The Cost of Having a Baby in Australia
Sharing my birth story quickly became one of my favorite conversations. I was fortunate: things went well and we were able to welcome our son into the world with relative ease and efficiency. One matter that never arises for discussion, however, is the cost of bringing our baby home — and that’s for a very good reason. Thanks to Australia’s public health system, I was able to walk into the hospital on a Saturday morning and back out (more slowly, less roundly, and accompanied by a small baby) on a Monday afternoon, all for the low, low cost of practically nothing.
Here’s a look at the costs we incurred throughout my pregnancy, as well as a brief introduction to Medicare, Australia’s public health system. All prices are in AUD (currently AUD$1 = ~USD$0.71).
Doctor visits: $90
As soon as I found out I was pregnant, I called to get on the waiting list for the birth center program offered by one of our hospitals. Seeing as the birth was still approximately nine months away, I think I ended up first on the list. However, midwife visits don’t start until about 16 weeks, so I saw my GP a couple of times in the first few months at about $45 out of pocket per visit (after a Medicare rebate of $37).
Midwifery and hospital appointments: $0 (or maybe $15 for snacks)
From around 16 weeks, I saw my assigned midwife. The program focussed on continuity of care, with support from the same person throughout the pregnancy, labor, and birth. Initially the appointments, which with few exceptions occurred in the comfort of our home, were every four weeks, moving closer together as I approached my due date. All in all, we had maybe eight or so appointments, including an appointment with the birth centre’s obstetrician.
The program also offered new parent classes for its participants. Every Thursday for four weeks we attended a small group, run by one of the midwives, learning about natural birth, medical birth, breastfeeding, and — viewed most important from my husband’s perspective — how to parent a human child. (They did not call it that.) Participants were each assigned a night to bring snacks, as the class ran for a few hours through dinner time. I baked brownies and brought sliced vegetables and hummus for our week, and in the last week thought longingly of the hospital vending machines when all the assigned snack-bringers forgot their duties.
As time progressed, I asked my midwife for suggestions on how to help establish labor naturally. After a hike up a small mountain failed to do anything, I tried out acupuncture. While I can’t say that it was as effective as, say, a medical induction (see below), at $130 for an initial consultation plus $90 each for three follow-up visits, it was a not inexpensive way to relax, think about my body and the journey ahead, and focus on my baby (he loved the experience and did a dance each time we went). I believe I can claim this on my health insurance for a partial rebate and, spurred on by this article, have eventually gotten around to doing so.
TENS machine rental: $140
My friend used a TENS machine during her labor and highly recommended it as a form of pain relief. Small machines suitable for labor were available for hire at our local pharmacy for $114 for a week, plus $25 for lead wires and pads. I honestly can’t remember if the $114 was partially refundable upon return of the unit (which my husband attended to in the newborn haze of our first week home) and this may also be a cost claimable on our insurance, should we find the receipt. Regardless of refund or rebate, this was a helpful expenditure that I would pay again.
Food during first day at hospital: $24
We went into hospital for an induction on a Saturday morning. My midwife started things off and recommended that we go on long walks to really get things going. As the hospital only required us to be there every six hours for monitoring, we spent the day walking around the surrounding suburbs. At some point, we stopped at a café (I assume around $20 for hot chips, a coffee and an iced chocolate — my husband paid so I don’t have exact figures) and later that afternoon I bought a couple of bags of chips for us to take back to the hospital, $4. I can’t recall getting dinner that night, so this was clearly a necessary expense.
Here’s where you might imagine the big costs arise — an induction, the birth, and the ensuing overnight stay. While the hospital expected me to “rest overnight” in the ward following the induction, the baby had other ideas. Without my midwife or husband (who had each gone home, also to rest), I gladly accepted whatever pain relief offered by the attending nurses — first panadeine, then morphine, and finally gas (none of which seemed to have any significant impact). By the time everyone had rushed back to the hospital a couple of hours later, we were ready to have a baby!
We ended up with two midwives, a nurse and some doctors in the room when we met our son. Several hours and some paperwork later, we were transferred to the postnatal ward, where we snatched both some toast for breakfast and a little rest. We stayed that night, receiving ongoing monitoring and support, and were discharged the next afternoon.
While we did receive a thermometer and a baby book upon discharge, we were not presented with a bill for our stay, and nor will we be. The only requirement was for me to provide my Medicare card, and the system took care of the rest.
Here’s where it gets slightly more complicated. As holders of “top extras” health insurance, we had the option to go through the private system. Although our insurance would cover a lot of the (higher) costs of seeing a private obstetrician, it would also result in a “gap” payment, payable by us. Anecdotal evidence from friends estimated this gap payment to be approximately $3,000 or so. While we didn’t choose this route, we have maintained our full insurance coverage, paying a smidge over $300 per month for the two of us (now slightly elevated to cover the three of us).
Australia has policies in place to encourage adults to maintain at least private hospital insurance (with various tax repercussions for failing to do so — the idea being that private hospital coverage will help ease the burden on the public system), but we could drop our insurance to a more basic package, particularly if we do not utilise it for things such as childbirth. However, I like the extras covered (including free glasses and two dental check-ups and cleaning) and the flexibility to go private in the future, should the need arise (and not just for childbirth, but for other procedures that could have longer wait times in the public system) — so this is a cost we would have incurred anyway.
Additionally, as I’m sure someone will point out, I do contribute to the public health system through paying taxes. In my tax bracket, I pay taxes of $20,797 plus 37 cents per dollar earned over $90,000, plus a Medicare levy surcharge. Of course, these taxes are used for far more than just healthcare — including for social services, such as the 18 weeks paid parental leave I was able to receive from the government. Overall, I much prefer a system where my costs (taxes) are known and medical costs are transparent, rather than one where my straightforward hospital stay could have resulted in a five-figure bill.
Laura Boekel has since realized that the cost of having a child in Australia (or, likely, anywhere) also includes many, many hours of sleep. She still considers it worth it.
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