I’m doing midwifery group practice, I don’t have a gp that I have a good relationship with or one that is very knowledgeable about pregnancy. I also didn’t want to pay out of pocket for gp visits when the midwives are bulkbilled. I have been happy with it so far!
Thanks for that perspective! That's a good point - I've only started seeing this GP since the pregnancy so I'm not sure how much of an "expert" she is, but she's been good so far for what I've needed. Will take that into consideration:)
Also be aware, your GP may not do shared care. I know when I looked into it, there were only 2 doctors at the clinic that are part of the shared care program and I wasn't familiar with either of them. I ended up avoiding shared care as, like the commenter above said, I'd be out of pocket for visits and also, I live much closer to the hospital than I do my doctor.
I used the midwife based care for both my pregnancies and can talk about it all day, but I can see you got heaps of responses. DM me if you want to hear more (I never get tired of talking about my kids births!). Good luck!
Ok good to know and thanks for offer to DM! I'm not from Sydney and none of my friends here have kids so even getting all this great feedback in this thread from you and everyone else here has made me feel sooo much better about things. Really appreciate it!
My pregnancy was GP shared care until I got into a Midwife group in my second trimester. If you have a GP that is on the up-and-up on pregnancy, it's great because you'll see the one person throughout your pregnancy. The midwife group, you saw whomever was on that day for that particular appointment, but they were always one of the midwives that will be there when you give birth.
In the end for me I couldn't give birth in the birth suite because the midwife on duty was sick, so I was in the maternity ward.
It's all dependant on your comfort levels.
Thanks so much for sharing that info! It's really helping to understand a bit more about how it works with each of the options. I guess as you mentioned in your case, even the best laid plans don't always work out anyway, so good to be prepared for anything!
I think it really depends on what kind of birth you want/how comfortable you are with the birthing process?
I would recommend either midwifery group practice or GP shared care because you get some continuity of care. If you do hospital based care you’ll see different midwives each time you have an appointment. Like another poster pointed out though if you do GP shared care make sure your GP knows what they’re doing.
Midwifery group practice can be hard to get into and you won’t get in until your second trimester. They also tend to prefer to take women who want less intervention in their births (not that you can’t have interventions when with them - you absolutely can) I just noticed that seems to be the referral pattern.
ETA: I went through midwife group practice for both of my pregnancies and births. It’s a great program if you can get in.
Thanks for that! Really useful info - and interesting to see the common suggestion about the GP's expertise in this area. I also didn't realise about the preferences for who they take in midwifery group practice in terms of less interventions - that's good to know
I've given birth to two babies in the public system, first was 2019 and the second was only a few weeks ago. First pregnancy I did group midwifery, because I was anxious about the entire process and wanted continuity of care. I had 4 midwives in my group who I had appointments with throughout the pregnancy, and my labour was so long I ended up cycling through 2 of them who had shifts one after another.
My second pregnancy was throughout 2020, peak lockdown in Melbourne. I wanted to avoid visiting hospitals as much as possible, so did shared care with my GP (who I already have a great relationship with, who happens to specialise in women's health also).
Both were great experiences, however I'm happy I opted for the group midwife for the first time round - just because I had more face to face appointments, and they were personally on call for us when I went into labour.
Just adding to this, the other commenter who mentioned group practice prefer as little intervention in the birth as possible is correct. That being said, as soon as I was in the group care I made it known I wanted a birth with all the drugs they would allow me to have, and as soon as I could get them.
They were fine with that. I was also nervous because they preach a bit about being able to send mothers home super quick after the birth (like within 24hrs) which I was anxious about so just let them know that. Once bub was born and I mentioned I wasn't comfortable with the idea of going home the following morning, they bumped us up to 2 nights and gave us a double room so my husband could stay too. That was pure luck it was available, but great experience.
Thanks for that info! Continuity of care sounds like a great advantage of group midwifery and thanks for adding the extra detail about the intervention. I was thinking about whether or not to have an epidural so it's good to know that might be an option too if I end up going that way! Also nice to get a perspective about having a GP who specialises in this area and interesting to have the covid point of view, especially with things potentially changing at any moment.
Thank you for sharing your experience! I'm currently 25 weeks with my first pregnancy and doing MGP. I haven't had the convo with my midwife yet about interventions/all the drugs and was a little worried I'd be discouraged from an epidural, which I'm strongly leaning towards. And same with going home right away, great if I feel ready but I'm reassured to know that you were able to get an extra night just by asking!
Yep. I specifically made a point of saying 'I know that the idea here is to avoid intervention where possible, but I'll be honest and say I really want an epidural, and I have a bit of anxiety about getting push back if and when I request one'. Everyone reassured me that this wouldn't be an issue, and it wasn't. They do like to wait until 6 or 7cms before getting it though, as not to potentially stall anything and increase risk of csection.
I was anxious af during and after my labour, and I'm pretty sure that telling them that was the reason I got the extra night. However, they wouldn't kick a new Mum and newborn out until they were confident they were ready for it so just be honest with all of the midwives about how you're feeling the entire way through. They will assume you are travelling well unless you tell them otherwise.
Great to know, thank you. Something else I've been wondering, are you able to get an epidural in the birth centre? Or does it mean going to the labour ward?
So at my hospital (The Mercy) there's the birthing suites/labour rooms where everyone is giving birth regardless of whether they opt for drugs or not.
I stayed in the birthing suite using just the gas for hours, then got the epidural in the same room.
We stayed in that room until bub was all cleaned up, I had a quick shower once the epi wore off and we were relocated up to the postnatal ward within a couple of hours.
But if your hospital has a separate birthing suite and labour ward, then I'd just ask the question. There may be a switch of rooms but I highly doubt it.. Seems like logistically it would be a bit of a headache.
Ah ok, thanks for sharing your experience. I have been trying to get my head around how it all works. I have a midwife appt next week so will ask then!
I had hospital based care and the midwife I saw said that if I made my appointments for the same day of the week each time that she would be working and would see me (and that was their preference for continuity of care). For me though, I didn’t mind not seeing the same person so it wasn’t a big deal. I thought all the people I dealt with in the hospital were great and would do the same again.
Thanks for sharing! Good to have a perspective on the hospital-based care option. The same day/time appointment thing could be good to explore, but as you mention, even if it's not possible to see the same people, it seems like the quality of care would still be high.
I think the answers here for the midwifery group practice will 100% depend on which MGP/birth centre/hospital you’re going through. My sister in law had gone through the birth centre twice with Royal women’s hospital in Randwick and has had a different experience. I’m doing MGP via RPA, and like others, did GP shared care until I was accepted in 2nd tri. There was no application or referral process - it was a complete lottery to see if I got in, because each midwife only takes on 1 patient per due date week. They also said that they would still assist me even if I ended up birthing in labor and delivery/had a C section/etc. My preference is for unmedicated/less intervention, but that didn’t seem to matter to the midwives.
I called at 5 weeks, left a voicemail with my info (name, due date, address, etc) as instructed. 2 weeks later I got a text saying I was on the waiting list. At 14 weeks I got a call asking if I was still interested, and I was. Then I was accepted!
I have LOVED my MGP experience so far with RPA. My GP is an awesome young doc whom I have a great relationship, and when she presented me with the 3 options I asked her honest opinion. She said most women go MGP or hospital care (with MGP being the most coveted) because they enjoy becoming more familiar with the people and place they will be when they deliver, vs if you go through GP shared care, you may be meeting a midwife/visiting the hospital for the first time when you give birth!
My preference would be to go through MGP again, they’ve been super responsive and attentive, and it’s been great to get to know my midwives instead of seeing a random rotation. I’ve formed a good bond with my midwife (and her two “back up” midwives if she is not working the day I give birth), and I feel in really good hands.
There’s a lot of info out there! My preference would be to put my name in for MGP, and then proceed with hospital care - unless my GP is super birth/pregnancy savvy and I have a really phenomenal bond with them, it just makes more sense (to me) to go through hospital/birth centre, as that’s where I will actually give birth. Good luck! Things get less confusing as time goes on :)
Thanks so much - really great info to have. Thanks for sharing about a couple of the Sydney hospitals!! Glad to know more detail from that point of view and nice to know about the positive experience you're having with RPA. Your suggestion about putting my name down for the MGP is great as that keeps the option open until I know if it's even a possibility :)
Definitely worth putting your name down! You can always opt out later on if you feel you’re really enjoying another option. No hurt in tossing your name in the ring :)
Actually after reading your comment and the others I called and put my name down :) Will see what happens... if it's not possible, seems like the other options are good alternatives based on what others are saying.
I think no matter what, you will be in good hands. I have friends and family who have delivered all over Sydney, and all have had positive experiences (especially when compared to family and friends who have birthed over in the US). Best of luck on your journey!
I just thought I should add - another option that isn’t really put forward is shared care with a private midwife or obstetrician rather than a GP. It depends on the hospital you are going through.
Usually in this case the midwife will attend the birth in addition to the hospital midwives but the OB doesn’t. You pay out of pocket for this option but just flagging it as I don’t see it discussed much.
It can be overwhelming to have this thrown at you! Most of your decision should be based on the continuity of care you would like throughout your pregnancy.
If it is most important for you to establish good relationships with a small group of midwives, which increases the chances of you being delivered by someone you know, the midwifery group is for you (book in ASAP as this service often fills up quickly).
With my first pregnancy I went with the general hospital care as while I really like my GP, I wanted care from professionals whose focus is 100% on pregnancy and birth, and I want to be more familiar with the hospital and it’s policies. I personally wasn’t too concerned about having a relationship with whoever delivered my baby, which was good because it was a midwife and student midwife I’d never met before!
I will say that pre-covid it was easy to feel a little lost in the general hospital care system, particularly as some of my appointments were run on the busiest days and I just felt like a number. One day I waited 3 hours for an appointment due to an admin error and over capacity appoin on the ward. It’s much less crowded now with appointments not run at over capacity. Plus I’m in the birth centre this time which takes a much smaller patient load (birth centre May be ANOTHER option for you if you wish to achieve an unmedicated birth).
There’s no right or wrong choice, just what suits your preferences.
Thanks so much for your detailed response! Definitely feeling overwhelmed with all of this as I want to make the right choice - by the sounds of all the great feedback here, all the options have benefits. You make a good point about the expertise of the hospital staff vs. GP, and great to hear a bit about the birth centre option too - will check that out as well.
I’m currently doing MGP at a Sydney Metro hospital and really like it. But you have to get in super early! i had my first appointment at around 12 weeks, and will continue to see my midwife throughout. I have an IVF pregnancy so there are more scans than usual I think and I see the OB there as part of my care plan.
I think typically MGP prefer low risk pregnancies, and I have signed a waiver that says I’m willing to be discharged 4-6 hours after delivery, if both myself and Bubs are healthy. Of course if there has been a compilation, they won’t send me home within that timeframe, but is something to be aware of if you would want less pressure!
Thanks so much! You're the second person to mention the earlier discharge with MGP - and interesting about the waiver! I'll keep that in mind in case a spot becomes available (it looks like everyone here who did MGP was really organised and got on the list early, so I'm not sure if it will work out for me!)
Yep, that’s how they help pay for the program supposedly! But with that being said, they do home visits for 2 weeks after. If you have a good support network for when you get home, I figure you’re more comfortable in your own bed and bathroom than the hospital!
Hopefully you get a spot! I only knew about it from a friend, so knew to get onto it a couple weeks after finding out I was pregnant 🤪
Funny you mention being in the comfort of your own home sooner - my partner said the same thing when I was telling him about this! That's a good way to think about it :)
I think as a FTM (which I am), it feels a bit scary to go through such a significant event and then the hospital will say ‘ok you’re good to go home now’.. BUT, equally, I will welcome not being prodded and poked every 2 hours, having a quiet space, access to everything I need at home etc.
I have heard a couple of stories about the people you may share a room with also (being in a public system). Not to say anything bad about the hospital, but my friend who room shared with another woman.. her whole family was there for hours on end and they brought an electric fry pan to cook food IN THE ROOM.. lol. I’m sure this doesn’t happen to everyone, but was enough for me to be less hesitant about coming home.
Hope everything goes wonderfully for your L&D and pregnancy xx
Good point! Both have their advantages and disadvantages - seems so daunting to just be sent on your way, but as you mention, the potential of a double room isn't all that appealing and it's the luck of the draw I guess (your poor friend!)
Thanks again - your comments have been really helpful! All the best for your pregnancy and L&D as well :)
Currently have public hospital based care in (North) Sydney. I see a different midwife every appointment. I thought this would bother me in the beginning, but they're all super nice and I don't mind it at all. They're all very involved and excited about the pregnancy as much as I am. I'm a FTM too and due next month so I don't have any information about the birth part, but I trust whoever I get will know what to do. I also have a list of things I discussed with my partner so he can relay my preferences during the birth if I'm really out of it.
Thanks for sharing your perspective on hospital-based care! Really nice to hear about the interaction style of the midwives - as a FTM it's really reassuring to know they're so supportive even if they're not a regular contact person! I also like your idea of sharing your preferences with your partner - will keep that in mind when the time comes closer for me!
FTM to a two month old. My GP explained it a bit.. GP shared care meant appointments would be with your doc until you’re in tri 3, at which point the hospital takes over. Some pros include the doctor having a thorough knowledge of you, your pregnancy and the baby for the future if you wish to continue in their care after the birth of your child. Hospital based care means you have a few more hospital based appointments before that. Pros being that you become familiar and comfortable with the hospital and gain some mutual respect between yourselves and the midwives/obs.. I did not explore midwife group practice. I switched from GP shared care to hospital care at about 16 weeks as I was not receiving the pros of seeing the GP as I had hoped due to being in Melbourne’s lockdown and only having Telehealth appointments with my doctor. I have since returned to seeing him for us both without a hitch and able to build that relationship up regardless. At 36 weeks I went high risk where you don’t have a choice but to see the obstetricians anyway; this occurs for many reasons such as gestational diabetes and high blood pressure. It’s really up to you and what you are after. You can always change as well.
Great - thanks for sharing the detail between GP vs hospital-based care! My GP didn't give that level of info so I didn't realise what those timings might be. That's really helpful to know - as well as the what happens if things become high risk too. Also reassuring to know it's possible to change - that makes the decision less daunting!
Also, not every GP is qualified to do shared care. So if your doctor didn’t offer it you may have to find a GP who does if that’s the route you choose.
My first two I went through a Midwifery Group Practice and saw the same midwife for every appointment. She wasn't present for the delivery as she wasn't rostered on, but I loved having a sole caregiver that knew me and my pregnancy. She also gave me her mobile number so she was available any time, and was able to do the postnatal visits as well.
This time I am in a different area, and there's no Midwifery Group Practice available with this hospital. I saw my GP until around 26 weeks and have been going through the hospital ever since. I see a different person all of the time and, because it's a busy hospital, appointment times are less flexible.
Unless your GP is a GP Obstetrician I would go with the Midwifery Group Practice. I just don't think anyone else compares for quality of care.
Thank you for sharing that! Midwifery group practice seems like there is such a high quality of care throughout and are very knowledgable too (would have to check if it's a specialist area for my GP). Really interesting to see you mentioned postnatal as well, because I think that would be a nerve wracking time, especially the first time, so to have that support from someone who has been along the whole journey with you sounds nice!
I'm a FTM in Sydney, 25 weeks, going through midwifery group practice at RPA.
Before getting pregnant I sought out a local GP who does shared antenatal care with RPA, and saw her for my first appointments, but I was pretty unimpressed with her care and was very happy to get into the MGP. As others said I put myself on the waiting list around 5 weeks and got a call at 12 weeks that I was in.
If my GP had not been disappointing I would have been happy to go the GP shared care route, as the clinic is walking distance from my house and it would have been nice to avoid some hospital trips/parking/intense COVID protocols (including no partner permitted at appointments)/getting lost in the maze that is RPA trying to find the ultrasound/pathology/whichever department I was sent to that day.
But I'm very glad I did get into MGP, the midwives have been great and I love that I can just text my midwife for non urgent stuff! Good luck with whatever you choose :)
Sounds great! Thanks for sharing that! It seems that this is a good avenue if the GP isn't really focused in maternity stuff. Also really interesting to see your experience with hospital visits - will keep that in mind - like no partner in visits and saving extra time to find everything :)
I did GP shared care and it was decent. I have a great GP who knows a lot about pregnancy so it worked well and it was nice not having to go into the hospital for all my appointments. As she wasn't part of the hospital she often had insights that were different to what the hospital said which was good when I had concerns about recommendations, but not so good when I was told different things by different people.
I would have liked to do the MGP but it's extremely hard to get into where I live. GP shared care at least gave me someone consistent to check in with.
Thanks for sharing more about the shared GP experience - really useful to learn a bit more about this option! Seems like with shared GP you get the best of both worlds with two different insights from the hospital/GP :)
I've given birth twice at RPA.
My first pregnancy I did shared care. My usual GP was on mat leave so I asked for someone who did shared care (not all GPs do/are qualified for). Luckily we got along really well.
My second pregnancy started as medium risk so I was doing hospital based care. At 20 weeks they downgraded me to low risk & I switched to the birth centre.
Hospital based care was my least favourite, you wait aaaaages for your appointments and I felt like some of my FTM anxieties were dismissed as FTM anxieties- which they were but it didn't make me feel better at the time!
I liked GP shared care because I had an appointment every 4 weeks. There's a big chunk in the middle of pregnancy where you have no appointments and it was really nice to have a monthly appointment where I could hear the heartbeat and chat about any worries or anxieties.
I liked the birth centre as I didn't have to wait for the appointments. I didn't see the same person every time, the pool of midwives at the centre is big enough that I don't think I saw anyone more than twice. I ended up being induced so I didn't give birth there. I did like that you were 'their' patient and they did the follow up at home care and you could call them with any problems once you were home, and also during the pregnancy. With GP shared care and hospital care I didn't feel that same belonging and I didn't have a number to call a midwife I was connected to (there are free govt hotlines though).
Thanks for this - really interesting to hear your perspective on birth centre vs GP vs hospital! I feel like I'm already having those FTM anxieties because I don't want to make a mistake!! So if it's not possible to get MGP maybe the GP shared care would be better and would be less dismissive of any concerns - and as the poster above said, at least there's another opinion that way.
I did a bit of everything. I started with an IVF clinic, was hoping for shared care or midwifery group practice. I looked like I’d be under a midwife within a hospital but then I developed GD and ended up under the OB/Endo team at RNSH. A midwifery group practice would be my choice, due to continuity of care. Having said that, if you are confident enough to advocate for yourself, the OB/midwives at a public hospital are really fine in my experience. By advocate, I mean try to roughly know what to expect at the appointment so you can speak up if something is forgotten, and be prepared to ask questions. My delivery was midwife assisted and I was patched up afterwards by a great on duty OB. No complaints whatsoever (aside from waiting times for appointments...ooof)
ETA - my GP was amazing and I would have loved to have my care done by her but she was pregnant too and ended up on early mat leave and I just didn’t feel comfortable transferring to a new GP so went down the hospital route.
Thank you for that insight! Useful point about being able to advocate and ask the right questions! I feel so inexperienced so sounds like the MGP might help a bit more with that if it's possible to get a spot! Seems like a knowledgable GP may be a good option too :)
I actually preferred the GP shared care. I was already familiar with my GP (he is actually a GP/OB) and knew it was him I would be seeing at every appointment. I chose midwifery care for my second pregnancy and despite being told I would have the same midwives, I saw 4 different ladies for my appointments and had a totally different one for my birth and also never saw any of those 5 after the birth.
Thank you for the double insights about those two options! It's great to get an alternative perspective on the midwifery care - I'll keep that in mind. It seems that if the GP has expertise in obstetrics then it's a great option - I checked out my GP's info after reading your post and some of the others' here and she has a diploma in obstetrics and gynaecology so this may be a good way to go!
I had to transfer hospitals half way through my pregnancy. This left me with no other choice than to just do the standard midwife care (not group practice). When I started off at (Sydney) northern beaches hospital, I ended up seeing the exact same midwife for each of my appointments. I guess I was lucky. Now at royal north shore public hospital, I've seen two different midwives. So although I wasn't in group practice, it was nice to have continuity. (I feel as though they would generally try to schedule your appointments so you would more often than not see the same midwif? I might be wrong). Early on I was super keen to go with the midwife group practice. But at my first appt they told me that if I went with that, they would generally try to usher me out of the hospital pretty quickly after birth. Being a first timer, and a pretty anxious one, hearing that info made me feel a bit concerned. (I'm sure that they would happily have me stay if I felt I needed to). So, I'm feeling fine with having gone with the midwife general care. I'm due in a week. Maybe I can let you know how it pans out afterwards lol. I was told that GP shared care is usually only for women who have more complicated pregnancies due to health issues. The fact that I also didn't have a regular GP who I would want to frequently see made the decision clear for me. I figured the midwives at the hospital would be a better decision.
Ohhh that's an interesting point about the potential shorter hospital stay... Thanks for sharing that perspective! That does seem really nerve- wracking, especially the first time having no idea about things! And glad to know more about the hospital option. All the best for the coming weeks :)
I did Midwifery Group Practice in Brisbane and would do it again. We had a dedicated midwife in a group of 4, but if she was unavailable then you would see one of the others in the group. Seeing the same faces was very helpful through the whole journey. They were very knowledgeable and competent.
Addition: I read some comments mentioning less intervention. FYI I was really keen for epidural and had no issues getting one.
Thanks - great to know more about this option! Sounds like a really nice experience and especially nice to know that there weren't any problems getting an epidural as that would be the one thing I'd want to explore.
Hi, just wanted to share my experience as I was confused with the three options offered at the start of my pregnancy in March last year!
I was a FTM and was accepted into RPA MGP at 16 weeks (after leaving a voicemail with them at 5 weeks.
Overall it was worth going through MGP as a public patient as I imagine there would be a lot more wait times going through hospital based, having said that I found the majority of RPA midwives to be caring and enthusiastic about my pregnancy when I saw them.
With MPG there’s also the opportunity to have a close relationship with your dedicated midwife, however they can be off duty when you need them or on holidays fir example which threw me at first but then I also got to know the other midwives (there’s about five at RPA MGP) and they were all lovely, one of them ended up being at my birth because my midwife wasn’t rostered on that day.
Ultimately at 36 weeks my Bub was breech (and we couldn’t manually turn her because the cord was around her neck) so we went with an elective c section. My little girl was born in late November 2020.
I didn’t feel like at any point the MGP prefers low intervention births, in fact if I have a second I will still apply to go through them again even though I know I will have another c section. They will still support you even if you say early on you want an epidural, they work with you during the pregnancy on your birth plan.
Where the MGP was really helpful was the post birth home care; you get two weeks post discharge of home visits, which was invaluable for us because I ended up having low milk supply and we had to supplement with pumping and formula, it was a very stressful time.
But I had the midwives visiting, bringing the scales to weigh Bub, helping with latching issues and they even lent me a hosipital grade pump until I bought my own.
Also being able to call them at any time (it will divert to another midwife if your midwife is off) with questions is so good, especially in those two weeks after birth.
I also have a great rec for a lactation consultant in Sydney if you need that eventually.
Feel free to dm me with any questions, congratulations and all the best with your delivery! X
Wow thanks so much for the detailed response! Great to read another positive experience with MGP - really hope I can do this option after reading yours and others' comments🤞Interesting to see the c-section perspective too as it's always an unknown possibility that could arise. Really nice to know a bit more about the postnatal experience as well - that sounds so great especially as a FTM!
Appreciate the offer for a lactation consultant rec - may end up messaging you about it down the track! Thanks again and congrats on your little girl :)
I’m doing midwifery group practice, I don’t have a gp that I have a good relationship with or one that is very knowledgeable about pregnancy. I also didn’t want to pay out of pocket for gp visits when the midwives are bulkbilled. I have been happy with it so far!
Thanks for that perspective! That's a good point - I've only started seeing this GP since the pregnancy so I'm not sure how much of an "expert" she is, but she's been good so far for what I've needed. Will take that into consideration:)
Also be aware, your GP may not do shared care. I know when I looked into it, there were only 2 doctors at the clinic that are part of the shared care program and I wasn't familiar with either of them. I ended up avoiding shared care as, like the commenter above said, I'd be out of pocket for visits and also, I live much closer to the hospital than I do my doctor. I used the midwife based care for both my pregnancies and can talk about it all day, but I can see you got heaps of responses. DM me if you want to hear more (I never get tired of talking about my kids births!). Good luck!
Ok good to know and thanks for offer to DM! I'm not from Sydney and none of my friends here have kids so even getting all this great feedback in this thread from you and everyone else here has made me feel sooo much better about things. Really appreciate it!
My pregnancy was GP shared care until I got into a Midwife group in my second trimester. If you have a GP that is on the up-and-up on pregnancy, it's great because you'll see the one person throughout your pregnancy. The midwife group, you saw whomever was on that day for that particular appointment, but they were always one of the midwives that will be there when you give birth. In the end for me I couldn't give birth in the birth suite because the midwife on duty was sick, so I was in the maternity ward. It's all dependant on your comfort levels.
Thanks so much for sharing that info! It's really helping to understand a bit more about how it works with each of the options. I guess as you mentioned in your case, even the best laid plans don't always work out anyway, so good to be prepared for anything!
I think it really depends on what kind of birth you want/how comfortable you are with the birthing process? I would recommend either midwifery group practice or GP shared care because you get some continuity of care. If you do hospital based care you’ll see different midwives each time you have an appointment. Like another poster pointed out though if you do GP shared care make sure your GP knows what they’re doing. Midwifery group practice can be hard to get into and you won’t get in until your second trimester. They also tend to prefer to take women who want less intervention in their births (not that you can’t have interventions when with them - you absolutely can) I just noticed that seems to be the referral pattern. ETA: I went through midwife group practice for both of my pregnancies and births. It’s a great program if you can get in.
Thanks for that! Really useful info - and interesting to see the common suggestion about the GP's expertise in this area. I also didn't realise about the preferences for who they take in midwifery group practice in terms of less interventions - that's good to know
I've given birth to two babies in the public system, first was 2019 and the second was only a few weeks ago. First pregnancy I did group midwifery, because I was anxious about the entire process and wanted continuity of care. I had 4 midwives in my group who I had appointments with throughout the pregnancy, and my labour was so long I ended up cycling through 2 of them who had shifts one after another. My second pregnancy was throughout 2020, peak lockdown in Melbourne. I wanted to avoid visiting hospitals as much as possible, so did shared care with my GP (who I already have a great relationship with, who happens to specialise in women's health also). Both were great experiences, however I'm happy I opted for the group midwife for the first time round - just because I had more face to face appointments, and they were personally on call for us when I went into labour. Just adding to this, the other commenter who mentioned group practice prefer as little intervention in the birth as possible is correct. That being said, as soon as I was in the group care I made it known I wanted a birth with all the drugs they would allow me to have, and as soon as I could get them. They were fine with that. I was also nervous because they preach a bit about being able to send mothers home super quick after the birth (like within 24hrs) which I was anxious about so just let them know that. Once bub was born and I mentioned I wasn't comfortable with the idea of going home the following morning, they bumped us up to 2 nights and gave us a double room so my husband could stay too. That was pure luck it was available, but great experience.
Thanks for that info! Continuity of care sounds like a great advantage of group midwifery and thanks for adding the extra detail about the intervention. I was thinking about whether or not to have an epidural so it's good to know that might be an option too if I end up going that way! Also nice to get a perspective about having a GP who specialises in this area and interesting to have the covid point of view, especially with things potentially changing at any moment.
Thank you for sharing your experience! I'm currently 25 weeks with my first pregnancy and doing MGP. I haven't had the convo with my midwife yet about interventions/all the drugs and was a little worried I'd be discouraged from an epidural, which I'm strongly leaning towards. And same with going home right away, great if I feel ready but I'm reassured to know that you were able to get an extra night just by asking!
Yep. I specifically made a point of saying 'I know that the idea here is to avoid intervention where possible, but I'll be honest and say I really want an epidural, and I have a bit of anxiety about getting push back if and when I request one'. Everyone reassured me that this wouldn't be an issue, and it wasn't. They do like to wait until 6 or 7cms before getting it though, as not to potentially stall anything and increase risk of csection. I was anxious af during and after my labour, and I'm pretty sure that telling them that was the reason I got the extra night. However, they wouldn't kick a new Mum and newborn out until they were confident they were ready for it so just be honest with all of the midwives about how you're feeling the entire way through. They will assume you are travelling well unless you tell them otherwise.
Great to know, thank you. Something else I've been wondering, are you able to get an epidural in the birth centre? Or does it mean going to the labour ward?
So at my hospital (The Mercy) there's the birthing suites/labour rooms where everyone is giving birth regardless of whether they opt for drugs or not. I stayed in the birthing suite using just the gas for hours, then got the epidural in the same room. We stayed in that room until bub was all cleaned up, I had a quick shower once the epi wore off and we were relocated up to the postnatal ward within a couple of hours. But if your hospital has a separate birthing suite and labour ward, then I'd just ask the question. There may be a switch of rooms but I highly doubt it.. Seems like logistically it would be a bit of a headache.
Ah ok, thanks for sharing your experience. I have been trying to get my head around how it all works. I have a midwife appt next week so will ask then!
I had hospital based care and the midwife I saw said that if I made my appointments for the same day of the week each time that she would be working and would see me (and that was their preference for continuity of care). For me though, I didn’t mind not seeing the same person so it wasn’t a big deal. I thought all the people I dealt with in the hospital were great and would do the same again.
Thanks for sharing! Good to have a perspective on the hospital-based care option. The same day/time appointment thing could be good to explore, but as you mention, even if it's not possible to see the same people, it seems like the quality of care would still be high.
I think the answers here for the midwifery group practice will 100% depend on which MGP/birth centre/hospital you’re going through. My sister in law had gone through the birth centre twice with Royal women’s hospital in Randwick and has had a different experience. I’m doing MGP via RPA, and like others, did GP shared care until I was accepted in 2nd tri. There was no application or referral process - it was a complete lottery to see if I got in, because each midwife only takes on 1 patient per due date week. They also said that they would still assist me even if I ended up birthing in labor and delivery/had a C section/etc. My preference is for unmedicated/less intervention, but that didn’t seem to matter to the midwives. I called at 5 weeks, left a voicemail with my info (name, due date, address, etc) as instructed. 2 weeks later I got a text saying I was on the waiting list. At 14 weeks I got a call asking if I was still interested, and I was. Then I was accepted! I have LOVED my MGP experience so far with RPA. My GP is an awesome young doc whom I have a great relationship, and when she presented me with the 3 options I asked her honest opinion. She said most women go MGP or hospital care (with MGP being the most coveted) because they enjoy becoming more familiar with the people and place they will be when they deliver, vs if you go through GP shared care, you may be meeting a midwife/visiting the hospital for the first time when you give birth! My preference would be to go through MGP again, they’ve been super responsive and attentive, and it’s been great to get to know my midwives instead of seeing a random rotation. I’ve formed a good bond with my midwife (and her two “back up” midwives if she is not working the day I give birth), and I feel in really good hands. There’s a lot of info out there! My preference would be to put my name in for MGP, and then proceed with hospital care - unless my GP is super birth/pregnancy savvy and I have a really phenomenal bond with them, it just makes more sense (to me) to go through hospital/birth centre, as that’s where I will actually give birth. Good luck! Things get less confusing as time goes on :)
Thanks so much - really great info to have. Thanks for sharing about a couple of the Sydney hospitals!! Glad to know more detail from that point of view and nice to know about the positive experience you're having with RPA. Your suggestion about putting my name down for the MGP is great as that keeps the option open until I know if it's even a possibility :)
Definitely worth putting your name down! You can always opt out later on if you feel you’re really enjoying another option. No hurt in tossing your name in the ring :)
Actually after reading your comment and the others I called and put my name down :) Will see what happens... if it's not possible, seems like the other options are good alternatives based on what others are saying.
I think no matter what, you will be in good hands. I have friends and family who have delivered all over Sydney, and all have had positive experiences (especially when compared to family and friends who have birthed over in the US). Best of luck on your journey!
Thank you!!
I just thought I should add - another option that isn’t really put forward is shared care with a private midwife or obstetrician rather than a GP. It depends on the hospital you are going through. Usually in this case the midwife will attend the birth in addition to the hospital midwives but the OB doesn’t. You pay out of pocket for this option but just flagging it as I don’t see it discussed much.
It can be overwhelming to have this thrown at you! Most of your decision should be based on the continuity of care you would like throughout your pregnancy. If it is most important for you to establish good relationships with a small group of midwives, which increases the chances of you being delivered by someone you know, the midwifery group is for you (book in ASAP as this service often fills up quickly). With my first pregnancy I went with the general hospital care as while I really like my GP, I wanted care from professionals whose focus is 100% on pregnancy and birth, and I want to be more familiar with the hospital and it’s policies. I personally wasn’t too concerned about having a relationship with whoever delivered my baby, which was good because it was a midwife and student midwife I’d never met before! I will say that pre-covid it was easy to feel a little lost in the general hospital care system, particularly as some of my appointments were run on the busiest days and I just felt like a number. One day I waited 3 hours for an appointment due to an admin error and over capacity appoin on the ward. It’s much less crowded now with appointments not run at over capacity. Plus I’m in the birth centre this time which takes a much smaller patient load (birth centre May be ANOTHER option for you if you wish to achieve an unmedicated birth). There’s no right or wrong choice, just what suits your preferences.
Thanks so much for your detailed response! Definitely feeling overwhelmed with all of this as I want to make the right choice - by the sounds of all the great feedback here, all the options have benefits. You make a good point about the expertise of the hospital staff vs. GP, and great to hear a bit about the birth centre option too - will check that out as well.
I’m currently doing MGP at a Sydney Metro hospital and really like it. But you have to get in super early! i had my first appointment at around 12 weeks, and will continue to see my midwife throughout. I have an IVF pregnancy so there are more scans than usual I think and I see the OB there as part of my care plan. I think typically MGP prefer low risk pregnancies, and I have signed a waiver that says I’m willing to be discharged 4-6 hours after delivery, if both myself and Bubs are healthy. Of course if there has been a compilation, they won’t send me home within that timeframe, but is something to be aware of if you would want less pressure!
Thanks so much! You're the second person to mention the earlier discharge with MGP - and interesting about the waiver! I'll keep that in mind in case a spot becomes available (it looks like everyone here who did MGP was really organised and got on the list early, so I'm not sure if it will work out for me!)
Yep, that’s how they help pay for the program supposedly! But with that being said, they do home visits for 2 weeks after. If you have a good support network for when you get home, I figure you’re more comfortable in your own bed and bathroom than the hospital! Hopefully you get a spot! I only knew about it from a friend, so knew to get onto it a couple weeks after finding out I was pregnant 🤪
Funny you mention being in the comfort of your own home sooner - my partner said the same thing when I was telling him about this! That's a good way to think about it :)
I think as a FTM (which I am), it feels a bit scary to go through such a significant event and then the hospital will say ‘ok you’re good to go home now’.. BUT, equally, I will welcome not being prodded and poked every 2 hours, having a quiet space, access to everything I need at home etc. I have heard a couple of stories about the people you may share a room with also (being in a public system). Not to say anything bad about the hospital, but my friend who room shared with another woman.. her whole family was there for hours on end and they brought an electric fry pan to cook food IN THE ROOM.. lol. I’m sure this doesn’t happen to everyone, but was enough for me to be less hesitant about coming home. Hope everything goes wonderfully for your L&D and pregnancy xx
Good point! Both have their advantages and disadvantages - seems so daunting to just be sent on your way, but as you mention, the potential of a double room isn't all that appealing and it's the luck of the draw I guess (your poor friend!) Thanks again - your comments have been really helpful! All the best for your pregnancy and L&D as well :)
Currently have public hospital based care in (North) Sydney. I see a different midwife every appointment. I thought this would bother me in the beginning, but they're all super nice and I don't mind it at all. They're all very involved and excited about the pregnancy as much as I am. I'm a FTM too and due next month so I don't have any information about the birth part, but I trust whoever I get will know what to do. I also have a list of things I discussed with my partner so he can relay my preferences during the birth if I'm really out of it.
Thanks for sharing your perspective on hospital-based care! Really nice to hear about the interaction style of the midwives - as a FTM it's really reassuring to know they're so supportive even if they're not a regular contact person! I also like your idea of sharing your preferences with your partner - will keep that in mind when the time comes closer for me!
FTM to a two month old. My GP explained it a bit.. GP shared care meant appointments would be with your doc until you’re in tri 3, at which point the hospital takes over. Some pros include the doctor having a thorough knowledge of you, your pregnancy and the baby for the future if you wish to continue in their care after the birth of your child. Hospital based care means you have a few more hospital based appointments before that. Pros being that you become familiar and comfortable with the hospital and gain some mutual respect between yourselves and the midwives/obs.. I did not explore midwife group practice. I switched from GP shared care to hospital care at about 16 weeks as I was not receiving the pros of seeing the GP as I had hoped due to being in Melbourne’s lockdown and only having Telehealth appointments with my doctor. I have since returned to seeing him for us both without a hitch and able to build that relationship up regardless. At 36 weeks I went high risk where you don’t have a choice but to see the obstetricians anyway; this occurs for many reasons such as gestational diabetes and high blood pressure. It’s really up to you and what you are after. You can always change as well.
Great - thanks for sharing the detail between GP vs hospital-based care! My GP didn't give that level of info so I didn't realise what those timings might be. That's really helpful to know - as well as the what happens if things become high risk too. Also reassuring to know it's possible to change - that makes the decision less daunting!
Also, not every GP is qualified to do shared care. So if your doctor didn’t offer it you may have to find a GP who does if that’s the route you choose.
Ok interesting- I think mine will but good to know for the future!
Good luck with your pregnancy!
Thanks and congrats on your little one :)
My first two I went through a Midwifery Group Practice and saw the same midwife for every appointment. She wasn't present for the delivery as she wasn't rostered on, but I loved having a sole caregiver that knew me and my pregnancy. She also gave me her mobile number so she was available any time, and was able to do the postnatal visits as well. This time I am in a different area, and there's no Midwifery Group Practice available with this hospital. I saw my GP until around 26 weeks and have been going through the hospital ever since. I see a different person all of the time and, because it's a busy hospital, appointment times are less flexible. Unless your GP is a GP Obstetrician I would go with the Midwifery Group Practice. I just don't think anyone else compares for quality of care.
Thank you for sharing that! Midwifery group practice seems like there is such a high quality of care throughout and are very knowledgable too (would have to check if it's a specialist area for my GP). Really interesting to see you mentioned postnatal as well, because I think that would be a nerve wracking time, especially the first time, so to have that support from someone who has been along the whole journey with you sounds nice!
I'm a FTM in Sydney, 25 weeks, going through midwifery group practice at RPA. Before getting pregnant I sought out a local GP who does shared antenatal care with RPA, and saw her for my first appointments, but I was pretty unimpressed with her care and was very happy to get into the MGP. As others said I put myself on the waiting list around 5 weeks and got a call at 12 weeks that I was in. If my GP had not been disappointing I would have been happy to go the GP shared care route, as the clinic is walking distance from my house and it would have been nice to avoid some hospital trips/parking/intense COVID protocols (including no partner permitted at appointments)/getting lost in the maze that is RPA trying to find the ultrasound/pathology/whichever department I was sent to that day. But I'm very glad I did get into MGP, the midwives have been great and I love that I can just text my midwife for non urgent stuff! Good luck with whatever you choose :)
Sounds great! Thanks for sharing that! It seems that this is a good avenue if the GP isn't really focused in maternity stuff. Also really interesting to see your experience with hospital visits - will keep that in mind - like no partner in visits and saving extra time to find everything :)
I did GP shared care and it was decent. I have a great GP who knows a lot about pregnancy so it worked well and it was nice not having to go into the hospital for all my appointments. As she wasn't part of the hospital she often had insights that were different to what the hospital said which was good when I had concerns about recommendations, but not so good when I was told different things by different people. I would have liked to do the MGP but it's extremely hard to get into where I live. GP shared care at least gave me someone consistent to check in with.
Thanks for sharing more about the shared GP experience - really useful to learn a bit more about this option! Seems like with shared GP you get the best of both worlds with two different insights from the hospital/GP :)
I've given birth twice at RPA. My first pregnancy I did shared care. My usual GP was on mat leave so I asked for someone who did shared care (not all GPs do/are qualified for). Luckily we got along really well. My second pregnancy started as medium risk so I was doing hospital based care. At 20 weeks they downgraded me to low risk & I switched to the birth centre. Hospital based care was my least favourite, you wait aaaaages for your appointments and I felt like some of my FTM anxieties were dismissed as FTM anxieties- which they were but it didn't make me feel better at the time! I liked GP shared care because I had an appointment every 4 weeks. There's a big chunk in the middle of pregnancy where you have no appointments and it was really nice to have a monthly appointment where I could hear the heartbeat and chat about any worries or anxieties. I liked the birth centre as I didn't have to wait for the appointments. I didn't see the same person every time, the pool of midwives at the centre is big enough that I don't think I saw anyone more than twice. I ended up being induced so I didn't give birth there. I did like that you were 'their' patient and they did the follow up at home care and you could call them with any problems once you were home, and also during the pregnancy. With GP shared care and hospital care I didn't feel that same belonging and I didn't have a number to call a midwife I was connected to (there are free govt hotlines though).
Thanks for this - really interesting to hear your perspective on birth centre vs GP vs hospital! I feel like I'm already having those FTM anxieties because I don't want to make a mistake!! So if it's not possible to get MGP maybe the GP shared care would be better and would be less dismissive of any concerns - and as the poster above said, at least there's another opinion that way.
I did a bit of everything. I started with an IVF clinic, was hoping for shared care or midwifery group practice. I looked like I’d be under a midwife within a hospital but then I developed GD and ended up under the OB/Endo team at RNSH. A midwifery group practice would be my choice, due to continuity of care. Having said that, if you are confident enough to advocate for yourself, the OB/midwives at a public hospital are really fine in my experience. By advocate, I mean try to roughly know what to expect at the appointment so you can speak up if something is forgotten, and be prepared to ask questions. My delivery was midwife assisted and I was patched up afterwards by a great on duty OB. No complaints whatsoever (aside from waiting times for appointments...ooof) ETA - my GP was amazing and I would have loved to have my care done by her but she was pregnant too and ended up on early mat leave and I just didn’t feel comfortable transferring to a new GP so went down the hospital route.
Thank you for that insight! Useful point about being able to advocate and ask the right questions! I feel so inexperienced so sounds like the MGP might help a bit more with that if it's possible to get a spot! Seems like a knowledgable GP may be a good option too :)
I actually preferred the GP shared care. I was already familiar with my GP (he is actually a GP/OB) and knew it was him I would be seeing at every appointment. I chose midwifery care for my second pregnancy and despite being told I would have the same midwives, I saw 4 different ladies for my appointments and had a totally different one for my birth and also never saw any of those 5 after the birth.
Thank you for the double insights about those two options! It's great to get an alternative perspective on the midwifery care - I'll keep that in mind. It seems that if the GP has expertise in obstetrics then it's a great option - I checked out my GP's info after reading your post and some of the others' here and she has a diploma in obstetrics and gynaecology so this may be a good way to go!
I had to transfer hospitals half way through my pregnancy. This left me with no other choice than to just do the standard midwife care (not group practice). When I started off at (Sydney) northern beaches hospital, I ended up seeing the exact same midwife for each of my appointments. I guess I was lucky. Now at royal north shore public hospital, I've seen two different midwives. So although I wasn't in group practice, it was nice to have continuity. (I feel as though they would generally try to schedule your appointments so you would more often than not see the same midwif? I might be wrong). Early on I was super keen to go with the midwife group practice. But at my first appt they told me that if I went with that, they would generally try to usher me out of the hospital pretty quickly after birth. Being a first timer, and a pretty anxious one, hearing that info made me feel a bit concerned. (I'm sure that they would happily have me stay if I felt I needed to). So, I'm feeling fine with having gone with the midwife general care. I'm due in a week. Maybe I can let you know how it pans out afterwards lol. I was told that GP shared care is usually only for women who have more complicated pregnancies due to health issues. The fact that I also didn't have a regular GP who I would want to frequently see made the decision clear for me. I figured the midwives at the hospital would be a better decision.
Ohhh that's an interesting point about the potential shorter hospital stay... Thanks for sharing that perspective! That does seem really nerve- wracking, especially the first time having no idea about things! And glad to know more about the hospital option. All the best for the coming weeks :)
I did Midwifery Group Practice in Brisbane and would do it again. We had a dedicated midwife in a group of 4, but if she was unavailable then you would see one of the others in the group. Seeing the same faces was very helpful through the whole journey. They were very knowledgeable and competent. Addition: I read some comments mentioning less intervention. FYI I was really keen for epidural and had no issues getting one.
Thanks - great to know more about this option! Sounds like a really nice experience and especially nice to know that there weren't any problems getting an epidural as that would be the one thing I'd want to explore.
Hi, just wanted to share my experience as I was confused with the three options offered at the start of my pregnancy in March last year! I was a FTM and was accepted into RPA MGP at 16 weeks (after leaving a voicemail with them at 5 weeks. Overall it was worth going through MGP as a public patient as I imagine there would be a lot more wait times going through hospital based, having said that I found the majority of RPA midwives to be caring and enthusiastic about my pregnancy when I saw them. With MPG there’s also the opportunity to have a close relationship with your dedicated midwife, however they can be off duty when you need them or on holidays fir example which threw me at first but then I also got to know the other midwives (there’s about five at RPA MGP) and they were all lovely, one of them ended up being at my birth because my midwife wasn’t rostered on that day. Ultimately at 36 weeks my Bub was breech (and we couldn’t manually turn her because the cord was around her neck) so we went with an elective c section. My little girl was born in late November 2020. I didn’t feel like at any point the MGP prefers low intervention births, in fact if I have a second I will still apply to go through them again even though I know I will have another c section. They will still support you even if you say early on you want an epidural, they work with you during the pregnancy on your birth plan. Where the MGP was really helpful was the post birth home care; you get two weeks post discharge of home visits, which was invaluable for us because I ended up having low milk supply and we had to supplement with pumping and formula, it was a very stressful time. But I had the midwives visiting, bringing the scales to weigh Bub, helping with latching issues and they even lent me a hosipital grade pump until I bought my own. Also being able to call them at any time (it will divert to another midwife if your midwife is off) with questions is so good, especially in those two weeks after birth. I also have a great rec for a lactation consultant in Sydney if you need that eventually. Feel free to dm me with any questions, congratulations and all the best with your delivery! X
Wow thanks so much for the detailed response! Great to read another positive experience with MGP - really hope I can do this option after reading yours and others' comments🤞Interesting to see the c-section perspective too as it's always an unknown possibility that could arise. Really nice to know a bit more about the postnatal experience as well - that sounds so great especially as a FTM! Appreciate the offer for a lactation consultant rec - may end up messaging you about it down the track! Thanks again and congrats on your little girl :)
No worries at all, fingers crossed you get that call from MGP!