Public vs Private Hospital Birth: How to Choose the Right Path for Your Pregnancy Journey.

An Elgin House guide for women+ and birthing people navigating one of the first major decisions of parenthood.

Planning a pregnancy or preparing to welcome a baby brings a cascade of decisions — and one of the earliest is where, and how, you want to give birth.

In Australia, almost all births take place in hospitals, and the vast majority occur within the public system. Both public and private pathways offer safe, high-quality care — but the experiences, costs, choices, and models of support can differ significantly.

At Elgin House, we believe every birthing person deserves compassionate, evidence-based information to help them make a choice that aligns with their values, needs, health circumstances, and access to services. Below is a clear, balanced guide to help you understand the landscape.

 Australia’s Maternity Landscape at a Glance:

• 97% of births in Australia occur in hospitals

• Around 75% of these are in public hospitals

• Access varies widely between metropolitan, regional, and remote areas

• Models of care differ in continuity, cost, practitioner involvement, and availability

Importantly, Australia remains one of the safest places in the world to give birth — but the pathway to that birth can look very different depending on what you choose.

Understanding Your Options

Private Hospital Births

Private maternity care typically appeals to women+ who want:

• Continuity with a chosen obstetrician

• A sense of personalised support throughout pregnancy

• Longer hospital stays after birth

• More control over who provides clinical care

However, private care requires:

• A private health insurance policy that includes maternity cover (usually with a 12-month waiting period)

• Potential out-of-pocket costs for obstetric appointments, gap fees, imaging, tests, and hospital excesses

Many birthing people value the consistency of seeing the same doctor throughout pregnancy — someone they trust, who knows their history, and who is likely to be present at the birth.

 Public Hospital Births

Public hospitals offer safe, high-quality maternity services with no cost for hospital care under Medicare. Models of care within the public system can include:

Midwifery continuity of care

One of the most evidence-based and beneficial models.
Women+ see the same midwife (or small team of midwives) across pregnancy, birth, and the postnatal period.

This model is associated with:

• Lower intervention rates

• Higher satisfaction

• Increased sense of safety and emotional support

• Better outcomes for many birthing people and babies

Standard public care

Appointments may be with different midwives, doctors, or registrars (junior doctors training under supervision). This model is safe but less consistent and can feel fragmented.

Shared care

A combination of GP appointments and hospital visits.

Home birth (publicly funded or private midwife models)

Available in select regions and recommended for low-risk pregnancies with strict safety frameworks.

For many in regional or remote areas, public care is the only available option due to the closure of some private maternity services and limited specialist availability. Some families must travel long distances for any birthing care at all.

What About Outcomes? What the Research Says?

A major Australian study comparing public and private maternity outcomes found differences including:

• Lower rates of stillbirth and neonatal death in private obstetric-led care

• Higher rates of severe tears and postpartum haemorrhage in public care

• Lower caesarean section rates in public hospitals

BUT — and this is crucial — these findings must be interpreted within context.

Public hospitals care for more complex populations, including higher rates of:

• medical complications

• social disadvantage

• mental health concerns

• late antenatal care

• limited access to continuity models

These factors significantly influence outcomes and cannot be fully adjusted for in large datasets.

Costs, Stays & Support

Cost

• Public: Free hospital care through Medicare

• Private: Potential gap fees and out-of-pockets, even with insurance

Length of Stay

• Public: Often 1–3 days due to bed pressure and early discharge programs

• Private: Commonly 4–5 days, with more time to rest and recover

Postnatal Care

Regardless of where you give birth, postnatal support is essential. Early parenthood requires wraparound care — in the home, in community, and with responsive follow-up from midwives, GPs, lactation consultants, and perinatal specialists.

So… Public or Private? How to Choose

There is no right or wrong choice — only the right choice for you.

Ask yourself:

·         Do I want continuity with a specific clinician?

·          Is private insurance financially accessible?

·         Am I comfortable with a midwife-led model?

·         What is available in my area?

·          Do I have medical or pregnancy complexities that require specialist involvement?

·         Where will I feel safest, most supported, and most informed?

The best birth outcomes come from care where you feel:

• heard

• respected

• safe

• informed

• empowered

Whatever path you choose, you deserve a model of care that honours your body, your preferences, and your wellbeing.