Birth Options In Newcastle and the Lower Hunter

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When I went to my local doctor for a formal pregnancy test, the first question she asked was what kind of maternity care I wanted. I had zero clue what options even existed!

If you’re having a baby (or hoping to) AND you live in the Newcastle-ish area, here is the whole deal spelled out for you.

Please note that estimated costs do not include additional support services like doulas or personally hired/purchased equipment like birth pools.


John Hunter Hospital

Most babies in the Hunter region are born at John Hunter Hospital (JHH).

“The John” has three birthing zones – the Birth Suite (previously called the Labour Ward), the Birth Centre (for low risk birthing parents under the care of the JHH Birth Centre Team Midwives) and the operating theatre for caesarean births.

FYI - The Birth Centre has some rooms with baths, the Birth Suite doesn’t have any.

Women with uncomplicated pregnancies have the options of “shared care” (that means some appointments with NSW Health and some with their GP) or using community antenatal clinics for check ups during pregnancy. If you take this route you will birth in the Birth Suite.

If you birth at the Birth Suite, it is unlikely you will have a known midwife on duty at the time of your birth. If you go through the JHH Birth Centre Team Midwives program, you have a better chance of having previously met your midwife.

You can read more about JHH options and take a virtual tour of the facilities here.

It is possible to have breech births and VBAC (vaginal birth after caesarean) at JHH (although you may have to advocate strongly for your decisions in some circumstances).

Specialty support teams available at JHH include: Birra-Li – for Aboriginal and/or Torres Strait Islander women, or women having an Aboriginal and/or Torres Strait Islander baby.

Specialist and M3 teams – for women with complicated pregnancies and/or obstetric conditions.

There are also Family Care Teams for mothers with special needs, the Multicultural Health Unit for families from Culturally and Linguistically Diverse Backgrounds, Aboriginal Liaison Officers to assist Aboriginal and Torres Strait Islander patients, and support for mothers with differing needs (e.g. drug and alcohol services, counselling and social work, dietetics, and physiotherapy).

Some private obstetricians also work at JHH. Your antenatal appointments would take place at their consulting rooms, and you would birth in the Birth Suite or operating theatre. Your obstetrician would not necessarily attend your birth unless required. Gap fees would be applicable (on top of your pubic health fund fees) for the outside-of-hospital consults.

Birth stats for JHH


% of births in 2019

General trend since 2008

Vaginal births (without instruments)

46.2%

Decreasing

Induction of labour

51.9%

Increasing

Instrumental births (forceps of vacuum)

24.6%

Fluctuates between 18.1-24.9%

C-section births

29.2%

Increasing


Data based on reports of first time mothers aged 20-34. Sourced from official NSW Health Stats data.

Out of pocket costs for birth in public hospitals is estimated to be $0-1500.

 

Maitland Hospital

Information about birthing options at Maitland is quite similar to that at the JHH.

Midwifery care at local health clinics, shared care with Your GP, specialist care under medical obstetric teams (for complicated pregnancies) and using a private obstetrician are all options for care.

Accessing care through the Midwifery Group Practice is the most likely to see you having a known midwife at your birth.

Aboriginal and Torres Strait Islander women or those having an Aboriginal and/or Torres Strait Islander baby can have their care provided by Naae-Wanni midwives and Aboriginal Health Care Workers at home, community antenatal clinics, or Mindaribba.

More info here.

Birth stats for Maitland Hospital


% of births in 2019

General trend since 2008

Vaginal births (without instruments)

62.2%

Variable, 47.9-67.1%

Induction of labour

53.9%

Increasing

Instrumental births (forceps of vacuum)

10.3%

Decreasing

C-section births

27.5%

Variable from 15.9-32.6%, but stable at 26.5-27.5% for the period 2017-19


Data based on reports of first time mothers aged 20-34. Sourced from official NSW Health Stats data.

Out of pocket costs for birth in public hospitals is estimated to be $0-1500.


Public hospital birth is also available at Singleton, Scone and Muswellbrook hospitals. Those requiring specialist or higher level care are referred on to Maitland Hospital or John Hunter Hospital.

 

Newcastle Private Hospital

According to their website, 2000 babies are born each year at Newcastle Private Hospital. All patients birthing here are under the care of a private obstetrician. This does not necessarily mean their OB or a known midwife will attend their birth.

[A note that if you have conceived with assisted technologies you do not have to continue care under your same specialist. You are free to choose from any of the care options provided here that are suitable to your level of risk and personal preferences.] You can read more about the services and care provided on their website here.

 

Birth stats for Newcastle Private


% of births in 2019

General trend since 2008

Vaginal births (without instruments)

35.6%

Decreasing

Induction of labour

53.2%

Increasing (this rate has doubled since 2008)

Instrumental births (forceps of vacuum)

27.4%

Stable

C-section births

37.1%

Increasing


Data based on reports of first time mothers aged 20-34. Sourced from NSW Health official data.


It is interesting to note that amongst the 20-34 year age group of first time mums, there is a private/public hospital statewide difference in birth outcomes in NSW. While it can be worthwhile for some families, paying for health insurance and private care does not guarantee more “control” over your birth experience if you are seeking a certain type of birth.



NSW PRIVATE HOSPITALS

% of births in 2019

NSW PUBLIC HOSPITALS

% of births in 2019

Vaginal births (without instruments)

33.9%

51.1%

Induction of labour

43.8%

45.5%

Instrumental births (forceps of vacuum)

24.4%

23.4%

C-section births

41.6%

25.5%


Data based on reports of first time mothers aged 20-34. Sourced from NSW Health Stats official data. 

Out of pocket costs for birth in private hospitals is estimated to be $2500 to 20,000. This is on top of your private health fund fees before conception, during your pregnancy and postnatal period.

 

Belmont Midwifery Group Practice

A team of nine NSW Health (publicly funded) midwives operate from the birth centre at Belmont Hospital. This service is for women identified as low risk at the JHH booking in visit (if it is not directly offered to you and you wish to pursue this option, you may need to ask to be referred on). You are assigned a primary midwife who you will see for the majority of your antenatal aooointments at home or Belmont Hospital, and meet others on the MGP team during your pregnancy. If you live within a certain radius from JHH you can elect to homebirth with BMGP support. More info on BMGP can be found at the Friends of Belmont Birthing community supporters website.

Monthly stats for BMGP are published on the Friends of Belmont Birthing Facebook page. Their busiest month in years, April 2021, recorded: 28 babies born

  • 24 vaginal and 4 c-section births
  • 7 home births
  • 94% had a know midwife at their birth
  • 43% first time mums, 57% subsequent births.

Out of pocket costs for birth through publicly funded hospital system (of which BMGP is a part) is estimated to be $0-1500.


Private Midwifery Care

Most people using a private midwife choose to have their pre- and post-natal appointments at home, and birth there too. Private midwifery care is preferred by many for personal and cultural reasons, and provides gold standard continuity of care. Those interested in the safety of home birth are encouraged to read more here

Many people don’t know that private midwives can work in collaboration with obstetricians and public hospitals as well. This means it is possible to have a private midwife and birth in a hospital if this is your preference.

Our region is serviced by independent Endorsed Midwife Karyn Besley, who provides thorough continuity of antenatal care, birth and labour support and postnatal care.

Heidi Williams and Tracy Pyle from Central Coast Homebirth also attend provide private midwifery care in our region. 

Birthing with a private midwife is estimated to cost up to around $6000, inclusive of all appointments pre- and post-natally.

 

Unassisted birth

A small percentage of birthing people choose to have their babies “outside the system” without medical supervision. I don’t necessarily support or reject this idea, just saying it’s not illegal.

As with all other births in NSW, you are required to register your baby’s birth within 60 days of child being born. 

[For clarity, it is important to note when reading literature about birth options that a “home birth” generally refers to birth outside a hospital or birth centre setting with a midwife. An unassisted or “free birth” refers to a birth planned to occur without involvement of a medical practitioner or midwife, even if it happens inside the home.]


What about COVID-19?

Rules on support people and visitors are changing all the time and are not consistent across maternity services, health systems or even within the same suburb! Many doulas in our area are recommending having an exemption application for support people and additional visitors on hand, even if restrictions don't seem to be an issue for you right now. This postdetails how to go about writing and applying for an exemption.

What about postnatal care?

Every service and care stream seems to have different level of postnatal follow up, and even varying levels of in hospital support for things you might assume as basic issues like early lactation. Locating and making contact ahead of time with a local postpartum doula (like me) and an International Board Certified Lactation Consultant (using the LCANZ Find a Lactation Consultant tool here) is a good idea.


Got Questions?

Feel free to drop me a line, or connect directly with Embracing Birth or Newcastle Birth Movement for decision making support, independent birth education options and connection with a range of local pregnancy, birth and doula services. Maternity Choices Australia and Evidence Based Birth are also valuable resources when considering your options for birth and birth planning.


Disclaimer: Nothing in this document is to constitute medical advice or be taken in place of individualised advice from a medical practitioner. I am not affiliated with any of the birth or maternity care services mentioned above. Information provided is true and accurate to the best of my knowledge as at the date of publication. If you notice errors or outdated information, please contact me using the "contact" section of this website.

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