Do You Know Your Birth Options in Perth?

I have just been a guest panellist at the Health Consumers’ Council multidisciplinary forum.

This was held at KEMH and was a forum for Midwifery and Obstetric professionals, plus consumer advocates, to discuss the current state of maternity services in WA.

It was clear from the forum that many  WA families, and maternity care providers, are confused regarding the choices that are actually on offer in maternity care, while others can not get the care that they want.

 

Most pregnant couples want to be able to choose their care provider and to be able to choose where they give birth.

However many don’t really know what these choices are and there doesn’t seem to be any clear way of finding out.

So I am updating a blog I wrote in 2014, as there have been many changes to maternity services in Perth with various hospitals opening, closing or no longer providing maternity services.

I apologise for not including regional services (except mentioning Broome and Northam have an MGP model of care), but I have kept this Perth based,

I try to keep this blog up to date so please feel free to contact me if you would like to make any comments on particular services.

MIDWIVES

The benefits of continuous care by a known midwife been widely studied around the world and in Australia.

Care from a known midwife, or a small group of midwives, enables women to develop a relationship with their care providers. Women who have the same midwife caring for them during pregnancy, labour, birth and post-birth have the opportunity to build a trusting relationship which increases their confidence.

This type of care is often referred to as midwifery continuity of care, midwifery group practice or caseload midwifery.

 Some of the benefits of care by a known midwife are:

the woman is more likely to have a normal birth, have a more positive experience of labour and birth and be satisfied with her maternity care; the baby is less likely to be preterm or die in their first 24 weeks of life and is more likely to  be successfully breastfed; plus it costs the health system less.

You can read the Cochrane Review that compared  care with a known midwife with other models of care HERE

Or read more about the benefits HERE

Type of Midwifery Led Care in Perth

Midwifery Group Practice (MGP)

The MGP is a now available at the Family Birthing Centre, KEMH, Armadale Hospital, Broome Hospital and now Northam Hospital.

In an MGP  service, you will be allocated a midwife who will stay with you throughout your pregnancy, labour, birth and postnatal period.

Your MGP midwife should be able to stay with you even if you develop complications and in most cases remain your primary caregiver.

For more information contact the hospital and let them know you are interested in the Midwifery Group Practice (MGP) option.

HGPhoto10This service is covered by Medicare

 Community Midwifery Programme (CMP)

Email: CMP.WCHS@health.wa.gov.au

Phone: 9406 7739

Website: http://cmp.thebumpwa.org.au

The CMP is a public service available to Perth women experiencing a low-risk pregnancy.

The CMP provides safe, evidence-based, continuity of care from a known midwife throughout pregnancy, labour, birth and up to four weeks postnatally.

The CMP can support you to have your baby at home, at the Family Birth Centre or in a public hospital.

The midwives do work in teams so in the event your primary midwife cannot be there the on-call midwife will attend.  Your midwife will stay with you for several hours after the birth and then visit you at home for up to 4 weeks for postnatal care.  If complications arise during pregnancy, labour or postpartum transfer to King Edward Memorial Hospital will be arranged.

The Community Midwifery Program also offers “domino” births where all the pre and post care is the same but the birth is planned for the hospital.

This service is fully covered by Medicare.

 

 Privately Practising Midwives

Privately Practicing Midwives offer individualised, flexible midwifery care that is woman centred.

You can choose your midwife and then your midwife will come to your home for antenatal appointments, remain with you during labour and birth and for several hours after the birth.

Your midwife will then visit you at home postnatally as you require for up to 6 weeks.

Most are Medicare Endorsed Midwives and have completed further qualifications and can order tests and procedures, and can prescribe certain medications. Non-eligible Independent Midwives will refer you to your GP or back up hospital for tests and prescriptions.

Privately Practising Midwives in Western Australia charge between $5000 – $8000 for antenatal, labour and birth and postnatal care.  You may be able to claim some of that from Medicare if your midwife is an Endorsed Midwife.

Some Privately Practising Midwives also have visiting rights to some public hospitals in Perth (KEMH and Armadale at present) and can continue to be your primary caregiver if you are transferred.

Here are some links to a couple of my favourite Privately Practising Midwives in Perth:

My Midwives Perth

Hand In Hand Midwives

Simply Midwifery

 

BIRTH CENTRESHGPhoto3

Birth centres also offer midwifery-led care with a known midwife.

 Family Birth Centre (FBC)

King Edward Memorial Hospital for Women (KEMH)
374 Bagot Road

Subiaco 6008

9340 1800

The FBC is located on the grounds of King Edward Memorial Hospital.

It offers a home-like setting for maternity care with the convenience of having the hospital nearby.

The FBC promotes natural, uninterrupted birth in a safe, comfortable environment.

Water births are available.

The antenatal appointments, labour and delivery occur at the centre and if complications arise transfer to the hospital is arranged. Your allocated midwife may be able to stay with you depending on the reason for the transfer.

After your baby is born, you stay for up to 6  hours and then your midwives will visit you at home for approximately 4 days.

The King Edward hospital services are still available to you for the first 6 weeks.

This service is fully covered by Medicare.

 

 PUBLIC HOSPITALS

c section rates perth

Public Maternity Hospital Care offers a couple of options.

Most offer the following:

Option 1:  All care during pregnancy and birth is provided by the hospital.

Option 2:  Care is provided on a shared arrangement between the hospital and your GP. At 36 weeks of pregnancy, care is transferred to the hospital up until the birth of your baby.

Mostly public hospitals follow the medical model of care and are often led by hospital policies.  So interventions are high compared to WHO standards, but not as high as Private Hospital births.

Continuity of Midwifery Care can be an option at some public hospitals for women anticipating a normal pregnancy and birth.

Full hospital care is covered by Medicare.  With shared care, your out of pocket expenses will depend on your GPs fees and your level of private health insurance.

If choosing Public Maternity Hospital Care you will be referred to the Public Hospital by your GP.  Each hospital now has a “catchment area” so unless you have complicated medical issues requiring tertiary level care, i.e. King Edward Memorial Hospital, the decision of which hospital is now dependent on your postcode.

If you choose full hospital care you will attend the Antenatal Clinic at the hospital for your appointments and may be seen by a Midwife, Resident, Registrar or Consultant Obstetrician depending on staffing and medical needs.

When labour begins you will be assisted by the midwife on duty and reviewed by the medical team on duty periodically.  If everything progresses normally the midwife on duty will deliver your baby.  If complications arise your baby may be delivered by one of the medical team.

You will stay in the hospital for approximately 24 hours after a normal delivery and 3-4 days after a c/section.

You will be assisted by the duty midwives and reviewed by the medical team as required.

After discharge, a midwife may visit you at home.

Then you will have a follow up with your GP at 6 weeks.  The services of the hospital are available to you for 6 weeks if required.

 

 Public Maternity Hospitals

Armadale Kelmscott Memorial Hospital

Postcodes:

  • 6108 – 6112
  • 6121 – 6126

3056 Albany Hwy,

Mt Nasura WA 6112

Phone: 9391 2169

Portable birthing pool available for water births.

MGP available.

Women can choose to attend the Antenatal Clinic on-site at Armadale Health Service (AHS).  This is a ‘shared care’ service, provided by the Canning Division GPs, and the midwives at the hospital.

Women can self-refer early in their pregnancy, or be referred by their own GP.  Alternatively, women can choose to be referred to one of a number of ‘GP Obstetricians’ in the area who attend AHS.  Ph 9391 2169 for a list of GPs.

AHS also offers ‘Boodjari Yorgas Antenatal Clinic’ for local Aboriginal women who are pregnant.

Unfortunately, due to security issues, we have no facility for partners to stay overnight – except in exceptional circumstances.

The Visiting Midwife Service is available for women who are well enough and confident enough to go home as soon as 6 hours post birth. This service is available to women living within a 30 minute travelling time of the hospital.  An experienced midwife will come to your home to check you and your baby if you go home earlier than the usual time frame.

 

Bentley Hospital 

Postcodes:

  • 6057
  • 6058
  • 6100 – 6110
  • 6147
  • 1648
  • 6151
  • 6152
  • 6155.

18-56 Mills St,

Bentley WA 6102

Phone: 9334 3666

Bentley Hospital does not have a bath. It does have showers but they are up the hall and for use by any of the women on labour ward.

Antenatal care is provided by midwives up until 38 weeks and then they must see an obstetrician. Obstetricians also see woman at 28 and 34 week appointments.

Hospital midwives are the primary caregivers during birth and the postnatal period.

 

Fiona Stanley Hospital

Postcodes:

  • 6147 – 6150
  • 6153 – 6160
  • 6162 – 6164
  • 6166.

102 – 118 Murdoch Drive, Murdoch, Western Australia, 6150

Phone: 6152 2222

FSH has a range of services and support for women with low risk through to complex pregnancies.

Women can be referred by their General Practitioner (GP) for outpatient care at the hospital’s antenatal clinics or Maternal Fetal Assessment Unit (MFAU), as well as inpatient care at the new maternity wards or birthing suites.

FSH say they deliver a “woman-centred model of care that is delivered by a team of experienced midwives, doctors, nurses and allied health professionals with the support of neonatologists and all related specialities”.

They also say the offer water births, but in the experience of my clients, this is not always a reality due to birthing numbers, staffing and OH&S issues.

They are in the process of setting up MGP (see above).

 

 Joondalup Health Campus(Public)

Postcodes:

  • 6019
  • 6020
  • 6023 – 6038
  • 6061
  • 6064 – 6067
  • 6069.

Cnr Grand Blvd & Shenton Ave
Joondalup WA 6027

Phone: 9400 9400

Joondalup Public maternity services offer a midwife-led clinic to low-risk women. All others are seen by an obstetrician for antenatal appointments.

Births are predominantly midwifery-led but overseen by obstetricians.

Each labour suite has its own bath. Water births are “not permitted” despite the fact they are meant to be available at all public hospitals. The Public-Private Partnership complicate arrangements but public patients attending the public side of JHC should be offered water births!

 

King Edward Memorial Hospital (KEMH)

Postcodes:

You must live in the area for low-risk births,  with the exception of the Family Birth Centre which accepts women from anywhere within the metropolitan area (places are limited).

Any women experiencing a complex or ‘high-risk’ pregnancy may be referred to KEMH for care.

  • 6000
  • 6001
  • 6003-6013
  • 6014 (Jolimont/Floreat/Wembley)
  • 6015
  • 6016
  • 6050
  • 6051
  • 6052 (Bedford)
  • 6053
  • 6062

374 Bagot Rd,

Subiaco WA 6008

9340 2222

KEMH has a variety of pregnancy care options available including Family Birth Centre care, shared care, routine midwifery care, Midwifery Group Practice or medical care.

A number of baths are available in labour ward and water births are available (however, once again this is not always a reality in the main hospital).

KEMH is a tertiary referral centre for complex pregnancies and high-risk birth. It wide-ranging support services to WA women with complicated pregnancies and infants born prematurely. There are also a number of specialised antenatal clinics at KEMH, specifically designed to cater to groups such as adolescents, mums with mental health issues and NBAC (Next Birth After Caesarean). The NBAC clinic has the highest success rate in WA hospitals and I recently had a client have a VBA2C there, here is her story: Kandi & Aaron

 

Midland Public Hospital

Postcodes: This hospital opened 24/11/2015 and replaces the Swan District Hospital Maternity service. I can’t find exact postcodes, but they will be the same as Swan.

St John Of God Midland Public Hospital

1 Clayton Rd

Midland 6056

Phone: Maternity reception (08) 9462 4860

This is a brand new service so we are yet to see how it pans out.

It is a Public Private Partnership, like Joondalup, but is run by St John Of Gods, not Ramsay.

It is a public service and should offer the same as government-run hospitals, but we will have to wait and see.

They don’t offer water births so that is not a good start.

 

Osborne Park Hospital 

Postcodes:

  • 6014 – 6015
  • 6017 – 6022
  • 6052 (Inglewood)
  • 6059 – 6061
  • 6063
  • 6066.

Osborne Pl,

Stirling WA 6021

Phone: 9346 8000

Osborne hospital has one bath in their labour suite.  Water births should be available but this is not the reality.

All women are seen by midwives in antenatal clinics and births are midwifery-led unless complications arrive.

Also, Osborne Park Hospital is the first hospital in Australia to open a Snoezelen Room.  It is designed to promote deep relaxation and well being, particularly for hypertensive and breastfeeding women, through the use of special lighting, sound, images and aromatic oils.

 

Rockingham General Hospital

postcodes:

  • 6165
  • 6167 – 6176.

Elanora Dr,

Rockingham WA 6168

Phone: 9599 4000

Rockingham General Hospital provides care for low and medium risk women.

They don’t advertise waterbirths and don’t have a birth pool, but once again this is something all public hospitals are meant to offer.

They also don’t offer MGP yet.

 

PRIVATE HOSPITALS

If you are choosing Private Hospital Maternity Care, you are choosing Private Obstetric care as you must have a Private Obstetrician to attend. It is important to be aware that women birthing at Private Hospitals are more likely than not to have an intervention and that Perth is now considered the Caesarean Capital of Australia. (See attached table for hospitals individual c-section rates)

Obstetricians are specialists in managing complications in pregnancy and birth, although you can also choose this style of care when you anticipate a normal pregnancy and birth.  Obstetricians use a medical model of care which tends to be more interventionist, however having an obstetrician does give you some continuity of care.

Your obstetrician will see you in his/her private rooms during pregnancy and can refer you for any tests and procedures you may require.  You will often also see their Clinic Midwife at your appointments.

Once in labour, your obstetrician will be kept informed of your progress by the hospital midwives and he/she will plan to actually deliver your baby.  He/she will check on you in the hospital in the immediate postnatal period and you will see him/her in his/her rooms for a postnatal appointment at about 6 weeks post birth.

Your stay in hospital will be around 3 days for a normal delivery and 5 days for a caesarean delivery, although some private hospitals are reducing stay times to 3 and 5 days.  Some private hospitals or health funds have home visiting midwives who will also visit you at home for a couple of days after you are discharged.

Your out of pocket expenses will depend on your level of private healthcare and the fees charged by your Obstetrician.

GP’s with obstetric training can also care for you in some private hospitals in Perth. They are usually less likely to promote c-section births as they are not trained to perform them.

Waterbirths are not available in any Private hospital. Some have a bath to labour in but this will be shared between all the birthing rooms. All have private showers.

c section rates perth

 

Private Maternity Hospitals

Glengarry Private Hospital

53 Arnisdale Rd

Duncraig 6023

9447 0111

No bath at present but renovations will include one bath.

 

Joondalup  Private Hospita

Joondalup Health Campus

Shenton Ave

Joondalup 6027

9400 9999

Joondalup private has a brand new maternity wing and every birthing suite has its own en-suite with a bath for labouring in.

 

St John Of God Mt Lawley (formerly Mercy)

Thirlmere Rd

Mt Lawley 6050

9370 9222

One shared bath

 

Peel Health Campus

110 Lakes Rd

Mandurah 6210

9531 8000

No bath

 

St John Of God Murdoch

100 Murdoch Drv

Murdoch 6150

9366 1111

One shared bath

 

St John Of God Subiaco

175 Cambridge St

Subiaco 6008

9382 6111

One bath in the family birthing suite, available only for women in this room. You can request this room once your labour begins.

 

 BIRTH SUPPORT

  DOULAS

A doula, or birth attendant, is a woman offering non-medical support and information to parents in pregnancy, childbirth and the postnatal period.

‘Doula’ is a Greek word that has come to mean “woman’s servant”.

A registered doula has completed training with a recognised institute and has knowledge and skills in comfort measures such as relaxation breathing, massage and positioning, managing labour sensations using water, hot packs and aromas.

Doulas specialise in non-medical skills and do not perform clinical tasks, such as vaginal exams or foetal heart rate monitoring. Doulas do not diagnose medical conditions, offer second opinions, or give medical advice.

Studies (and reviews of the studies) consistently demonstrate benefits for the mother, father and baby, including: fewer caesarean sections, reduction in instrumental delivery, fewer requests for epidurals,reduction in the use of synthetic oxytocin for inductions or augmentations, reduction in use of pain medication,reduction in labour length, increased rates of breastfeeding at 6 weeks and higher self-esteem ,less anxiety and less depression at 6 weeks after birth.

 

MIDWIFERY STUDENTS

As part of their studies, Midwifery Students are required to participate in the Continuity of Care program which involves following a woman’s pregnancy, labour, birth, and early parenting period. Pregnant women need to be less than 35 weeks pregnant at the start of these programmes. The student will always be under the supervision of a qualified healthcare professional.

The students gain a lot from this experience, and in return, participants have a familiar face at their side right through pregnancy, labour (if they wish) and beyond.

Universities with Midwifery Student Programmes

Edith Cowan University (ECU)

Mothers Adopting Midwifery Students (MAMS) Program

http://www.ecu.edu.au/schools/nursing-and-midwifery/community-activity/mothers-adopting-midwifery-students-mams-program

 

Curtin University

Continuity of Care Experience

Contact:  School of Nursing and Midwifery

Email: midwifery.cce@curtin.edu.au

 

Notre Dame University

Contact:  School of Nursing and Midwifery

 

 Comparing Caesarean Section Rates in Perth Hospitals and Around the World

cs rates 2013

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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