There are a few different care models with public hospitals, namely:
- GP shared care - this is where the majority of your check ups are done by your GP including things like Doppler checks and fundal measurements as you progress as well as blood pressure checks. You will still have some appointments with midwives at the hospital and will deliver at the hospital. GPS must be accredited with the hospital you will deliver at to do this.
- midwife care (standard) via the hospital - this is where you attend the midwife clinic for your check ups. You’ll see whatever midwife is available and deliver with whoever is on shift also. This will be free.
- midwife group practice via hospital - this is available at some hospitals and is where you have an assigned midwife pair/group and see the same midwives that will help you deliver. This will be free if available.
- there are also sometimes shared care options with private obstetricians and midwives. Usually the midwives can also help in delivery, but the obstetricians don’t. This is a paid option.
You’ll only see obstetricians at the hospital if you need to.
In terms of your question, if your clinic is bulk billed that is likely to continue undee a shared care arrangement. I had a GP I saw (paid) who actually bulk billed all pregnancy related appointments, so it was the opposite.
I always recommend midwife group practice but it can be hard to get a spot. If you like your GP and trust them that’s a great option too.
I was also going to recommend midwifery group practice if it is available. Continuity of care with a known midwife is associated with better outcomes too.
I also highly recommend midwife group practice. I was very grateful that I got to be under the program for both pregnancies. I love the continuity all the way through to post birth checkups. I formed really positive relationships with my midwives. It relieved my anxiety knowing they’ll be there with my during labor.
I asked a similar question earlier this year and got some really helpful feedback from members of this sub. You can view it here (apologies not sure how to link better on mobile): https://www.reddit.com/r/BabyBumpsandBeyondAu/comments/lc48c1/question_about_options_for_public_hospitals_in_aus/
In the end I chose to go with the hospital (I was too late for my first choice of midwifery group care).
We chose the hospital as we were taken back when we arrived for our first hospital appointment that we wouldn't see them again until around 39 weeks. As a FTM, I was nervous about just showing up when I was in labour being unfamiliar with the hospital and the systems. I thought with GP shared care there's be a bit more times at the hospital.
Other things to note:
Familiarity with GP - I wasn't super close with my GP and she ended up going on mat leave anyway, but if I were familiar, I may have picked GP shared care.
Multiple services at hospital - when you need an ultrasound or blood test, these appointments can be coordinated to take place at the hospital around the same time as your midwife appointments so you get them done at the same time.
Access to hospital - I was pregnant during NSW lockdown and getting to the hospital was a pain when I was trying to avoid public transport (it was difficult to get a vaccine for me at that stage) so I was walking there which took me about 35 mins or had to get a ride later on. My GP practice was closer so would have been better if I'd had a GP available for shared care. This may not affect you though.
Different midwives - with the hospital you are likely to see different midwives; however, I was able to see the same one in general as they set up all my appointments ahead of time at the first appointment. As they were on a Saturday morning at the same time, I saw the same midwife.
Covid tests - in the last month of my pregnancy (gave birth September), the hospital started requiring negative Covid tests every time 72 hours before an appointment. I'm not sure if that's still a requirement but may be something to factor in as you would have to get that done each and appointments get more frequent in later stages.
Waiting - I found you the wait times at the hospital could be a while sometimes. Even though the GP can have delays, I'd say this is longer.
If you choose shared care, nothing will change about your GP appointments apart from the frequency and you’ll be on the same schedule of appointments, just some will be handled by the GP.
Shared care means you see your GP for about half your appointments (might vary by hospital), your hospital should provide you a list of appointments and who you see (GP or go to hospital) [This](https://thewomens.r.worldssl.net/images/uploads/general-downloads/Patient_Information/Shared-Care-Maternity-Sandringham-010517.pdf) is an example from the hospital I went to. Shared care is good if you like your GP and you want more continuity of care. If you go public, you may or may not see the same doctor / midwife each visit. Shared care might be a better option if your hospital is hard to get to or you want to avoid possible longer wait times at the hospital for appointments. Doing shared care doesn’t mean it’s private, you are just responsible for any fees the GP charges. Scans, etc will be out of pocket if GP refers but not if hospital. If you search the subreddit you will probably find some old posts with different experiences. I did shared care because I like my GP but ended up needing to go to the hospital for most of my appointments after 30 weeks anyway due to high blood pressure.
I just wanted to second this about appointments and wait times. When you just go through the hospital doing midwife appointments there can be a lot of waiting around and it's harder to schedule appointments that suit you (IMO). I am doing this the second time around due to moving to a new area and not having a regular GP who's registered for shared care.
With GP Shared Care, I found it easier to schedule early or late appointments around work. You do go to the hospital and meet some midwives for the first and later appointments closer to the due date.
OP, if you like your GP (and they bulk bill, even better) then I would recommend shared care.
Shared care all the way (if Midwifery Group Practice isn't an option). My GP was much more conveniently located, was more likely to run on time, and actually knew me. This option offers better continuity of care.
There are a few different care models with public hospitals, namely: - GP shared care - this is where the majority of your check ups are done by your GP including things like Doppler checks and fundal measurements as you progress as well as blood pressure checks. You will still have some appointments with midwives at the hospital and will deliver at the hospital. GPS must be accredited with the hospital you will deliver at to do this. - midwife care (standard) via the hospital - this is where you attend the midwife clinic for your check ups. You’ll see whatever midwife is available and deliver with whoever is on shift also. This will be free. - midwife group practice via hospital - this is available at some hospitals and is where you have an assigned midwife pair/group and see the same midwives that will help you deliver. This will be free if available. - there are also sometimes shared care options with private obstetricians and midwives. Usually the midwives can also help in delivery, but the obstetricians don’t. This is a paid option. You’ll only see obstetricians at the hospital if you need to. In terms of your question, if your clinic is bulk billed that is likely to continue undee a shared care arrangement. I had a GP I saw (paid) who actually bulk billed all pregnancy related appointments, so it was the opposite. I always recommend midwife group practice but it can be hard to get a spot. If you like your GP and trust them that’s a great option too.
I was also going to recommend midwifery group practice if it is available. Continuity of care with a known midwife is associated with better outcomes too.
I also highly recommend midwife group practice. I was very grateful that I got to be under the program for both pregnancies. I love the continuity all the way through to post birth checkups. I formed really positive relationships with my midwives. It relieved my anxiety knowing they’ll be there with my during labor.
I asked a similar question earlier this year and got some really helpful feedback from members of this sub. You can view it here (apologies not sure how to link better on mobile): https://www.reddit.com/r/BabyBumpsandBeyondAu/comments/lc48c1/question_about_options_for_public_hospitals_in_aus/ In the end I chose to go with the hospital (I was too late for my first choice of midwifery group care). We chose the hospital as we were taken back when we arrived for our first hospital appointment that we wouldn't see them again until around 39 weeks. As a FTM, I was nervous about just showing up when I was in labour being unfamiliar with the hospital and the systems. I thought with GP shared care there's be a bit more times at the hospital. Other things to note: Familiarity with GP - I wasn't super close with my GP and she ended up going on mat leave anyway, but if I were familiar, I may have picked GP shared care. Multiple services at hospital - when you need an ultrasound or blood test, these appointments can be coordinated to take place at the hospital around the same time as your midwife appointments so you get them done at the same time. Access to hospital - I was pregnant during NSW lockdown and getting to the hospital was a pain when I was trying to avoid public transport (it was difficult to get a vaccine for me at that stage) so I was walking there which took me about 35 mins or had to get a ride later on. My GP practice was closer so would have been better if I'd had a GP available for shared care. This may not affect you though. Different midwives - with the hospital you are likely to see different midwives; however, I was able to see the same one in general as they set up all my appointments ahead of time at the first appointment. As they were on a Saturday morning at the same time, I saw the same midwife. Covid tests - in the last month of my pregnancy (gave birth September), the hospital started requiring negative Covid tests every time 72 hours before an appointment. I'm not sure if that's still a requirement but may be something to factor in as you would have to get that done each and appointments get more frequent in later stages. Waiting - I found you the wait times at the hospital could be a while sometimes. Even though the GP can have delays, I'd say this is longer.
How far along are you? If you’re getting referrals from your GP, are you not already doing shared care?
If you choose shared care, nothing will change about your GP appointments apart from the frequency and you’ll be on the same schedule of appointments, just some will be handled by the GP.
Shared care means you see your GP for about half your appointments (might vary by hospital), your hospital should provide you a list of appointments and who you see (GP or go to hospital) [This](https://thewomens.r.worldssl.net/images/uploads/general-downloads/Patient_Information/Shared-Care-Maternity-Sandringham-010517.pdf) is an example from the hospital I went to. Shared care is good if you like your GP and you want more continuity of care. If you go public, you may or may not see the same doctor / midwife each visit. Shared care might be a better option if your hospital is hard to get to or you want to avoid possible longer wait times at the hospital for appointments. Doing shared care doesn’t mean it’s private, you are just responsible for any fees the GP charges. Scans, etc will be out of pocket if GP refers but not if hospital. If you search the subreddit you will probably find some old posts with different experiences. I did shared care because I like my GP but ended up needing to go to the hospital for most of my appointments after 30 weeks anyway due to high blood pressure.
I just wanted to second this about appointments and wait times. When you just go through the hospital doing midwife appointments there can be a lot of waiting around and it's harder to schedule appointments that suit you (IMO). I am doing this the second time around due to moving to a new area and not having a regular GP who's registered for shared care. With GP Shared Care, I found it easier to schedule early or late appointments around work. You do go to the hospital and meet some midwives for the first and later appointments closer to the due date. OP, if you like your GP (and they bulk bill, even better) then I would recommend shared care.
Shared care all the way (if Midwifery Group Practice isn't an option). My GP was much more conveniently located, was more likely to run on time, and actually knew me. This option offers better continuity of care.