Birth Options In Newcastle and the Lower Hunter

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.

If you'd like an overall view of the maternity system in Australia, you might like to start by listening to this episode of the Science of Motherhood podcast titled "What you need to know about the Australian Birth System".

A note on statistics

Stats are just stats! They can guide your care stream decision making, but do not dictate your experience. Birth can be great - I've done it twice! But you do need to have your wits about you going into systems that are based to serve their own needs as much (if not more than) their patients.

Please note when reading the tables regarding hospital births below that the figures shown are for "selected mothers" only. This gives a snap shot of a consistent group of patients across health services, which makes it easier to compare and monitor trends. This group includes women who are

• 20–34 years of age at the time of giving birth
• Giving birth for the first time at 20 weeks or greater gestation
• Pregnant with a single baby
• Whose baby has a cephalic (head down) presentation
• During the period 37 weeks and 0 days to 40 weeks and 6 days gestation.

If your situation is different to that listed above, you may need to do some more digging as to what outcomes patients like you experience a each service so you can make decisions about which care pathways are best for you. If you have been told you will be a "high risk" patient or are "going overdue", I would also highly recommend looking into the work of Dr Sara Wickham, whose books on topics such as induction and Plus Size Pregnancy give far greater information than most short medical consults have scope to provide.

When it comes to statistics for privately practicing midwives, tthere is no data available for "selected mothers" as a separate group, so data for all births (including situations where the mother/birth parent is older, plus size or having a vaginal birth after caesarean) is included together.

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 (but not all) 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 personally attend your birth, unless you undergo a scheduled caesarean section. Gap fees would be applicable (this is on top of your pubic health fund fees) for the outside-of-hospital consults.

Birth stats for JHH

Data based on reports of selected 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

Data based on reports of selected 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, who they see for their pregnancy appointments. 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

Data based on reports of selected 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.

Data based on reports of selected 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. In this care model the same person will be with you for your pregnancy appointments, your birth and six weeks of postnatal care visits. Privately practicing/independent midwives have additional training compared with the majority of hospital midwives. 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 the following independent midwives, who provide thorough continuity of antenatal care, birth and labour support and postnatal care. If you're interested in this model of care, I'd encourage you to get in contact with them ASAP as they only take a few families per month each so do fill up quickly. If there's more than one available, it's also a good idea to interview 2 or 3 and see who feels like a  good fit for your family.

• Helen Young - Homebirth With Helen
• Haley Weir - Nurturing Birth
• Di Longworth - Valley Births
• Ineka Morosini - Morisini Midwifery
• Heidi Williams and Tracy Pyle - Central Coast Homebirth 
• Rhiannon Tongue -The Mindful Midwife
• Haylie Shaw

Unfortunately there isn't comprehensive data available for private praciting midwives in NSW. Many of them publish annual stats on their social media pages, and as stated before these include both "low" and "high" risk mothers/birth parents. As an example, here are Helen Young’s 2022 figures. Generally with privately practicing/independent midwives the rates of spontaneous (non-induced labour) and vaginal birth are upwards of 85%, with C-section and instrumental births around 5-10% each. 

Birthing with a private midwife is estimated to cost $5500-7000, inclusive of all appointments pre- and post-natally. You will get around $1500 of this back from Medicare.

If homebirth with either BMGP or a private midwife is of interest to you, you are welcome to join the "Newcastle and Surrounds Homebirth Community" facebook group to ask questions or connect with others who have taken the homebirth route. 

Unassisted birth

A small percentage of birthing people choose to have their babies “outside the system” without medical supervision. Yes, people do this by choice, and no, it’s not illegal.

If unassisted/free birth is something you want to learn more about, there is a Facebook group called “Hunter Freebirth Unassisted Birth Wild Pregnancy Local Connections”.

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?

Thankfully, things seem to have settled down with this, but you will still need to be across regulations in case you or your support person(s) are COVID-19 positive at the time of your birth. Rules on support people and visitors are changing all the time and are not consistent across maternity services or public/private health systems.

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?

I offer birth mapping, postpartum planning and birth debrief services and would love to assist you. Feel free to book a session with me, or connect with Newcastle Birth Movement for a range of local pregnancy, birth classes and doula services.

Maternity Choices Australia and Evidence Based Birth are also valuable resources when considering your options for birth.

If you are birthing in hospital, I would highly recommend accessing Karli Smith’s hospital birth education course, and also looking into hiring a birth doula (this episode of The Great Birth Rebellion podcast discusses why).

Pregnancy Loss

If you are reading this, it’s likely that you’re pretty early in your pregnancy or even pre-conception. Although it’s not talked about much, miscarriage, early birth, pregnancy loss and termination for medical reasons occur in around 1 in 4 pregnancies. I don’t want to scare you, but I do want you to know where you can get support if this happens to you:

• Pink Elephants Foundation
• Bears of Hope
• SANDS
• Perinatal Anxiety and Depression Australia
• The Gidget Foundation
• Perinatal Psychologists

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.