Without a doubt, one of the most common questions asked of a Private Midwife is about Home Birth. On the Sunshine Coast we often get asked about Home Births. What does it involve? Is it safe? How much does it cost?
In this series of posts, we are going to examine some of the many questions we get asked about Home Births, starting with the Cost.
On the Sunshine Coast, when a mother-to-be starts to investigate her options for birth, it is more and more common for her to investigate options for Home birth as well as Hospital Birth. And one of the first questions that we (and many midwives) are asked is: How much does it cost?
The problem with answering this question outright is that there are many options for supporting a woman through pregnancy, birth and postnatally that it can be difficult to state a standard price. But, it is however, possible to give you an overview of the possible inclusions (and best practice for service) when looking at options for Home birth.
So let’s look at some “recommended fees” and average prices, and most importantly, the inclusions that the midwife will provide as part of these fees:
What is the Average Cost of a Home Birth?
Again, this varies, but the average cost of the homebirth is approximately $2000. Please note that this is the homebirth alone and not the ante-natal and post-natal care. There is currently no medicare rebate for the birth, but some private health insurance companies such as Australia Unity can offer as much as $3000 back for a homebirth and midwifery care. It’s worth investigating if you have Private Health Insurance.
Antenatal and postnatal care attracts medicare rebates from medicare eligible midwives. Again, the type of antenatal and post-natal care that you arrange with your midwife will vary from woman to woman (please read below for advice for what you should consider and how to set up an agreement with your midwife).
If a woman is over the Extended Medicare Safety Net (EMSN) she will receive back approx $67 for a long antenatal visit 40 minutes and over, and approx $88 for a long postnatal attendance (which most appointments are with a midwife ). She will be rebated a lower amount if it is for a short visit (of 40 minutes and less). Some visits may even be bulk billed by some midwives depending on the contract a woman has signed (again, see below for more information about how this works). These fees and rebates are subject to change and should be used as a guide only, as every situation is different.
The total cost of care throughout your pregnancy, birth and postnatal care is best discussed personally with each midwife. Many midwives, like ourselves, will probably tailor any care program to your needs and payment plans are always an option. Antenatal and postnatal visits incur different costs with each midwife/practice. So instead of focusing on the price of the care (as we recommend you discuss antenatal and postnatal care with your midwife), let’s look at what should be included and what you need to ask about:
What does the midwife include in her care?
This is the most important question you need to ask, and there are a number of things to look for:
Recommended midwifery care should include:
- A private booking in session where you discuss in detail your medical, surgical, pregnancy and family history. This is documented in detail. Your antenatal program, frequency of visits, contact details of midwife and back up midwife is given. Your pregnancy health record should be given to you at this visit with the Recommended Minimum Antenatal Schedule Checklist for you to consider. At this appointment you should also discuss your “Contract of Care” and any payment arrangements are to be clearly documented. You should also ideally receive other educational materials. For instance, in our practice we provide CD’s, DVDs, and a highly recommended book about birthing, which is all part of our program designed to help women experience the best birth possible.
- Your bloods and scans are organized by the midwife if she is medicare eligible otherwise they will be organized by your GP. You should receive confirmation from your midwife concerning all results throughout your pregnancy.
- Monthly antenatal checkups until 32 weeks then fortnightly until 36 weeks, then weekly until birth. Unless there are concerns about your health.
- A written care plan is formulated with you and your midwife detailing agreed expectations of care during the pregnancy, labour and delivery; details of health problems or issues; details of collaborative arrangements pertaining to the women; details of medications required or those that may be required such as in a homebirth; details of referrals that may be required for the woman during her pregnancy. This care plan is explained, written and agreed upon between the woman and the midwife. It is a requirement for a medicare eligible midwife to complete this care plan with a woman.
- A plan of communication methods with your midwife so that any enquiry is met by her within 24 hrs if not urgent and asap if it is urgent. You must have alternative hospital numbers and a back up midwife number in case your midwife is not able to be contacted for urgent concerns. You should have access to 24/7 contact with your midwifery team and should be provided with a definite response within 24 hrs for non urgent enquires. With a “back-up” medicare registered midwife, two midwives will always be available for calls in the case of a homebirth.
- If your midwife is medicare eligible you should receive receipts of items claimed and if you are paying a gap fee, ensure you retain these receipts for tax purposes. Every service should be documented and your midwife should advise you of any items that are to be bulk billed.
- A home birth midwife should carry all emergency equipment including drugs such as Syntocinon, Syntometrine and Misoprostil to stop any postpartum haemorrhaging. It’s not something that any of us hope you will ever have to use, but in the case that it is necessary, check that your midwife will carry this. If your midwife does not carry this, you should obtain a script from your GP and have the drugs available.
- A postnatal program is organized between you and your midwife according to your needs. You should be seen until 6 weeks post-birth from which time you will usually discharged to your GP and Community Health Care.
- Following a homebirth, your Midwife should stay with you for up to 4 hours and no less than 2 hours. After birthing, you should have midwife visits between 3-5 times in the first week, twice in the second week and then weekly till discharge from your midwifery team.
- Your midwife should also provide referral to a lactation consultant should it be necessary if she is not herself a lactation consultant.
These recommendations are based up on best practice for standards of care in Australia and we advise that you run through these items with your midwife before deciding on the right midwife for you and completing your Written Care Plan.
If you would like more updates and tips about pregnancy and birth (in particular home birth) please subscribe to our Updates in the Opt-In box at the top (right) of this page. Alternatively give one of our friendly midwives a call!