The 3 biggest differences between giving birth in a public and private hospital, from mothers who've done both.

Public versus private healthcare. It’s one of the key decisions a woman will make in planning a pregnancy and birth. It’s also among the most contentious.

We’re fortunate in Australia to have a robust public system, but those who have the means to afford private cover and the ability to plan ahead (waiting periods on pregnancy cover are typically 12 months) have yet another avenue of choice.

Each offers high-quality care and has advantages over the other.

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So what sets them apart?

We asked mothers who’ve given birth in both public and private hospitals to share the biggest differences between the two.

1. Who looks after you.

In the private system, an expectant mother chooses her obstetrician. This choice may be based on a referral or recommendation, or simply based on who works at her preferred private hospital.

This obstetrician will see the mother through the entire process, from pregnancy appointments to the birth itself.  If they aren’t available when the mother is ready to deliver (they may be with another patient, for example), they will send a colleague.

In the public system, the mother will typically be cared for by whichever midwives are on shift at the time of her prenatal appointments and delivery. An obstetrician may be involved for a complex pregnancy or delivery.

Some local health districts offer ‘midwifery group practice’, in which a mother is assigned a small group of midwives who are on call throughout the process. But places in these programs are typically pretty limited.

Most mums Mamamia spoke to identified having continuous care from a dedicated obstetrician as one of the key advantages of the private system.

But NSW mum, Jess, experienced the flip-side with her first birth.

“The main reason I decided to go private was that it was an IVF pregnancy and my fertility specialist recommended a particular OB… But I didn’t find my OB very personable,” she said. “I really like my GP and my medical practice has a midwife, so I got to see the same people with my second pregnancy anyway most of the time.”

2. The cost.

Emily Callander, Associate Professor of Health Economics at Griffith University, recently conducted research that found that women who gave birth in the public system paid, on average, $500 in out-of-pocket costs. That covered all associated healthcare from conception right through to 12 months postpartum.

Meanwhile, in the private system, that figure was roughly $3,000.

So where does that difference come from?

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If a mother chooses the public system, her pregnancy consultations, delivery, hospital stay and even some post-natal care (lactation consultations, for example) are fully covered by Medicare. However, some services performed outside of hospital, including ultrasounds and scans, are not.

If she takes the private route, the majority of her bill will come from obstetrician’s fees. That because, by law, private health insurance cannot cover out-of-hospital medical services, including consultations with specialists in their own clinic/rooms. And specialists are able to charge whatever they like above the Medicare Scheduled fee.

As Assoc. Prof. Callander previously explained to Mamamia, “There’s no regulation as to the amount that private providers can charge, because it’s a private business. By definition, they’re seeking to make a profit, so fees are generally charged at an amount that they believe women are willing or able to pay.”

For more on the cost of childbirth, read: From “eye-watering” to “not a cent”: Australian women share how much childbirth cost them.

3. Accommodation: your room, how long you can stay and who can stay with you.

After giving birth in a public hospital, the patient will share a public room with several other new mothers. For a complication-free vaginal birth, she’ll typically stay one or two days before being discharged.

In the private system, she will get her own room, sometimes with a double bed, and will typically stay for four to five days.

That was the case for mum of three, Alethea. She went private for the birth of her first child, and spent five days in hospital.

“The private room and en suite meant it was very comfortable. It felt like a cosy cocoon away from the rest of the world, and I loved that,” she told Mamamia.

For her second and third children, Alethea opted for the public system and returned home in less than 24 hours.

“I was in a room with three other mums and their babies with my first son, and in a shared ward with one other mum with my youngest. It was definitely noisier! But the quality of care in general and attention to detail in terms of the immediate postnatal care was outstanding.”

Another point of difference mothers raised is that in the private system, partners are allowed to stay overnight, unlike in the public hospitals where they have to leave for the evening.

WA mum, Brodie, said that was one of the stark differences between her first birth in a private hospital and her second in a public one.

“I think I would have struggled [without my partner] if it was my first baby,” she said. “Because it was my second, it wasn’t as big an issue.

“It was hard, though, because I had nobody to hold bub for me when I needed to do things. I had to call a midwife every time.”

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Of course, the decision to choose public or private is a highly personal one. So be sure to talk to your GP about which path will be best for you.

The above contains general information and opinions only, and should not be substituted for personalised advice from a healthcare professional.