Public vs private care: What’s the difference when you have a baby?

Posted in Pregnancy Essentials.

When you become pregnant, there’s a lot to consider. However, one of the first things you need to decide is whether you’ll be going private or using the public system for the birth. Confused? Here’s a breakdown comparing the two, starting with all the costs! 

Money honey

Financially, a lot of people don’t have a choice when it comes to having a baby; they simply can’t afford to go private even if they wanted to. So what exactly is the cost comparison? Here’s a rough guide of what bills you’ll be facing in either camp.

Public costs

In most (but not all) cases, all of your care including pregnancy check-ups, ultrasounds, pathology tests, antenatal classes, the birth (whether at a birthing centre, hospital or with a home birthing program), epidurals, c-sections and your hospital stay after the birth (if at a hospital), is covered by Medicare. In other words, FREE. 

The only instances where you may be hit up for some cash are the following: 

  • GP appointments – Many, of course, offer bulk billing which means they don’t charge. However, if they don’t, you’ll need to pay the gap not covered by Medicare. This may only be an issue if you’re doing a ‘shared care’ option where your GP works with the hospital staff, and more appointments are required.
  • Harmony test – This relatively new prenatal test is optional and will accurately determine the sex and check for genetic disorders such as Down Syndrome. If you want it, the cost is $425. Medicare and private health insurers currently do not cover it.
  • Additional tests – If you want more ultrasounds or tests outside of the hospital, you will be charged for these. However, you can claim some back on Medicare. The same goes for non-hospital birthing classes.
  • Special birth requests – Such as a privately hired obstetrician, midwife, doula or another type of birthing assistant. Private health cover may give you back something for this (unless it’s a private obstetrician caring for your whole pregnancy). Other requests such as a TV in your hospital room may incur extra charges too.

Total estimate = $0 – $1,500

Newborn baby premature

Private costs

Going private is an entirely different matter altogether. The first thing you will need is private health insurance that covers you for pregnancy and birth – and you need to have it for at least 12 months before the baby is born. Outside of your health cover fees though, here are where all your expenses lie:

  • Obstetrician – The most significant cost is your specialist doctor. Anywhere between $2,000 and $10,000 depending on where you live and who you choose. Medicare only covers a very small portion of this, and according to the Commonwealth Ombudsman, medical services incurred outside of hospital including specialist consultations and obstetrician’s check-ups may not be covered. 
  • Hospital stay fees – These can be several thousands of dollars. Depending on your health cover, you should get some or all of this back.
  • Pain relief and surgery – Things like epidurals and c-sections are additional costs, with you having to pay for the anaesthetist and doctor’s assistant if you have a caesarean. You can claim some of this back via Medicare and possibly your health cover.
  • Other extras – Things like the Harmony Test and a doula, you have to pay for yourself. And if you are also seeing a GP who doesn’t bulk bill (on top of your obstetrician), there will be a gap you’ll need to pay too.

Total estimate = $2,500 – $20,000 (more if you don’t have private health cover).

Read more about birth preparation:

The private perks

Given the cost of having a baby via the private system has the potential to be vastly more expensive than going public, why do people do it? Not just for the mega-rich, many families actually save ahead to ensure they have this option. Here are some of these reasons:

  • You usually get your own hospital room rather than having to share with another mother, and the food and facilities are generally better.
  • You get to choose your doctor (obstetrician) who will care for you during your pregnancy, discuss your birth plan, deliver your baby and help with your recovery; rather than seeing different midwives and doctors each time which can provide peace of mind.
  • Your doctor will generally be more experienced than the doctors on call at public hospitals who are often juniors, which is helpful if you have a high-risk pregnancy.
  • You have an option to stay longer in hospital after the birth (several days more, even if you had a vaginal birth).

childbirth baby

Don’t panic

If you like the sound of going private but don’t have insurance or can’t afford it, there is also the option to be a private patient in a public hospital. This is where you hire an obstetrician for your baby journey but don’t get hit with things like hospital fees or anaesthesiologist bills.

This, of course, is still too expensive for some, but the good news is that the public system is used by the majority of women in Australia and aside from being mostly free, there are some other benefits, such as, having less chance of intervention (e.g. being induced or having a c-section) and the public hospitals are better equipped for situations where you or your baby need intensive care. Plus, many women swear by their great experiences there!

Do your research

To be properly informed, make sure you do speak to your health care provider and any doctors up front for all the details and costs specific to you.

Did you go private or public for your baby? Share your experience with us on our Facebook page.


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