Women Deserve Better: Play Your Part in Maternity System Reform

As Women’s Health Week 2025 draws to a close one crucial area has been absent from the media coverage and events, and that is the need to relieve the pressure on Australia’s maternity system.

Birth numbers are falling in the private sector, public hospitals are stretched and policy debates too often prioritise cost-cutting and access over safety. Yet the evidence is crystal clear: continuity of care with a specialist obstetrician delivers safer outcomes, better value and genuine choice for women.

The recent Callander Report—a study of more than 360,000 births—showed that private obstetric-led care halved rates of stillbirths and neonatal deaths compared with public standard care, and significantly reduced NICU admissions, haemorrhage and severe perineal trauma.

Adverse outcomes are not abstract numbers. Birth trauma drives long-term mental ill-health, loss of workforce participation, higher NDIS demand and ongoing family strain. More than half of women diagnosed with a birth injury report suicidal ideation within a year. Investing in escalation-ready, team-based maternity care is not only safer for women and babies, it will also protect national productivity and family wellbeing.

 Importantly, it also revealed that public care costs nearly $6,000 more per birth. If private capacity collapses, taxpayers would face an additional $1.77 billion in costs every year.

The Reform Agenda

NASOG has outlined three critical reforms that can restore balance and sustainability:

Risk Equalisation Reform

Private health insurance must share maternity costs fairly across the system. Including O&G in the risk equalisation pool will stabilise premiums, protect maternity-inclusive policies and stop penalising funds with younger members.

NASOG Vice President, Dr Elizabeth Jackson, initiated a Parliamentary e-Petition, EN7227, to request the inclusion of O&G in the risk equalisation pool. The petition was presented to the House of Representatives on 25 August 2025 and has been referred to Minister Butler for response within 90 days.

A Private Efficient Price (PEP)

Private hospitals need predictable, casemix-based funding to keep maternity units viable. A PEP, modelled on the National Efficient Price in public hospitals, would create a fair floor for maternity funding, helping prevent further closures of private units across the country.

Review of MBS Item Numbers

Medicare rebates for obstetric services have not kept pace with costs or indemnity pressures. Updating items like 16500, 16519, 16522 and 16407 will better reflect the complexity of care, improve affordability for families and ensure continuity with a trusted doctor remains viable.

These reforms are not ideological. They are about evidence, fairness and ensuring Australia does not repeat mistakes seen overseas when escalation pathways were under-resourced. Integrated, team-based care with obstetricians at the centre of escalation is the only defensible approach.

Be Part of the Reform for the Future

Advancing this agenda requires a strong, unified voice. NASOG is the only national organisation dedicated solely to representing specialist obstetricians and gynaecologists in both public and private practice.

We are already engaging with government, insurers and regulators.

A key next step is to seek ACCC Authorisation to convene member consultations on fees and rebates so we can present constructive proposals with full professional backing.

But to influence reform at the scale required, we need the strength of numbers. With more members, our voice is louder, our mandate stronger, and our ability to secure reforms greater.

If you believe women deserve genuine choice… If you believe continuity of care with a specialist must remain accessible… If you believe private obstetric practice must survive for the next generation—then we need you with us.

Membership of NASOG is more than an annual subscription. It is a commitment to your patients, your colleagues and the future of our profession.

Help us help you. Help us help Australian women. Join NASOG today.

Become a NASOG Member