Exploring Birthing Options in Victoria
Congratulations on embarking on the first step toward achieving your desired birth experience!
The location and the people attending your birth can significantly impact your birth outcome. Having a continuous support during childbirth has shown to have a positive impact on maternal and baby health outcomes. It also significantly influences the satisfaction levels of mothers and fathers/partners throughout the entire pregnancy, birth, and postpartum care journey. This Cochrane review evaluated the impact, both on women and their infants, of continuous, one-to-one intrapartum support as opposed to standard care, in any given setting.
In this article, I will discuss various birthing options based on care models, including:
· Standard public care
· Team midwifery care
· Caseload/Midwifery group practice (MGP)
· Shared care
· Private midwifery care
· Private obstetric care
Additionally, alternative birthing choices such as homebirth, freebirth and doula support services will be explored. The information provided here is tailored for mothers who are planning to give birth in the greater west of Melbourne, Victoria.
Standard Public Care
Care is provided by midwives or obstetricians based on individual "risk" status. The model is fragmented, involving different providers for each appointment and during labour.
Antenatal appointments may take place at the hospital or community clinics, and birth usually occurs in a hospital. After giving birth, there's a short hospital stay of 1-2 nights, followed by home visit(s) from a hospital midwife.The cost is covered by Medicare, and private insurance is unnecessary. Public hospitals often offer extra services for specific social or cultural groups.
Team Midwifery Care
A small team of hospital midwives provides care, with appointments typically at the hospital or accessible community clinics. The continuity model aims for familiarity by having you meet various team members during childbirth and the postpartum period.
Antenatal appointments occur in the hospital or community clinic, and the birth location is a public hospital. Postnatal stays involve a short ward stay, with a potential 6-hour discharge eligibility or generally 1-2 nights unless complications arise. Home visit(s) from a hospital midwife follow discharge. The cost is nil for Medicare-eligible individuals, and private insurance is unnecessary.
Caseload/Midwifery Group Practice
In the Maternity Group Practice (MGP), your Primary Midwife offers clinical and emotional support throughout pregnancy, labour/birth, and the early postpartum period. Midwifery 'Continuity of Care' fosters trusting relationships, positively impacting birth outcomes and maternal satisfaction.
For women identified as 'low risk,' homebirth is an option. Primary Midwives operate in both home and hospital settings, maintaining collaborative ties with medical teams. This integration ensures program effectiveness in hospitals, making home birth a secure option with a smooth transition of care if necessary. This care model is covered by Medicare and may require eligibility criteria and early referral. Some hospitals offer culturally or socially caseload programs.
Shared Care
Private midwives or general practitioners (GPs) deliver care in collaboration with the local public hospital. Appointments occur mainly in the community with your private midwife or GP, and a few may take place at the public hospital.
This model provides continuity during the antenatal period but typically lacks continuity during birth unless the private midwife provides support. Antenatal appointments can happen at a midwife/GP clinic, home, or the hospital. Birth usually occurs in a public hospital, followed by a short ward stay and home visit(s) from a hospital midwife after discharge. Some costs may be associated with antenatal appointments, with applicable Medicare rebates.
Private Midwifery Care
Care is provided by a privately practicing midwife (PPM), serving as your sole care provider, part of shared care, or supplementing other pregnancy care. The level of involvement depends on your chosen birth location, and if in a hospital, whether the PPM has admitting rights.
This continuity model covers pregnancy, birth, and the postpartum period. Antenatal appointments can occur at your home or the PPM's clinic, with the birth location being a hospital or home.
Postnatal stay is flexible based on the chosen birthing location, with comprehensive home care provided by the PPM. Costs involve out-of-pocket expenses, with Medicare rebates available for antenatal and postnatal appointments and potentially for birth in specific circumstances. Private insurance is not required, but it may assist with some costs in limited circumstances.
Private Obstetric Care
Care is provided by a private obstetrician or a small team of private obstetricians throughout pregnancy. This continuity model spans pregnancy, birth, and the postpartum period, with labour support primarily provided by hospital midwives.
Antenatal appointments occur at a private hospital or clinic, and the birth location is a private hospital or a public hospital as a private patient. After giving birth, there is typically a 4-5 day postnatal ward stay, with no home visits afterward.
Costs include Medicare and private health cover rebates if eligible, with out-of-pocket expenses for management fees and hospital excess. Private insurance is generally required to avoid substantial out-of-pocket costs.
Homebirth
In Victoria, homebirth can be accessed in two main ways. Some women choose to engage a privately practising midwife, which is typically self-funded and offers continuity of care throughout pregnancy, birth, and the postpartum period. Others may be eligible for a publicly funded homebirth program offered through select public hospitals within their catchment area. Read Homebirth Resources for a list of usefull websites when planning for a hombirth.
Publicly funded homebirth programs are limited and operate under specific eligibility criteria. Acceptance is usually based on being low-risk, overall maternal health, previous medical and obstetric history, current pregnancy progress, and any identified risk factors. Availability may also depend on postcode, demand, and how early you apply to the program.
Because places are limited and criteria are strict, it is important for families to explore their options early in pregnancy, seek accurate information, and consider what model of care best aligns with their values, preferences, and support needs.
Freebirth
Freebirth, or unassisted childbirth, involves giving birth without medical professionals' assistance. In a freebirth scenario, the expectant mother chooses to deliver her baby at home or a chosen location without medical interventions or support. Freebirth is not illegal.
Those opting for freebirth often do so based on personal beliefs, preferences, and philosophies about childbirth. Some see it as a more natural and empowering birth experience, avoiding unnecessary or potentially harmful medical interventions. They trust in the female body's ability to handle the birthing process.
There’s always a risk associated with childbirth, but we can minimise that by mentally and physically preparing ourselves. Preparation for childbirth begins as early as preconception but it’s never too late to start if you absolutely believe in your ability and power to give birth on your own. It is important to acknowledge that if complication arises, there will be a slight delay in accessing medical assistance. Therefore, it’s important to be well-informed in your options and risks regarding free birthing.
Doula Support Services
Another option to consider is hiring a doula, who can offer emotional support during labour and birth. Doulas are not medically trained professionals; instead, they provide continuous mental, emotional, and physical support for women and their partners throughout pregnancy, labour, birth, and postpartum. While they do not offer medical advice or make decisions for clients, doulas provide information and resources to assist in making informed decisions. Importantly, they do not pressure clients into specific choices; rather, they advocate for the client's preferences and provide unwavering support
It's essential to note that doulas do not replace the roles of partners or midwives. Instead, their presence in the birthing space is dedicated to serving birthing women by offering support in every capacity to ensure a positive experience.
I recommend this article by Vicky Hobbs to deepened your understanding about homebirth, freebirth and doulas. Also this article on the Evidence on: Doulas from Evidence Based Birth outlines the roles of a doula and the effectiveness of having one in your birthing space.
I’m Gess, a Muslim birth and postpartum doula offering holistic, faith-centred support both online and in person. I walk alongside women with nurturing care, evidence-based education, and a deep respect for your intuition, values, and spiritual journey into motherhood.
If you’re seeking calm, culturally safe, and personalised support throughout pregnancy, birth, and postpartum — I would be honoured to support you.
✨ Book a discovery call with me to explore how we can prepare for a birth experience that feels informed, supported, and spiritually grounded.
Let’s create a space where you feel confident, heard, and deeply supported every step of the way.
