Models of Care

Written By Jade Wyllie

Just as a Woman’s heart knows how to pump,

her lungs to fill with air,

and her hand to pull back from fire,

so her body knows how to birth.

⎆ Virginia Di Orio

Choosing your health care provider and place of birth is a very important decision.

This can potentially impact your birthing experience.

Therefore, when choosing a model of care it is so important that it aligns with the values and vision you have for your birth.

Below you will find the available options in Perth, WA. This is based off my own research, please also do your own exploration after reading.

Midwifery Care

Midwives are highly trained professionals in natural, physiological birth.

They provide care to Women in all phases of pregnancy, antenatal, labour, birth and postpartum. Most antenatal and postpartum appointments and check up’s are with a midwife, and they are usually the one’s that help to deliver baby.

There are many options of midwifery care, these include:

  • Midwifery Group Practice (MGP)

  • Community Midwifery Program (CMP)

  • Private Midwives

Let’s discuss each of these.

Midwifery Group Practice (MGP)

The MGP model is based on a case load. This means that each midwife cares for an allocated amount of Women. The midwives usually work in a small group, so that if your primary midwife can not attend your birth for whatever reason, another midwife from their team will, and you would have usually met this person before.

The midwives working in MGP are usually apart of the Family Birthing Centre of the hospital. The Family Birth Centre is set up like a ‘home environment’, with minimal medical equipment and most of the rooms have a birthing pool for those wanting a water birth.

Benefits:

  • Continuity of care

  • More likely to have a vaginal birth

  • Shorter stay in hospital

  • Reduced interventions

  • Better breastfeeding outcomes

  • Home like environment

Community Midwifery Program (CMP)

CMP is a model of care provided to Women who are classified as a low risk for pregnancy and birth. CMP supports women who are wishing to birth either at home, the family birth centre or in a hospital. The philosophy of CMP is to protect, and support natural, physiological birth. Most of the care in CMP is in the comfort of your home, with occasional visits to the clinic or classes run in the community. These midwives are highly trained in home birth and water birth, and work in collaboration with the hospital if a transfer is required.

Benefits

  • Continuity of care

  • Safer outcomes for Mother and baby

  • Comprehensive care

  • More likely to have a vaginal birth

  • Reduced interventions

Private Practising Midwives

Private practising midwives offer care to Women outside of the hospital system. Most are endorsed midwives, meaning that they are able to arrange and order tests, carry out procedures and prescribe medications if required.

Private practising midwives provide antenatal, labour and birth support, and postpartum care in the comfort of your own home, or their clinic space.

Some private midwives have admitting rights to public hospitals. Meaning that if you were required to be transferred to a hospital, your private midwife can still provide care to you in that environment.

Medicare covers some of the cost of hiring a private midwife, however, there is usually an out of pocket expense.

Benefits

  • 1:1 individualised care

  • Reduced intervention

  • Care in your own environment

  • Ideal for those wanting a home birth

  • Continuity of care

  • More likely to have a natural physiological birth

  • Independent information and advice

  • Advocacy

Other models of care

Private Hospitals

In order to receive care in the private hospital system you need to be under the care of private obstetrician. Obstetricians are specialists in managing complications that occur in pregnancy, labour and birth, however you do not have to have medical concerns to be seen by an obstetrician. They are medically trained and follow the medical model of birth. This means that there is an increase in potential intervention to occur, such as induction and caesarean section. Although you may have private health insurance, there can be out of pocket expenses depending on your level of cover, the tests your obstetrician orders and whether they charge above the gap. Once in labour and admitted, the midwives at the hospital will care for you through your labour and birth, your obstetrician will be kept updated and contacted if there is an emergency.

Benefits

  • Private room

  • Ability to stay for a few days postpartum usually

  • Extra time with support available from the midwives

  • Specialised training for high risk pregnancies

Public Hospital

In order to receive public hospital care, your GP will refer you to the hospital in your catchment area. However, if you have any pregnancy concerns needing specialist attention you may be referred to a particular hospital that can care for these needs.

Your antenatal appointments will be held at the hospital clinic, and you will be seen by either a midwife, doctor or obstetrician depending on your medical needs. During your labour and birth you will be cared for by the midwife on duty and seen by the doctor or obstetrician as required. Most postpartum care is through your GP, however hospital services are available if needed.

Public hospital care is covered by Medicare.

GP Shared Care

Shared care is between your chosen GP and the hospital. Your GP will see you for antenatal appointments, and then from 36 weeks till birth, the hospital will take over your care. This option can be preferred if you have a positive and long-term relationship with your family GP.

Benefits

  • Appointments closer to home

  • Longterm GP, knowing your health history already

  • Ability to meet other parents through antenatal classes/mother’s groups

I hope this information brings some clarity and education around the various models of care available to Women and their babies.

Please be kind to yourself, as it can be overwhelming deciding which option aligns with you and your family. I recommend researching further if you feel called to and writing out a pros and cons list on each care option.

Much love, Jade xx

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