This groundbreaking Australian study has confirmed what many have long feared: the current model of public maternity care not only delivers poorer outcomes for women and babies—it also costs the health system significantly more.

 

Published on 15 July 2025 in the British Journal of Obstetrics and Gynaecology, the study by Professor Emily Callander and colleagues compared more than 368,000 matched low-risk births across Queensland, New South Wales and Victoria between 2016 and 2019. It found alarming disparities between standard public care and private obstetric-led continuity care.

 

The Key Findings Are Stark:

• Stillbirth and neonatal death occurred 2.2 times more often in the public system.
• Severe perineal trauma was 3.4 times higher.
• Maternal haemorrhage occurred 2.2 times more frequently.
• NICU admissions were 3.4 times more common.
• Babies born in public care were 4.8 times more likely to experience oxygen deprivation.
• The total health system cost per birth was $5,900 higher in the public sector.

 

These results send a clear message; reducing womens access to continuous, specialist-led care is not only potentially harmful—it’s economically i

rresponsible.

 

President A/Prof Gino Pecoraro says the findings confirm what doctors and women have long known:

 

“Continuity of care with an experienced obstetrician saves lives and prevents trauma. It’s efficient, it’s safe and must remain an option for Australian families.”

 

The data is clear. Policies that restrict women’s access to obstetric-led care are not just inefficient—they're dangerous. The study concludes:

 

“These large differences in outcomes are unlikely to be clinically acceptable… Policies which limit women’s access to obstetric-led continuity models of care are likely to have major negative consequences for population health and budget impact.”

 

The Federal Government must act now to:

• Reform Medicare to support and sustain private antenatal care.
• Fix private health insurance by including maternity in risk equalisation.
• Incentivise collaborative care models where every woman has access to continuity of care with a known obstetrician.

 

As A/Prof Pecoraro says:

 

“This is not about ideology. It’s about data, lives and delivering the best possible care to Australian women and babies. We now have the evidence—there is no excuse for inaction.”