In short: In Australia you can have your pregnancy care through the public system (generally free with Medicare) or privately (with a private obstetrician, usually needing private health insurance that includes obstetrics). Your GP is the best place to start — they confirm your pregnancy, talk through your options, and refer you to the care that suits you. This guide explains how it all works.
How Maternity Care Works in Australia
Australia has a strong maternity system with several different "models of care" to choose from. Which one is right for you depends on your health, your preferences, your budget, and what is available where you live.
Most people start with their GP, who helps them understand the choices and arranges a referral. You do not have to decide everything at once — your GP can guide you.
Your GP and "Antenatal Shared Care"
Your GP plays an important role throughout pregnancy. Early on, they confirm the pregnancy, work out your due date, arrange your first blood tests, and discuss your options for care.
Many GPs also offer antenatal shared care. This means your routine pregnancy check-ups are shared between your local GP and the hospital maternity team, following an agreed plan. You have most of your appointments with your GP close to home, and only a smaller number of visits at the hospital — where you will also have your baby.
Shared care suits healthy, low-risk pregnancies and can be more convenient. If anything comes up that needs extra attention, your GP will refer you to specialist care.
Models of Care Explained
Here are the main pregnancy care options in Australia. Availability varies by location, so ask your GP what is offered near you.
- Public hospital antenatal clinic — care at a public hospital's clinic from a team of midwives and doctors. This is the most widely used model. You may not always see the same person at each visit.
- GP shared care — your care is shared between your local GP and the hospital, as described above.
- Midwifery group practice (caseload midwifery) — you have one primary midwife who cares for you through your pregnancy and is on call for your birth, with one or two backup midwives. This offers strong continuity of carer and suits low-risk pregnancies.
- Team midwifery — you are cared for by a small team of midwives, so you may see a few different faces.
- Private obstetrician — you choose a private specialist obstetrician who cares for you through pregnancy, birth and afterwards. This offers continuity but involves fees (see below).
- Private midwife — care from a privately practising midwife, which also involves a fee.
- Home birth — usually with a private midwife; some public hospitals offer publicly funded home-birth programs for low-risk pregnancies.
Models range from midwife-led care (for healthy, low-risk pregnancies) to obstetrician-led care (when there are medical or pregnancy-related risk factors). Your GP will help match you to the right level of care.
The Public Hospital Pathway
If you choose public care, here is broadly how it works:
- Your GP refers you to the public hospital (or to your chosen model of care), ideally early enough for a first visit before 10 weeks.
- You will have a first hospital "booking-in" appointment, usually in the first half of pregnancy, where the hospital takes over or shares your antenatal care.
- For Medicare-eligible patients, public maternity care is generally free, including the birth in a public hospital.
- A typical first pregnancy involves around 10 antenatal visits; if you have had an uncomplicated pregnancy before, it may be fewer. You will have more visits if any concerns arise.
To access Medicare-funded care you need a Medicare card. If you do not have one, Services Australia can advise on your options, and arrangements differ for some visas.
Going Private and Private Health Insurance
Choosing private care — usually a private obstetrician — gives you continuity (you generally see the same doctor throughout) and choice of your specialist and hospital. There are some important things to understand about the costs.
- You need the right insurance. To be covered for private obstetric care, you need private hospital cover that includes pregnancy and birth (obstetrics). This is typically included in higher-level (Gold) policies, and some "Silver Plus" policies add it — always check that your specific policy includes obstetrics.
- There is a 12-month waiting period. Private health funds apply a standard 12-month waiting period for pregnancy and birth. This means your cover needs to be in place before you conceive, not after you find out you are pregnant. This is one of the most commonly misunderstood parts of going private.
- Expect some out-of-pocket ("gap") costs. Even with insurance, private obstetricians and midwives usually charge fees above what Medicare and your fund pay back, so there are gap costs. You may also pay an excess for your hospital admission.
- Medicare still helps. Medicare pays a rebate towards private obstetric fees and part of a private hospital stay, but it does not cover the full gap. Your obstetrician's rooms can give you a cost estimate before you commit.
You can also choose to be treated as a private patient in a public hospital, depending on your policy.
Public vs Private: At a Glance
Both pathways provide safe, high-quality care. The main differences are:
- Cost — public care is generally free for Medicare-eligible patients; private care involves out-of-pocket gap costs even with insurance.
- Choice of carer — public care is provided by the hospital team; private care lets you choose your obstetrician and hospital.
- Continuity — with a private obstetrician or a midwifery group practice you tend to see the same carer; standard public clinic care may involve different staff at each visit.
- Waiting periods — there are none in the public system; private insurance has a 12-month obstetrics waiting period.
There is no single "best" option — the right choice depends on what matters most to you.
Costs and Medicare
- Medicare can cover some or all of the cost of doctor and midwife visits, pathology (blood) tests, ultrasounds, and birth in an approved facility.
- If a provider bulk bills, you pay nothing for that service. Not all providers bulk bill, so it is worth asking when you book.
- The Medicare Safety Net can reduce your out-of-hospital costs once you reach a yearly threshold.
- Some things are not covered by Medicare — for example, NIPT screening and the gap fees charged by private obstetricians and private midwives.
How to Decide What's Right for You
The best first step is to talk to your GP early. They can explain which models of care are available near you, help you weigh up public versus private, and make the referral once you have decided. There is no wrong choice — it is about what fits your health, your preferences and your circumstances.
How Reliance Medical Centre Can Help
Our GPs at Reliance Medical Centre in Truganina can help you navigate your pregnancy care from the start. We can:
- Confirm your pregnancy and arrange your early tests through our on-site pathology
- Talk through your antenatal care options and what is available locally
- Provide GP shared antenatal care close to home
- Refer you to your chosen public or private model of care
To discuss your options, book an appointment online or call us on (03) 9958 6699.
Frequently Asked Questions
Do I need a referral to start pregnancy care?
It is best to see your GP first. Your GP confirms your pregnancy, arranges early tests, talks through your options, and refers you to your chosen model of care — whether that is a public hospital, an obstetrician, a birth centre or a midwifery service. Some midwifery group or private practices can be contacted directly without a referral.
What is antenatal shared care?
Antenatal shared care means your routine pregnancy check-ups are shared between your local GP and the hospital maternity team under an agreed plan. You have most of your appointments with your GP close to home and a smaller number at the hospital, where you will have your baby. It suits healthy, low-risk pregnancies.
Is public hospital maternity care free in Australia?
For Medicare-eligible patients, public maternity care — including antenatal visits and birth in a public hospital — is generally free. You need a Medicare card to access Medicare-funded care; Services Australia can advise if you do not have one or are on a visa.
What does private health insurance cover for pregnancy and birth?
To be covered for private obstetric care you need private hospital cover that specifically includes pregnancy and birth (obstetrics). This is usually part of higher-level (Gold) policies, with some Silver Plus policies adding it. Even with cover, there are usually out-of-pocket gap costs, so check your policy details carefully.
When do I need to take out private health insurance for pregnancy?
Private health funds apply a 12-month waiting period for pregnancy and birth, so your cover needs to be in place before you conceive — not after you find out you are pregnant. If having a private obstetrician is important to you, it is worth planning your insurance well ahead.
What's the difference between public and private pregnancy care?
The main differences are cost, choice and continuity. Public care is generally free for Medicare-eligible patients but you are cared for by the hospital team. Private care lets you choose your obstetrician and hospital and usually see the same carer throughout, but it involves out-of-pocket gap costs and requires suitable insurance. Both provide safe, high-quality care.
Does Medicare cover pregnancy ultrasounds and blood tests?
Medicare covers many pregnancy blood tests and ultrasounds, and some providers bulk bill. A few items are not covered — for example, NIPT screening and the gap fees of private obstetricians and midwives. Your GP can explain what to expect for your situation.
Trusted Sources for Further Reading
- Pregnancy, Birth and Baby (Healthdirect) — Maternity models of care and Public vs private care in pregnancy
- Pregnancy, Birth and Baby — Private health insurance and pregnancy and Medicare during pregnancy
- privatehealth.gov.au — Waiting periods and Product tiers
- Services Australia — Medicare services for pregnancy and birth
This article is for general information only and does not replace professional medical advice. Insurance cover, costs and the care options available vary between funds, hospitals and locations, and can change over time — always check current details with your GP, your health fund and your chosen hospital.
