The collapse of private maternity would be a public health disaster

By Dr Katharine Bassett

In Australia today, giving birth in a private hospital is fast becoming a luxury rather than a choice. Since 2018, 18 private maternity units have closed their doors — 13 of them in just the past three years. That’s not just a statistic. That’s thousands of women left with fewer options and growing uncertainty at one of the most critical moments of their lives.

This crisis is not creeping. It’s galloping. Across Australia the closure of private maternity services is accelerating.

These closures are the result of a perfect storm: soaring out-of-pocket costs, fewer people with private obstetric cover, an outdated funding model, and a national workforce crisis.

For many women, private maternity services are now either unaffordable or unavailable.

Some women face out-of-pocket costs exceeding $12,000 — even after paying for top-tier Gold private health insurance, which comes with a hefty premium and a 12-month waiting period. But let’s be clear: the biggest expenses aren’t from the hospital stay. They accumulate well before birth, in the obstetrician’s rooms. A pregnancy management fee alone can top $5,000, with Medicare often covering less than $350. Add routine prenatal and postnatal appointments, and it’s easy to see why many women with Gold cover are now opting for the public system instead.

Many private hospitals simply aren’t seeing enough births to stay viable. On top of that, shortages of obstetricians, anaesthetists, paediatricians, and midwives mean that many maternity wards don’t have the right team available, and so they can’t keep their doors open.

Private hospitals have historically delivered one in five babies in Australia. When those services collapse, the burden falls squarely on public hospitals which are already grappling with staff shortages, waitlists, and stretched budgets. At the same time, women lose choice, control, and continuity of care — especially in regional and rural areas where alternatives are few and far between.

This is not just a private problem — it’s a public health disaster in the making.

It doesn’t have to be this way.

First, private health insurers must be allowed to fund the full maternity journey — not just the hospital episode, but prenatal check-ups, postnatal care, and everything in between. Families pay for insurance expecting it will cover their pregnancy. It’s time the system caught up with that expectation.

We’re also calling for smarter, more flexible workforce solutions. Let midwives do what they’re trained to do — take the lead in antenatal and postnatal care — so obstetricians can focus on complex cases. At the same time, we need to confront the root causes of our workforce shortages. That starts with establishing a national health workforce planning body — one with the authority to monitor trends, respond to emerging gaps, and ensure we have the right people in the right places, now and into the future.

Finally, we need a new funding model — a national private price — that ensures private hospitals are paid fairly and consistently for the care they provide. The current patchwork of funding arrangements is putting patient access and hospital viability at risk.

This isn’t just about private care. It’s about preserving choice for women. It’s about relieving pressure on public hospitals. And it’s about ensuring that no family — no matter where they live or how they choose to give birth — is left without safe, accessible, high-quality maternity care.

The clock is ticking. Let’s not wait until the lights go out in the last private maternity ward.