Pregnancy After Loss
Choosing your Model of Care
Your model of care is simply who you choose to be your care provider during your pregnancy, birth and post-partum + where you choose to birth.
There is absolutely no "one size fits all" when it comes to model of care choice for Halo Mumma's- every woman will have different preferences, values and needs. The key is to choose the right model of care for you- so you can feel supported, listened to and safe throughout your pregnancy after loss, birth and postpartum period.
The following information explains the differences, statistics, pro's and con's of each model so you can make an informed decision as to which is best suited to you and your situation.
Your model of care is simply who you choose to be your care provider during your pregnancy, birth and post-partum and where you choose to birth.
Choosing the right model of care for you during your pregnancy after loss is essential and it is something you need to start thinking about before you get pregnant (especially if you want to choose a model that requires private health).
As a Halo Mumma you’re probably thinking “My number 1 goal is just to bring my baby home- which option is most likely to give me a healthy live baby at the end of this!?”
Well... there is actually significant statistical differences in the likelihood of pregnancy/baby loss, neonatal death, health of the mother AND birth trauma directly associated with which model you choose!
Read on to find out more.
^ the moment I pulled my rainbow baby up onto my chest will forever bring me happy tears! I strongly believe that choosing the right model of care for ME was a key part in my positive experience.
Continuity of Care is Key
Continuity of care means to have the same person looking after you throughout your entire pregnancy, birth and post-partum.
For Halo Mummas in particular, continuity of care has more than just health benefits!
Continuity of care throughout pregnancy after loss allows you to establish a relationship with your care provider who will get to know your loss story and be able to tailor their care to you with your angel baby and loss history being considered at every stage. You won’t have to re-tell your story over and over again to random strangers you’ve just met and will likely never see again.
To see which models offer continuity of care- see the table below. If you're unable to access continuity of care during your pregnancy after loss, services such as a doula may be a good option to bridge that gap if this is financially an option for you.
Midwife Continuity of Care is the Gold Standard
Research shows that continuity of care with a midwife has the best outcomes for both mum and baby including significantly lower levels of birth related trauma (which is a huge win for Halo Mummas' because let's face it... we've had enough trauma thanks.)
Midwife continuity of care models include public midwifery programs (often referred to as "MGP" Midwifery Group Practice) and Private midwife care.
Unfortunately, midwife continuity is only accessible by approximately 10% of Australian women due to high demand and limited services.
For information on how to give yourself the best chance of accessing these services see the table below!
Benefits of Midwife Continuity of Care as demonstrated by research:
-Babies are more likely to be born healthy and at term
-Lower rates of stillbirth
-Women are more likely to have a normal physiological birth,
-Women are less likely to experience unnecessary intervention (Caesarean section rate has risen from 32% in 2010 to 37% in 2020)
-Women are more likely to have a positive experience of labour and birth and to be satisfied with the experience
-Women are more likely to breastfeed successfully
- The Australian College of Midwives
Let’s have a look at your options:
In Australia, there is generally 5 different models of care to choose from...
Public Standard Care
Public Midwifery Program
GP Shared Care
Private Obstetrician
Private Midwife
The following table details the 5 models of care to choose from within Australia.
Model of care | Brief Description | Continuity of care? | Cost | Place of birth | Pro's | Cons |
|---|---|---|---|---|---|---|
Public Standard Care | This option will have you cared for by both Midwives and Obstetricians throughout your pregnancy and birth in a public hospital. The staff you see will be random depending on who is on shift that day and you may not see the same person more than once. | No | Free- publicly funded | Public Hospital | Low cost | - No continuity of care. - May not have a private room if birthing in a public hospital. - No choice in care provider (staff randomly allocated to you). |
Public Midwifery Program | (Commonly known as an “MGP” program). This option will have you cared by a small team of midwife’s throughout your pregnancy, with one being allocated as your primary midwife. You will mostly be cared for by the primary midwife unless she is sick or on a day off- then you will see one of the others in that team. Your primary midwife will then be on call for you labour and birth. This is usually a hard program to get into due to high demand and limited spaces so ask your GP for a referral as soon as you know you’re pregnant (some GP’s will say you have to wait until 12 weeks but this is not usually the case and they’ll accept referrals prior to this so push and advocate for that early referral !) | Yes | Free- publicly funded | Public hospital. Some areas have the option for birth center's and home births too. | - Low cost - Continuity of care with a midwife - Best outcomes in terms of health of mother and baby as shown by research - May have the option for a specialised "bereavement" midwife service- someone trained in working with mums post loss | - May not have a private room if birthing in a public hospital. - Difficult to get into.. advocate for an early referral! - No choice in Midwife (midwife randomly allocated) - Not available in all areas |
GP Shared Care | This option will have you cared for throughout your pregnancy by your GP for all standard appointments. You will then birth in a public hospital with whichever midwife/ obstetrician is on shift that day. | During pregnancy- Yes. For labor/ birth- No | Free- Publicly funded. | Public Hospital | - Ease and flexibility of booking pregnancy appointments as done via GP. - Continuity of care throughout pregnancy with your GP. | - No regular contact with a midwife - No continuity of care for labour/ birth |
Private Obstetrician | This will involve being cared for by an Obstetrician throughout your pregnancy and this obstetrician will then be on call for your birth. | Yes | Average out of pocket costs= $5000 + health insurance costs. | Private hospital. | - Continuity of care - Choice of obstetrician - Guaranteed private room - May be beneficial to some who need extra reassurance scans to manage anxiety or want/ need the medical care of a doctor instead of a midwife for whatever reason. | - High cost - Statistically more likely to have instrumental birth or cesarian section compared to all other models - Need to have private health insurance OR pay very high out of pocket costs |
Private Midwife | This option will have you cared for by a private midwife throughout your pregnancy who will then be on call for your birth. There are options for hospital birth, home birth, and post-partum care up to 6 weeks. | Yes | Between $1500- $5000 depending on what services are chosen | Public hospital, private hospital, home birth, birth center. | - Continuity of care - Best outcomes in terms of health of mother and baby as shown by research - Appointments available in your own home - Choice of midwife - Option for home birth - No private health insurance required | - High Cost - High demand, need to book in early |
* I want to acknowledge that these services are not available in every area and some women don't get much choice on their model of care due to the area they live in and/or their financial situation. To those women I want to say... You can do this (and have a great experience) no matter which model of care you're in- educate yourself and become your own biggest advocate for yourself and your rainbow baby. Surround yourself with the support of an amazing birth partner/ birth support people. You are enough and your babies (all of them) are lucky to have you as a mum.
I hope this guide helps you choose the option that is most likely to give you the rainbow baby pregnancy and birth of your dreams- one you’ll look back on with happy tears for the rest of your life… because you are deserving of all the happiness and blessings this rainbow is going to bring.
