An Evidence-Based Guide to Choosing What's Right for You

Choosing a model of care is one of the first big decisions you’ll make in pregnancy - and for many women, it can feel confusing and overwhelming.

You may hear strong opinions from friends, family, social media, or even care providers. You might come across information that feels biased, fear-based, or leaves you wondering if you’re “making the right choice”.

Here’s the most important thing to know upfront:

There is no single “best” model of care - only the model that best aligns with your values, needs, preferences, and circumstances.

This guide is here to inform, not persuade. You deserve access to clear, evidence-based information, the freedom to explore your options, and the support to choose care that feels right for you.

What even is a Model of Care?

Model of care refers to the different ways pregnancy, birth, and postnatal care are organised and delivered. They describe:

• Who provides your care (midwives, obstetricians, GPs or a combination)

• How your care is structured

• Whether you experience continuity of care (seeing the same provider or team)

• Where you give birth

In Australia, there are several different models available through both the public and private health systems. Each comes with benefits and limitations, and availability can vary depending on where you live.

Importantly, the way care is structured - not just where you give birth - can influence both outcomes and how supported you feel during your pregnancy and birth experiences.

What does the Evidence say?

You may hear that midwifery continuity of care is the “gold standard” - and from a research and evidence perspective, this is true. Research consistently shows that continuity of care with a known midwife is associated with:

• Higher rates of vaginal birth

• Lower rates of intervention

• Lower rates of preterm birth and NICU admission

• Higher breastfeeding rates

• Higher satisfaction with care

However, evidence does not exist to remove choice.

Your values, health, preferences, previous experiences, financial considerations, and what feels safe for you all matter. A model of care that feels empowering for one woman may not feel right for another - and that’s okay.

The goal isn’t to choose the “most recommended” option.
The goal is to choose the option that best supports you to feel informed, safe, respected, and confident through pregnancy, birth and beyond.

How Do I Decide What's Best for Me?

Choosing a model of care is a personal decision, and it’s okay for your thoughts to change as pregnancy progresses. Taking time to reflect on what matters most to you can make this decision feel clearer and less overwhelming.

Some helpful questions to ask yourself include:

The System

• Do I prefer public or private care?

• What costs am I comfortable with, if any?

Continuity of Care

• Do I value seeing the same care provider throughout pregnancy, birth, and postpartum?

• Or am I comfortable seeing multiple providers?

Philosophy of Care

• Do I prefer a midwifery-led approach, an obstetric-led approach, or a combination?

• How important is shared decision-making and informed consent to me?

• Think about the type of birth you are working towards - vaginal birth vs caesarean, as natural as possible vs wanting medical pain relief options. (Your care provider has a massive impact on your birth experience)

• Consider the medicalisation of birth (research has shown that hospital based obstetric led models are often associated with increased intervention when compared to midwifery based or home birth models)

Health & Risk Factors

• Is my pregnancy currently considered low risk?

• Are there medical considerations that may influence my options?

Birth Environment

• Where do I feel safest giving birth - hospital birth suite, birth centre, or home?

• How important is the physical environment to me?

Availability

• What models are actually available in my local area?

• Would I be disappointed if I missed out on a particular option?

Some models - such as Midwifery Group Practice (MGP), birth centres, and publicly funded homebirth - have limited places and fill quickly. If you’re interested in these options, it’s worth exploring them early in pregnancy.

👉 If you’re feeling unsure about what matters most to you, my free guides are designed to help you clarify your values and priorities so you can make confident, informed choices - without overwhelm.

Let's Deep Dive into your Options for Model of Maternity Care within Australia

Below is an overview of the most common models of care available in Australia. Availability, eligibility criteria, and how each model operates can vary by location, so it’s important to check what’s offered in your local area.

Public options -

Midwifery Group Practice (MGP) / Caseload Midwifery

What it is

Midwifery Group Practice (MGP) offers continuity of care, meaning you are cared for by a known midwife (or a small team of midwives) throughout pregnancy, birth and the postnatal period. Your midwife is on call for your birth and often provides postnatal care at home for up to six weeks.

Cost

Free under Medicare.

Who provides care

• One primary midwife (working within a hospital or birth centre)

• A backup midwife if your primary midwife is unavailable

Pros

• Builds a strong, trusting relationship with a known midwife

• Strong evidence base supporting this as the gold standard of maternity care with improved outcomes and maternal satisfaction

• Lower rates of intervention compared to obstetric-led models

• Your midwife can strongly advocate for your preferences within the hospital system as they know you well

Cons

• Limited availability and high demand (meaning many women miss you)

• Often restricted to low-risk pregnancies or women who meet specific criteria. 

• You usually need to apply early in pregnancy

 

Publicly Funded Homebirth

What it is

This model supports women with low-risk pregnancies to give birth at home with publicly employed midwives, while remaining connected to a hospital service.

Cost

Free under Medicare.

Who provides care

• A small team of hospital-employed midwives

• Postnatal care provided at home

Pros

• Continuity of care with known midwives

• Strong support for physiological birth

• Low rates of intervention

Cons

• Very limited availability (not every hospital has this model of care)

• Only suitable for low-risk pregnancies

• Some pain relief options and interventions are not available at home (e.g. epidural)

Note: If complications arise during labour or birth, you will be transferred to hospital for birth. 

 

Birth Centre

What it is

A birth centre is a midwife-led unit either stand-alone or within a hospital, designed for women with low-risk pregnancies. Birth centres offer a more home-like environment while maintaining access to hospital support if needed.

Cost

Free under Medicare.

Who provides care

• A team of midwives

• Some birth centres offer continuity models such as MGP where you have a known care provider

Pros

• Calm, home-like environment

• Encourages physiological birth (promotes natural birth with minimal intervention)

• Access to hospital support and services if needed

Cons

• Limited availability and some birth centres have strict eligibility criteria

• Transfer to the main birth suite required if complications arise

 

Public Hospital Midwifery Clinic

What it is

A common public model where antenatal care is provided by hospital midwives in an antenatal clinic setting. You will usually see different midwives at each appointment.

Cost

Free under Medicare.

Who provides care

• Rotating midwives (likely a different midwife at each of your appointments)

• Obstetric involvement if pregnancy complications arise

Pros

• Free care with access to public hospital facilities

• Suitable for most pregnancies

• Midwifery led-care - Midwives are highly trained and experienced in pregnancy and birth

Cons

• No continuity of care

• Busy clinics which can mean longer wait times

• You may not know the midwife caring for you during labour and birth

 

Public Hospital Obstetric Clinic

What it is

Care is provided by hospital obstetricians and midwives, often for pregnancies that are higher risk or require specialist input. This could include: medical conditions, pregnancy complications or multiple pregnancies. 

Cost

Free under Medicare.

Who provides care

• Obstetricians, midwives, and other specialists as required

• Likely a different provider at each appointment 

Pros

• Appropriate for high-risk pregnancies

• Immediate access to medical interventions and specialists

Cons

• No continuity of care

• Wait times can be long

• Higher average rates of intervention

• Women have reported this model was often more medically focused, with less time for education when compared to midwifery models

 

Shared Care (GP + Hospital)

What it is

A model where antenatal care is shared between your GP and the hospital. Your GP provides most routine appointments, while the hospital manages birth and any complications.

Cost

• GP fees vary (bulk billing may apply)

• Hospital care is free under Medicare

Who provides care

• Your GP for most antenatal visits

• Hospital midwives and obstetricians for a few key appointments (usually an initial booking in, 36 week and 40 week appointment)

• Hospital midwives and obstetricians for birth and any pregnancy complications

Pros

• Convenient if you have a trusted GP (especially if they are trained in pregnancy!)

• Suitable for low-risk pregnancies

• Familiarity with a known provider (as you will likely have the same GP for every appointment)

Cons

• GPs may not specialise in maternity care

• Less in-depth antenatal education (usually due to short appointment time and lack of training in pregnancy and birth)

• No continuity of care with a midwife and limited involvement from midwives and the hospital until birth

 

Private options -

Private Obstetrician

What it is

Women receive care from a private obstetrician throughout pregnancy and give birth in a private hospital (or privately in a public hospital).

Cost

Out-of-pocket costs typically range from $3,000–$10,000+, with private health insurance (higher without). This varies depending on the obstetrician and your level of health insurance coverage. Even with insurance, some costs such as ultrasounds and certain blood tests may not be covered. 

If you are considering this model of care, discuss with your private health insurance provider what the GAP fee is and what is included in your policy. Some healthcare funds also have waiting periods after signing up before you can claim pregnancy cover. Then talk to your obstetrician about their specific costs to help you calculate the overall cost. 

Who provides care

• A private obstetrician for antenatal care

• Hospital midwives during labour

• Obstetrician present for birth or complications (may be your primary obstetrician or another in their team that is on call)

Pros

• Continuity of care with an obstetrician

• More choice over your provider

• Private hospital amenities and often longer hospital stays

Cons

• Cost involved

• On average, higher rates of intervention when compared to public or midwifery-led programs

• May not align with low-intervention birth preferences (have an honest discussion with your obstetrician about their philosophy for birth if your preference is a low-intervention birth. You need to find a provider that aligns with your preferences)

 

Private Midwife (Home or Hospital Birth)

What it is

Continuity of care with a private midwife throughout pregnancy, birth, and the postnatal period. Most commonly used for home birth, though some midwives have hospital admitting rights.

Cost

Approximately $2,000–$7,000+, with some Medicare rebates. This varies between midwives - it’s best to contact them directly about their specific costs.

Who provides care

• One primary midwife for all care

• A second midwife present at birth

Pros

• Full continuity of care

• Highly personalised, holistic support for a physiological birth

• Lower intervention rates and high maternal satisfaction

Cons

• Cost involved

• Typically limited to low-risk pregnancies

• Some private midwives do not have hospital admitting rights meaning homebirth is the only option.

• Hospital transfer required if complications arise during labour and birth

 

Combined Care: Private Obstetrician + Private Midwife

What it is

A collaborative model where care is shared between private midwives and a private obstetrician, offering a combination of both midwifery and medical support.

Cost

Typically $5,000–$12,000+ out-of-pocket. Varies widely - consult your clinic for more information on pricing.

Who provides care

• A team of midwives and obstetricians

• In many cases, a known midwife provides labour care and a known obstetrician is present for birth

Pros

• Best of both worlds - combines midwifery continuity with obstetric support

• Access to private hospital facilities and often a longer hospital stay

Cons

• Cost involved

• Limited availability - only some obstetric clinics provide this model

• Higher intervention rates when compared to midwifery-led care

Note: Each combined care model functions differently. It is important to speak to your clinic to understand the specific care they provide. 

Why Models of Care Matter

The model of care you choose can influence:

• How informed and supported you feel

• Your confidence going into birth

• Your partner’s involvement

• Your postpartum experience

Understanding your options helps you move away from fear-based decision-making and towards informed, empowered choice.

Final Thoughts

You deserve maternity care that feels respectful, supportive, and aligned with your values. Evidence matters - but so do you.

Whatever model you choose, you are allowed to:

• Ask questions

• Change your mind

• Seek second opinions

• Choose care that feels right for your family

👉 If you’d like extra support navigating your options, my free guides are designed to give you clarity, confidence, and evidence-based education - without judgement or overwhelm.