Pregnant mothers are having to pay too many out-of-pocket costs for antenatal appointments making them out of reach for some, the peak body representing Australian GPs says.
The Royal Australian College of General Practitioners (RACGP) is calling on the Federal Government to raise the Medicare rebate for antenatal appointments with GPs.
While many pregnant women have their antenatal appointments at a public hospital through a midwifery clinic, or privately through an obstetrician, general practitioners can provide this service through what is known as shared care.
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In a letter to Health Minister Greg Hunt, RACGP President Dr Karen Price said antenatal care in general practice plays an important role, particularly in remote or rural areas where there is a lack of other specialists available.
"Many expectant mothers also prefer to see their usual GP for antenatal care because they know and trust them and want their support during what can be an uncertain and anxious time," Dr Price said.
Dr Price said there was a consensus among GPs that antenatal care was growing more complex, but the Medicare items – which pay $41.70 regardless of the duration of the appointment – did not reflect this.
"Antenatal consultations today involve extensive monitoring of health problems and potential complications, such as diabetes and anaemia," she said.
"GPs also provide advice on nutrition and physical activity and help prepare the new mother for childbirth and breastfeeding."
GPs often needed far longer than 20 minutes for an antenatal appointment, she said.
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"This is particularly true for vulnerable and disadvantaged patient groups, such as those in rural and remote communities, Aboriginal and Torres Strait Islander patients and culturally and linguistically diverse patients," she said.
The RACGP is calling for the government to amend level C and D Medicare Benefits Schedule general attendance items, which are for longer GP consultations, so that GPs can use them for some antenatal appointments.
Single mother Bonnie McBeath said she is now an avid advocate for shared care after it got her through her tumultuous first pregnancy during the pandemic in 2020.
Ms McBeath was living in Busselton, Western Australia when she fell pregnant with her now 16-month-old daughter.
She would have had to travel two-and-a-half hours to Perth for her antenatal appointments in the public health system, if she did not choose shared care.
"I also desperately wanted continuity of care and my GP was somebody that I was familiar with, he was my family GP," she said.
When Ms McBeath was 30 weeks' pregnant, she moved interstate to Ballarat in Victoria, where she continued pregnancy appointments with a GP.
It meant she could see the same doctor, who still looks after her and her baby daughter now.
Ms McBeath said amidst moving states and going through her first pregnancy during the pandemic, the support provided by her GP was a godsend.
"Even though they're not there for births, I guess there's no other model of care that offers anything really like it, and I'm a huge advocate for it," she said.
The care did come with many out-of-pocket costs, however, with her pregnancy appointments costing far more than the standard general appointment, Ms McBeath said.
Ms McBeath said she was fortunate that she could afford to pay, but felt it should be a service available to every pregnant woman.
"I would love to be able to see it available to all women with no out-of-pocket expenses," she said.
A spokesperson for the Department of Health said in a statement: "The department has already had preliminary discussions with representatives of the RACGP on this matter, and will continue to work with them.
"Expectant mothers have a multitude of options available to receive antenatal assistance in Australia, including and in addition to the GP network," the spokesperson said.
"They can receive antenatal, birthing and postnatal care through the public health system, privately, or through a combination of public and private services under shared care arrangements. Care can be provided by midwives, GPs, GP obstetricians and specialist obstetricians."
In the latest Federal Budget, $1.2 million was provided to support the development of collaborative care models for maternity services in rural and regional areas and to address lower access to maternity services compared with metropolitan locations, the spokesperson said.
