Page 3801 - Week 11 - Thursday, 24 November 2022

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across the two. What we really want to be looking at is costs across the whole of pregnancy, birth and post-birth care and that will be so variable between different women. What I can also say is there was a population-based study from New South Wales published in 2021 by Scarf et al that calculated the overall costs of a place of birth. I have run out of time. I can give you some more information in the supplementary. (Time expired.)

MS CLAY: Minister, what plans does the government have to expand midwife led continuity of care so that 100 per cent of Canberra women can access this?

MS STEPHEN-SMITH: I will come to that specific question. Just to finish the point around the Scarf et al study, it calculated the overall costs of a place of birth from Australian Refined Diagnosis Related Group, so AR-DRGs, of almost 500,000 women between 2000 and 2012. This revealed the overall costs of a birth centre birth was just under $5,000 versus just over $5,400 or almost $5,500 for a hospital birth. So overall, on that large population-based study the information is accurate around the cost of birth centre births. One of the other things that was indicated is at that national level is that there are not that many of these birth centre options. The ACT has this capability and is continuing to expand continuity of care.

Continuity of care by a known midwife provides support during the antenatal, intrapartum and postpartum periods. The model is supported by a multi-disciplinary team to ensure a woman or pregnant person’s care needs are met. The ACT provides whole-of-duration maternity period continuity in 38.1 per cent of pregnancies, which is the third highest in the country and above the national average of 31 per cent. Our Maternity in Focus strategy commits us to having more than 50 per cent of women and pregnant people having access to this model of care by 2028.

MR DAVIS: Minster, do we know how much money the ACT government would stand to save long term if midwife-led continuity of care was available to all Canberra mothers?

MS STEPHEN-SMITH: It is important to recognise that mothers-to-be, parents-to-be and pregnant people need to have the option of choice that will suit them, including GP shared care, if that is what makes sense for them. We are committed to expanding the continuity of care models. Those become more expensive as the pregnancy is more complex. So when you start talking about all the pregnant people have access to continuing of care, you are going to start seeing an increase in cost in that continuity model because you are going to start expanding that to more complex pregnancies. It will not be an apples-to-apples comparison with the pregnant people who currently access continuity versus all pregnancies. But it is important, having said that, that we continue to expand access to continuity models to people who have more complex pregnancies. That is exactly what the CatCH program does, formerly called the Continuity of Care (All Risk) program. It is suitable for all women and pregnant people including those complex and high risk pregnancies wanting care from a known primary midwife. It is a very important model of care in our system and, as part of the expansion of continuity, we would certainly like to see that expanded as well, in addition to our commitment to expand home birth.


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