The role of midwives is critical for the successful birth of any baby, but how those duties are performed can be impacted by whether labour takes place in a private or public hospital.

According to senior midwife, Claire McAteer, there are pros and cons to both, but the experience itself is quite different.

At public hospitals, midwives generally see women through their entire antenatal period, with an obstetrician’s input at pivotal times.

“Midwives can assist a woman through a normal intrapartum period, assisting with delivery,” said McAteer.

“Obstetricians are available when labour is not going according to plan.”

In public hospitals, women have the option of midwifery led care which enables continuity, she said.  

“As long as everything is well throughout the antenatal period, women have the option of birthing at home or a midwifery led unit.

“When care needs to escalate the woman will then be transferred to hospital.”

In private hospitals, women have their nominated obstetrician, allowing them continuity of care, though not with a midwife.

“Obstetricians quite often have their own midwives working in their rooms so women also have that midwifery input.

“Women are cared for and assisted through labour by midwives and generally keep the Obstetrician updated on events.”

Ultimately, though, the Obstetrician is responsible for their care and will go on to assist the woman in delivering when the time arrives. 

“Of course babies don’t arrive with an appointment time and midwives may well assist delivery if the OB does not make it.”

Although midwives in the public sector are more able to utilise their midwifery skills, private midwives are utilising those skills more and more, said McAteer.

“Whilst midwives in both the public and the private sector are tasked with providing care to women, especially during labour and birth, there are still some differences for us between the two models,” she said.

“The public sector tends to have a significantly more diverse patient population, which includes women from all socioeconomic groups. In addition, our public system is incredibly overrun with massive birth volumes, which comes with its own set
of challenges.

“It is not uncommon at all for one midwife to be managing the labour and delivery of several women at one time in the public sector.”

In the private sector, due to a smaller patient cohort, shifts are likely to be less hectic, meaning midwives may have more time to provide personalised care.

“And I'm only ever looking after one woman at any one time on the labour ward.”

While salary is similar in both private and public, McAteer works as an agency midwife in both, where rates vary.

Recently, the Victorian State Government came to an agreement with Victorian public sector nurses and midwives for a 28.4 per cent wage increase by November 2027.

Private sector enterprise bargaining agreements are also due for an update, said McAteer.

“So it is imperative that we get the negotiations right, so that we do not see a large number of nursing staff leave the private sector for the public sector on the basis of pay alone. Similarly, we need to ensure that the system remains sustainable for all involved.”