Leslie Massey
Homebirth is not illegal in Australia, and some pregnant women prefer this option. There are two main ways to have a homebirth in Australia: either through a program linked to a public hospital or by employing a private midwife. Midwives who care for women at home during pregnancy and labour are highly skilled and trained, and they bring special equipment for monitoring and treatment in case complications arise. However, private midwives' professional indemnity insurance does not cover labour and birth at home, and it is important to understand all the costs associated with a private homebirth, including ambulance fees if needed. In South Australia, it is an offence for anyone other than a registered medical practitioner or midwife to carry out a restricted birthing practice. This restriction aims to ensure that only qualified practitioners with the necessary education and training can provide these services, prioritising the safety of the mother and baby.
| Characteristics | Values |
|---|---|
| Is homebirth illegal in Australia? | Homebirth is acceptable in Australia, but it is recommended to check with your healthcare providers about the care they provide, their skills and experience. |
| Number of homebirths in Australia | In 2009, there were 863 babies born at home. This increased to 1345 in 2010, and in 2012 there were 1177 home births. |
| Types of homebirth | There are two main ways to have a homebirth in Australia: through a program linked to a public hospital or by employing a private midwife. |
| Cost of a private midwife | The average cost of employing a PPM is between $3500-$5500, with some private health insurers providing rebates. Employing a privately practising midwife can cost up to $6,000 before rebates. |
| Publicly funded homebirth programs | There are around 12 publicly funded homebirth programs in all states, except for Queensland, the Australian Capital Territory and Tasmania. |
| Eligibility for publicly funded homebirth programs | The main criterion is that women are having a low-risk, healthy pregnancy and live within a certain distance of the hospital. |
| Freebirth | A freebirth is a birth at home without any medical support. This is not illegal in Australia, but it is important to consider the potential risks. |
| Restricted birthing practices | In South Australia, it is an offence for any person other than a registered medical practitioner or midwife to carry out a restricted birthing practice. |
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What You'll Learn
Homebirth is not illegal in Australia, but it is not the norm.
Publicly funded homebirth programs are available in all states except Queensland, the Australian Capital Territory, and Tasmania. These programs are typically run through the public hospital system, and women may need to live within a certain distance of the hospital to be eligible. The criteria for eligibility vary depending on the state, but generally, women must have a low-risk, healthy pregnancy. Midwives in these programs provide caseload care, which involves continuity of care with an allocated primary midwife and a secondary or backup midwife. If complications arise during pregnancy or labour, the woman is referred to an obstetrician within a hospital for specialist care and is no longer able to birth at home.
Privately practising midwives (PPMs) are self-employed and often work in group practices. They bring special equipment to monitor the mother and baby and provide treatment in the unlikely event of complications. PPMs do not currently have access to hospital rights in most states, except for ten hospitals across Queensland, South Australia, and Western Australia. Employing a PPM can cost between $3500 and $6000 before rebates, and it is important to understand their fees, what they cover, and whether you are eligible for rebates.
While homebirth is a safe option for low-risk women, it is important to carefully consider all the costs associated with a private homebirth, including the cost of an ambulance if ambulance cover is not available. Additionally, it is crucial to ensure that your midwife is registered and meets the necessary standards. In South Australia, it is an offence for anyone other than a registered medical practitioner or midwife to carry out a restricted birthing practice. This restriction was implemented to ensure that only qualified practitioners with the necessary education and training provide these services, prioritising the safety of the mother and baby.
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Two ways to have a homebirth in Australia:
Homebirth is acceptable in Australia, and some pregnant women prefer this option. There are two main ways to have a homebirth in Australia:
Through a program linked to a public hospital
There are around 12 publicly funded homebirth programs in all states, except for Queensland, the Australian Capital Territory, and Tasmania. These programs are run through the public hospital system, and women may need to live within a certain distance from the hospital to be eligible. The main criterion for eligibility is that women have a low-risk, healthy pregnancy. Midwives provide caseload care, involving continuity of care with an allocated secondary or backup midwife. If a woman develops complications during pregnancy or labour, the primary midwife collaborates with other medical staff, and the woman will need to give birth in a hospital.
Employing a private midwife
Privately practising midwives (PPMs) are self-employed and often work in a group practice with other midwives. They are highly skilled and trained and bring special equipment to monitor the mother and baby and provide treatment if needed. Women who develop complications during pregnancy are referred to an obstetrician within a hospital for specialist care. If complications occur during labour, the PPM will arrange a transfer to the nearest hospital. Currently, PPMs do not have access to hospital rights, except for eight hospitals in Queensland, one in South Australia, and one in Western Australia. The average cost of employing a PPM is between $3500-$5500, and some private health insurers provide rebates for private antenatal and postnatal care.
It is important to note that homebirth options may differ from state to state in Australia. Additionally, a "freebirth" is a planned homebirth without any medical support, which some women also choose.
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Private midwife costs:
Private midwife costs for home birth in Australia vary depending on the midwife's fee structure, your location, and your health insurance coverage.
Homebirth Australia has a list of verified private midwives, and some hospitals also offer publicly funded homebirth programs where you will be under the care of a team of hospital-based midwives.
The cost of a private home birth in Australia can range from $5,000 to $8,000, including the services of two midwives (as required by the NMBA), your pregnancy care, and postnatal care. Some private midwives may offer Medicare rebates, bringing the total cost down to about half of the Medicare scheduled fee. To be eligible for a Medicare rebate, you will need a GP referral.
Private health insurance may also cover the costs of private midwifery care, depending on your policy and care provider. It is important to check with your insurance provider to determine what services are covered.
Some additional costs to consider when planning a home birth include ambulance membership, pool hire, antenatal classes, and any other necessary equipment or services.
It is worth noting that the availability of alternative birth settings in Australia is limited, and the cost of providing birth at home from the perspective of the health system is unknown.
Before choosing a private midwife for a home birth, it is essential to ask about their fees, what their services include, and what rebates you may be eligible for. Understanding all the costs associated with a private home birth will help you make an informed decision about your care during pregnancy, birth, and postnatal period.
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Homebirth criteria:
Homebirth is a safe option for low-risk women in Australia. To be eligible for a homebirth, women must have a low-risk, healthy pregnancy and live close to a hospital in case of an emergency. The specific criteria for eligibility vary depending on the state. For instance, in Western Australia, homebirths are offered as part of a government-funded program or with a Privately Practising Midwife (PPM). In New South Wales, there are six Publicly Funded Homebirth (PFHB) programs and several PPMs. PFHB programs have strict criteria governing when women are able to continue with their plans to homebirth, so many women will not end up being able to birth at home depending on the risks that arise during their pregnancy. To determine eligibility, women should look at the hospital policies and contact the hospital directly. To determine eligibility for a homebirth with a PPM, contact the midwife. PPMs look at the Australian College of Midwives Guidelines for Consultation and Referral and decide whether they feel comfortable supporting a homebirth. Not all PPMs have the same criteria for acceptance, so it is recommended to speak to several midwives in your area.
In South Australia, it is illegal for anyone other than a registered medical practitioner or midwife to carry out a restricted birthing practice. This restriction was implemented in response to the deaths of three babies during or shortly after their birth between 2007 and 2011 due to complications experienced during planned homebirths.
The average cost of employing a PPM is between $3500 and $5500, with some private health insurers providing rebates for private antenatal and postnatal care. If a PPM is Medicare-eligible, clients can claim Medicare rebates on antenatal care. It is important to understand all the costs associated with a private homebirth, including the cost of an ambulance if you do not have ambulance cover. Private midwives' professional indemnity insurance does not cover labour and birth at home.
Midwives, including those providing homebirth services, must be registered with the Nursing and Midwifery Board of Australia (NMBA) and meet the NMBA's registration standards. To check if your midwife is registered, visit the Australian Health Practitioner Regulation Agency website.
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Freebirth:
In Australia, childbirth occurs predominantly in a biomedical context, with 97% of births occurring in hospitals. However, a small percentage of women opt for homebirths or freebirths. A freebirth is a birth that is intentionally unattended by any health professional. While homebirths are facilitated by midwives, freebirths are not.
In Western Australia and South Australia, the Health Practitioner Regulation National Law and Section 123A discuss "Restricted Birthing Practices". This legislation restricts birthing practices to registered medical practitioners or midwives to ensure the safety of the mother and child during the three stages of labour and childbirth. As such, it is an offence in South Australia for anyone other than a registered medical practitioner or midwife to carry out a restricted birthing practice.
Despite these restrictions, freebirth is not illegal in Australia. However, it is important to carefully consider the risks involved. For instance, the Birthplace study found that for first-time mothers, a planned homebirth increased the risk of serious problems for the baby from 5 in 1,000 for a hospital birth to 9 in 1,000 for a homebirth. Additionally, women who choose to freebirth should live within a certain distance of a hospital in case of emergencies.
Women who choose to freebirth should also be aware of the costs associated with private homebirths, including the cost of an ambulance if they do not have ambulance cover. While private midwives' professional indemnity insurance covers antenatal and postnatal care, it does not cover labour and birth at home.
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Frequently asked questions
Homebirth is not illegal in Australia. However, it is important to note that the availability of homebirth options differs from state to state.
There are two main ways to have a homebirth in Australia. The first is through a program linked to a public hospital, and the second is by employing a private midwife.
The average cost of employing a private midwife is between $3500 and $5500. Some private health insurers provide rebates for private antenatal and postnatal care.
Homebirth is generally considered a safe option for low-risk, healthy women with no complications during pregnancy or labour. However, it is important to understand that there may be additional risks associated with homebirth, especially for first-time mothers.
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