Women and Babies at Greater Risk – and It Costs More: NASOG’s Longstanding Warnings Now Backed by National Study

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

Recently published 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: denying women access to continuous, specialist-led care is not only harmful—it’s economically irresponsible.

NASOG Has Been Warning of This for Years

NASOG has led advocacy in this space through:

• Direct submissions to the Health Minister and Department with economic modelling and funding reform proposals.

• Public campaigns calling for urgent Medicare reform to support private antenatal care.

• The Private Obstetric Alliance Forum and the Australian Birth Forum, uniting doctors, researchers, policymakers and women to highlight these very issues.

• Ongoing lobbying for inclusion of obstetrics in the Risk Equalisation Pool to eliminate gendered funding discrimination in private health insurance.

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

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

It’s Time for Action, Not Excuses

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

Read the full study here: BJOG: Callander et al. 2025

Help NASOG advocate for better care! Renew your membership or join HERE