decisions with your partner / birth partner, doula, midwife, and anyone else who may need to know.
Going to hospital
If you are pregnant for the first time, you may feel unsure about when you should go into hospital once you are in labour. It is usually best to call ahead and ask for advice, rather than arrive unannounced.
Once your baby is born, you will most likely stay in hospital for at least one night. You may need to stay for several days, though this will depend on your recovery. If you have had a cesarean delivery, or if you or your baby have any complications, you will need to stay longer.
The cost of maternity care varies, depending on whether you are using the public or private system. If you opt for public care, there is no charge, but you will be unable to choose your doctor or midwife. In the private system, you may choose who looks after you, but you will be required to pay for the privilege, either upfront or via private health insurance.
If you have any concerns, whether about costs or anything else pregnancy or birth related, remember you can always speak to your GP.
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