Choosing your Birth Place

Choosing where you will have your baby is an important decision which can have an enourmous influence on how your birth unfolds. If you would like a natural birth for example, it is important that you choose an environment and care providers who can support that.

Once you have a basic understanding of what conditions are required for birth to unfold best you can see how important choosing the right environment for you can be. In Australia, depending on where you live, you have the choice between private and public hospitals, birth centres and homebirth. If you want a natural birth you will want to choose a birth place that has low intervention rates and if you are wanting a VBAC (Vaginal Birth After Cesarean) then it’s important to look at the VBAC success rates of the places and care providers you are choosing between.

Luckily in NSW, hospital statistics are made publicly available so that you can look at and compare intervention rates . Homebirth statistics  are also available.

Locally I compared Manly Hospital with Royal North Shore Private, the Mater and 3 homebirth midwives. I just had a quick look at the VBAC (Vaginal birth after caesarean) success rates (Manly 17.5%, Private 4-6%, Homebirth 80-90%)  episiotomy rates (Manly 10%, Private 26.5%, Homebirth 0-3%),and caesarean rates (Manly 24%, Private 45%, Homebirth 5-8%) which are quite telling.

Choosing your care provider carefully is probably even more important than birth place. One-to-one care with a midwife has been shown to result in the best outcomes for women and babies. This is where you know your midwife and she looks after all your care antenatally, attends your birth and visits you postnatally until 6-8 weeks after the birth.

There are some public hospital based programs that offer this service in Sydney: the RHW in Randwick, RNSH in St Leonards and soon (fingers crossed!) there should be one opening through Mona Vale Hospital (set to open November 2010). With these public programs there is no guarantee that your midwife would be available for the birth however, so if you want true continuity of care then the “Gold Standard” would be to hire a midwife in private practice (MIPP).  Most MIPPs offer homebirth and many will look after your antenatal and postnatal care in your home and support you in the hospital if you choose to birth there. 

I could move onto discussing Doulas, but we’ll save that for a new post!

Happy Hunting,

H