I recently put up a question box on my instagram, asking you what questions you have about hiring a private midwife in Australia. I reached out to Jenny from Jenny's South Coast Midwifery to get answers for you (not to mention she was our private midwife and is awesome).
what does hiring a private midwife look like?
Firstly I'd say that not all private midwives practice in exactly the same way but for me and my practice, hiring a private midwife often involves women contacting me prior to conception or very shortly after discovering they are pregnant. We often meet for a cuppa and answer each others questions. Once the woman has decided yes, she wants to book with me we meet monthly until 30 weeks, fortnightly until 36 weeks then weekly until birth unless the woman needs or wants otherwise. I am on call for the birth and if a first pregnancy, a doula might be helpful to provide support through the earlier stages of labour or for a particularly long labour. We have two midwives at a birth and you may or may not have an opportunity to meet the second midwife ahead of time. We usually stay about 4 hours after the birth, attending to mum and baby and cleaning up and then I visit daily for approx 4 days (or as needed) then usually around week 1, 2, 4 & 6 postpartum. As my service is a package, I aim to be flexible and tailor the care according to the needs and preferences of the woman.
what is included in hiring a private midwife?
Care as mentioned above, including fee for second midwife, pool hire and disposable pool liner and any other equipment or medication we may need.
what kinds of cost am I looking at to hire a private midwife?
The cost varies between midwives and locations but I'd say around $6-8k. There is also a medicare rebate available for some aspects of care and the rebates are about to increase which is great.
what's the difference between hiring a private midwife and a private obstetrician (OB)?
A private midwife specialises in healthy pregnancy and physiological birth and generally provides care in your home whereas an obstetrician specialises in complicated pregnancy and medicalised birth and you see them in a clinic and/or the hospital.
do I need to have a homebirth to have a private midwife?
Some private midwives offer hospital support however some, like myself, tend to keep ourselves available for women planning a homebirth. If a situation necessitates hospital transfer, I will accompany my client and continue to support her there.
what experience and qualifications do private midwives have?
Private midwives must already be registered midwives, have more than 5000 hours of clinical experience and have completed an additional qualification in prescribing and diagnostics, and become 'endorsed' which enables us to gain insurance.
can I hire a private midwife for a:
- vbac?
generally yes
- multiple birth? (twins, triplets etc)
generally no
- breech?
it depends
- scheduled caesarean?
it depends
This is midwife specific so be sure to ask when you're looking at engaging a private midwife.
what situations would hiring a private midwife not be advisable?
Never really as long as the woman and midwife have discussed any complexities and both are happy to work within a multidisciplinary team to achieve the best outcome for the woman.
can I have a private midwife in the hospital with me?
Yes, some midwives will happily support women planning a hospital birth, others of us will absolutely accompany the woman if hospital attendance is wanted or needed. A private midwife's scope of practice within a hospital is dependent on her having visiting rights in that particular hospital. If no visiting rights, a midwife takes on a non-clinical support role and works in conjunction with hospital staff.
9.2 do private midwives have visiting rights if I birth in the hospital?
Some midwives in some hospitals do.
9.3 I am looking for a private midwife who has visiting rights at Shoalhaven Hospital
As far as I understand, the only midwives with visiting rights at Shoalhaven hospital at the moment are the midwives with Waminda.
what are the benefits of hiring a private midwife?
I'm sure the benefits are countless...
Continuity of midwifery carer has been shown in countless studies to improve outcomes for women and babies, both physical and emotional. Private midwifery care gives women freedom and autonomy over their care and place of birth. The time spent with a private midwife allows for a real relationship to be established where information is shared, trust established and true informed consent possible. Care tends to take place in a woman's home, removing the power imbalance that can come with entering an institution. Statistically the rates of normal vaginal birth are higher, VBAC rates much higher, reduction in perineal tears, higher breastfeeding rates, greater satisfaction with care...to name a few.
why did you decide to become a private midwife?
Since studying midwifery, it was apparent to me that women wanted and deserved continuity of midwifery care and after having a taste of this in my degree, I only ever wanted to work this way. As a student I was also privileged to attend a homebirth and felt that I'd just witnessed birth for the very first time, despite having been at many, many births. To see a woman in her own home, completely free and untethered, to birth in her own way with her chosen support people, without intervention, beeping machines, fear or coercion was like a breath of fresh air and I just knew that's where it was at for me. I saw women and babies absolutely thrive under the diligent care of their private midwife.
After working on the south coast within the hospital system for a while, I noticed a gap in service offerings in the area, there was a demand for private midwifery care that could not be met and it has been my pleasure to be able to offer this service to women.
I hope this was helpful if you are considering hiring a private midwife, or if the thought never crossed your mind but now understanding more about it, it's sparked an interest for you.
Unfortunately, our public medical system in Australia very rarely allows for continuity of care. One of the biggest protective factors of a positive experience of pregnancy, birth, postpartum and breastfeeding is continuity of care. As Jenny mentioned, there are plenty of benefits to hiring a private midwife, if the cost is within your financial capacity.
Contact Jenny at Jenny's South Coast Midwifery Service
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