The way you are treated during pregnancy, and during birth, and after your baby’s born, means the difference between a positive experience that you feel good about, regardless of whether you had a natural birth, an induction or a caesarean, or that can leave you feeling disappointed, frustrated, angry or traumatised.  So your choices do matter.

On the Sunshine Coast you can give birth at these places

• Sunshine Coast University Hospital (which I’ll refer to as SCUH – pronounced skuw)
• Buderim Private Hospital
• Home 

Is there a difference between public and private?

Generally, public hospitals are less likely to offer drugs and interventions than private hospitals because at the end of the day these procedures are more expensive.  Interventions such as inductions, drugs for pain relief or speed up labour, forceps, vacuum extraction, continuous monitoring and episiotomies are usually lower in public hospitals compared to private.  Caesarean rates are usually higher in private hospitals, because women can choose elective procedures and caesareans when they’re private patients, or high risk women might choose private obstetric care.  

Although I believe caesarean rates are still higher at Buderim Private Hospital, I’m hearing of more and more routine interventions being used in women’s labours at SCUH which is extremely concerning, considering that most of the women (you!) are healthy women in good health with low-risk pregnancies. Why is it a problem?  Because if you intervene in normal labour you’re likely to create complications that snowball to needing more interventions, changing the course of the way your body works, and potentially leading to caesarean birth.  This is known as a cascade of intervention.

The World Health Organisation states “Since 1985, the international healthcare community has considered the ideal rate for caesarean sections to be between 10-15%.”   That includes all women who are likely to have complications in labour.  Not many, is it?  If Australia’s caesarean rate is 34%, one of the highest rates in the developing world, what is your hospital doing to lower that average so that you’re more likely to experience a straightforward, uncomplicated labour and birth?  Ask your caregivers how many women in their care have a physiological, normal birth without interventions.

What are the implications of the place I choose to give birth?

Care at SCUH is free, covered by your Medicare plan, as it’s a government run public teaching hospital attached to University of the Sunshine Coast.  Some of the implications of this are that:

• It’s a large hospital with around 3,000 women birthing there every year.
•  There are a lot of student doctors and midwives who might attend your birth.
• Unless you have your own midwife you’re not likely to know the people in attendance at your birth, which reduces levels of comfort.
• It has a state of the art Neonatal Intensive Care Unit should your baby need special care.The operating theatres are always open for emergencies.

If you choose the private system you hire a private obstetrician or a team of obstetricians and give birth at Buderim Private Hospital.  This used to be seen as better care, but with the new SCUH more and more women are moving to the free, public service.  If you’re choosing a private obstetrician, ask how many women in their care experience physiological, normal birth and how many have a caesarean, to give you an idea of how they practice. 

Receiving care from the same caregiver right throughout pregnancy, birth and in the early postnatal period is called continuity of care. This is known as the gold standard or the best type of care. It’s obvious that if you get to know one person or a small team of people and see them right through your pregnancy you’ll know how they work and they’ll learn what’s important to you.  When you’re in labour you won’t have to get to know a stranger or explain yourself to them because they already know what you want.  That makes it more likey that you will have better outcomes during birth and also in the postnatal period as you learn to breastfeed and care for your baby.  

On the Sunshine Coast you can receive continuity of care through SCUH’s Midwifery Group Program, if places are available and you qualify, or by hiring a private midwife and birthing at SCUH or at home.

Is homebirth safe?  What happens if there’s a problem or emergency?

Yes, planned homebirth with qualified carers for low-risk women is safe and you can locate statistics and information online about it, or talk to a private midwife to find out more.  About 900 women give birth at home in Australia each year.  Midwives are trained to recognise problems and will call for help or transfer to hospital if they believe staying at home is no longer safe.  On the Sunshine Coast we have a number of highly trained and respected homebirth midwives who attend local homebirths every year.

I’ve created the table below to show all of your options – where you can give birth and who can care for you medically i.e. your caregivers. I’ve divided your care into three areas: pregnancy care, labour and birth, care immediately after birth in the first few hours or days, then postnatal care of you and your baby which is generally regarded as up to 6 weeks after birth.  I’ve included some pros and cons and look forward to hearing from you if you’re a birthing woman or a maternity care professional with any comments on what I’ve written based on my experience talking with birthing couples on the Sunshine Coast for 9 years and all around Australia for more than 20 years.