So you’re pregnant! Congratulations.

This is one of the most exciting times of your life.

It’s easy to get caught up in thoughts about which pram to buy, and the excitement of choosing baby names.

The financial cost of having your baby, therefore, might be something you put on the back burner.

Most of us assume having a baby in Australia is free.

How much does it cost to give birth in Australia?

However, this isn’t necessarily the case. It depends largely on the type of maternity care and birth setting you choose.

In Australia, there are several options. You can choose:

The public health system (Medicare)
A private obstetrician/hospital
Homebirth (private or public-funded)

You can read more about these options in Who Cares? Maternity Care Options For Australian Women.

What does it cost in a public hospital?

Approximately 72% of Australian women who give birth use the public health system.

If you have a Medicare card, your pregnancy and birth-related costs are covered by Medicare, which is a health insurance scheme funded by the government.

All of your medical care is managed through the hospital and isn’t charged to you. This includes routine ultrasounds, blood tests, birth classes, labour and birth care, and the time you and your baby stay in hospital after the birth.

If your baby needs a paediatrician or specialist care in the NICU, this is also covered.

A fully public patient who chooses to have extra facilities, such as a phone or TV, or who wants to use hospital supplies, such as baby nappies, will incur out-of-pocket expenses.

Women who choose shared care – for example, seeing a non-bulk billing GP for antenatal appointments – or who have ultrasounds through a private clinic, will also incur out-of-pocket expenses.

Pros:

Little to no cost for pregnancy and birth care.
Lower rates of intervention and a higher rate of normal birth (compared with private obstetric care).
Most often, specialists such as obstetricians, anaesthetists and paediatricians are on-site, and don’t have to be called in.
Special baby care, such as NICU is free, and better equipped to care for unwell or premature babies.
Some public hospitals have midwifery group practice programs, which give you access to one midwife, or a small group of midwives, for pregnancy and labour care.
There are usually 1-3 free home visits from midwives in the week after you come home from the hospital.

Cons:

Public care can mean long waiting times for appointments.
Lack of continuity of care, which means different staff at each appointment and during labour.
You might have to share a room with other mothers and babies after birth.
The time you can stay in hospital after birth might be limited.
Midwifery group programs can fill quickly and you might miss out.

What does it cost in a private hospital?

Almost 30% of women choose to have a private obstetrician and to give birth in a private hospital. Some women might have a private obstetrician and birth in a public hospital if their doctors have a special agreement with that hospital.

Depending on where you live, the cost of giving birth privately can vary between $2,000 and $10,000.

Medibank Private figures from 2015 show the average bill for giving birth to a baby in a private hospital was $8,500.

Why is it more expensive to give birth privately, even with private health insurance?

Private health insurance funds aren’t allowed to cover out of hospital care. This includes antenatal appointments with your obstetrician, ultrasounds, and pathology tests. Anaesthetists’ and surgical assistants’ fees (for c-sections) are also not covered.

The amount you will be out of pocket will depend on whether, and by how much, your obstetrician charges above the Medicare Scheduled Fee. Obstetricians also charge a pregnancy management fee, which can be $2,000 to $5,000. You will also be charged an accommodation fee for the length of time you stay in the private hospital.

Private health insurance is essential if you want to give birth in a private hospital, but each insurer offers different policies. You need to make sure you have the correct level of cover and extras to get any benefits. Insurers usually require you to have held this cover for at least 12 months before you qualify for rebates. Before getting pregnant, it’s best to check with your insurer to find out more.

To ensure your baby is covered by your health insurer, you will need to update your policy to a family policy. If your birth is normal and your baby is well, the baby won’t be admitted to hospital and won’t need cover.

Babies who are born prematurely, have health problems, or are twins, might need to be admitted to special care and this will be charged separately to you. This care can cost thousands of dollars.

The Private Health Insurance Ombudsman says parents-to-be should be aware health insurers have clamped down on the following conditions:

There is a waiting period that applies twelve months before the date you’re admitted to hospital for the birth.
If you give birth prematurely, within the waiting period or even give birth a few days before the end of the waiting period, you won’t be covered.
You are not covered if your expected due date is after the waiting period but you give birth within the waiting period.

Pros:

You choose your own obstetrician and midwives during your pregnancy.
There is a better chance of a private room.
Facilities and food can be better than those in a public hospital.

Cons:

There is a higher rate of intervention at private hospitals (compared with public hospitals).
Out-of-pocket expenses can be high, on top of monthly premiums.
Your obstetrician might not be available for your birth.
You’re unlikely to know the midwives who will attend your birth.
You might need to transfer to another hospital if you or your baby need specialist intensive care.
Doctors and anaesthetists are generally not on-site and have to be called in case of emergency.
If you give birth before your insurance waiting period ends, you are not covered.
Postnatal care is in your doctor’s office, and you have to pay for it.

What does it cost to give birth at home?

Less than 1% of Australian women, choose home as their preferred setting to give birth.

There are two main ways to home birth in Australia: either with a private midwife or through a public funded homebirth program.

Medicare-funded homebirth programs are run through a select number of public hospitals, and the cost can range from $0 to $1500.

Medicare funded homebirths cover, or partially cover, your pregnancy and homebirth care, and ultrasounds and tests, if you have them through the associated hospital.

Women who choose to employ private midwives for pregnancy and birth care can face costs ranging between $3,500 and $6,000. The costs include pregnancy appointments, labour and birth support, and postnatal care for up to six weeks.

Costs for ultrasounds, blood tests and other pathology testing are not included.

Some private health insurance companies will partially cover private midwives’ fees. If you have private health insurance and are planning a homebirth, check your insurer’s policy or find out which insurer covers private midwives’ fees.

You are also able to claim a medical expense rebate as part of your tax assessment.

Using private midwives who have a Medicare provider number (and referred to as ‘Medicare eligible’) will entitle you to rebates for the pre and post-birth appointments, usually about $1,000 to $1,800. There is no rebate for the birth booking and attendance fees.

Pros:

You choose your birth setting and care provider.
You can access the gold standard of maternity care in Australia.
You can choose to have antenatal appointments in your own home.
Private midwifery care has the lowest rate of intervention of all birth options.

Cons:

Transfer to hospital might mean an ambulance ride (check you have ambulance cover to avoid extra costs).
Any extra antenatal tests could be expensive.
Current restrictions on private midwives mean many women are unable to access homebirth care.

Do you get what you pay for?

Contrary to what you might think, paying top dollar doesn’t necessarily get you the best maternity care.

In Australia, we are fortunate to have access to quality public hospital care. For most women, this is the most affordable option.

For those women fortunate enough to access midwifery group care or Medicare funded homebirth programs, this is a boon, as these forms of maternity care are associated with higher birth satisfaction and fewer interventions. High demand means these programs fill up quickly.

Birth with a private obstetrician and in a private hospital can seem a very attractive option. For some women, paying for better facilities, a private room and seeing the same doctor is a plus.

There are no guarantees in life, however, and even if you take this option you might end up paying for a shared room and an unknown doctor to attend your birth. Intervention rates are much higher in obstetric settings. On top of this, navigating the health insurance policy criteria and Medicare rebates can be a headache.

While private midwifery care might seem financially out of reach for many, the benefits speak for themselves. Homebirth is safe for low risk women, and in countries such as the UK and New Zealand, it is actively encouraged.

If you are interested in accessing the gold standard of maternity care in Australia, many private midwifery practices offer payment plans. Being creative as you save for a homebirth can include asking for donations instead of gifts at your baby shower.

Whatever choice you make, keep in mind how your care provider and the environment will affect your birth experience. Although it is one day in your life, the experience will live with you forever.

Recommended Reading: