Sunshine Coast Pregnancy and Birth Care- what are my options?
Updated: Apr 30, 2020
There are quite a few different options for care providers in Australia, but I will aim to stick to the main care provider options on the Sunshine Coast:
This is called continuity of midwifery carer. Your care is by a midwife you get to know throughout pregnancy, who is there for birth and regular postnatal visits up to six weeks. Evidence (highest quality) says this model of care benefits mothers and babies through lower intervention, higher spontaneous vaginal birth rate, fewer preterm birth and stillbirth, higher satisfaction and higher breastfeeding rates. There are various models under continuity of midwifery carer, which I will address here:
Midwifery Group Practice is the name given to hospital based (and in some states public homebirth) models that provide continuity of midwifery carer. It is for hospital based births on the Sunshine Coast. It is offered out of the public hospital, Sunshine Coast University Hospital or SCUH. You will be allocated a primary midwife who provides most of your care (this midwife will be supported by small group of midwives who you will get to know and may be there for birth, if your midwife is absent or away, or if your midwife has a shared caseload). Most antenatal care is attended at the hospital, though there are some in-home visits included. Birth is at the hospital and there is postnatal care in-home for 2 weeks (sometimes more if needed/asked for).
To access this model on the Sunshine Coast:
- go to your GP and ask for a referral to the SCUH (Sunshine Coast University Hospital) MGP (make sure they specify MGP and not just maternity!)
How else can you access continuity of midwifery carer?
There are also private midwives with Medicare access (so you get to claim a rebate on their fees). The one I practice from has several midwives (Coast Life Midwifery) and there are also some smaller private midwifery businesses around the Sunshine Coast. Their results are exemplary- 8% cesarean rate, over 90% breastfeeding rates, high satisfaction, low trauma rates. There is a fee involved (much like the gap payments at GP clinics), but they have payment plans and an initial bulk billed appointment. Most of their appointments are based in their clinic. They also do postnatal home visits. They have access to SCUH if you need any appointments there, and for birth. You don't need a GP referral, you simply call the clinic. They also offer postnatal packages for in-home and in-clinic visits (they also have a child health nurse on site who bulk bills).
This is very fragmented care. Your General Practitioner will see you up until birth, where you will birth at your local hospital (and perhaps have another appointment or two there as well). They have medicare access, so a portion (or all if they bulk bill) of your appointment will be covered by medicare. Your GP can provide antenatal care and postnatal care. They don't have visiting arrangements with local hospitals to provide any birth care. There are two suggestions I have IF you are choosing this model of care:
a) make sure your GP has some experience or has completed ongoing professional development in pregnancy and postnatal care
b) know that you will have to go to the GP clinic where sick people are for any of your pre and/or postnatal appointments.
Private hospitals will have obstetricians to offer you antenatal and postnatal care and you’ll birth with your obstetrician or a backup obstetrician. Obstetricians are surgeons. I have always wondered why they look after low-risk, well women and babies, when there is little (any!?!) evidence to this. You can choose your OB in a private hospital (but they will have a clinic you will see them in for antenatal care). Your postnatal care will be limited to the hospital ward and an appointment at 6 weeks. Some of your appointments will also be with a midwife. Private OBs have access to medicare, and if you have private health insurance with pregnancy cover, you will be able to recoup some costs. You will need a referral from your GP to access a private OB. Keep this in mind if you are “low risk”, that your OB is trained to look for things that go wrong, and we know that in “low risk” women who have obstetric care, their outcomes are not as good as “low risk” women who have known midwives. Some local private obstetricians include: Dr Nerida Flannary, Dr Kylie Isaacs, Dr Kelvin Larwood, Dr George Bogiatzis, and Dr Kirsten Morrow. They all have their clients birth at Buderim Private Hospital.
Public Hospitals will offer either MGP (see known midwife) or fragmented, standard care, where you will see a range of midwives and obstetricians (mostly midwives, unless you have special circumstances during pregnancy for you or your baby, medical issues that need referrals to consultants or require an induction, epidural, ceasarean or other intervention during birth). Rarely would you have met the midwife who attends to you in birth during labour , but the stats at public hospitals are still much lower than private obstetric care. Nationally, the cesaran rate is around 35% in public hospitals, 40% in private. I have heard through contacts the cesarean rate at SCUH is about 22%. It can be quite challenging having to retell your "story" at every appointment and also have a midwife who you haven't met attend your birth.
The best advise I can give you for your birth preparation is to find a care provider who aligns with what you want for birth. We know the outcomes for midwifery continuity of carer are superior- and not just for low-risk women, but high-risk women too. Meet with care providers (just as you would for venues and dressmakers when planning a wedding) and find the best fit for you and your family. Have a list of questions you'd like to ask and follow your intuiation to find someone who is best fit for you and your family.
See research around continuity of midwifery carer (a known midwife) in this Cochrane review: