Observational studyBJOG : an international journal of obstetrics and gynaecology2026
Maternal and Neonatal Outcomes and Health System Costs in Standard Public Maternity Care Compared to Private Obstetric-Led Care: A Population-Level Matched Cohort Study.
Observational study in BJOG : an international journal of obstetrics and gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Comparing Costs to the Public Healthcare System Between Induction of Labor and Expectant Management, Stratified by Parity and Gestation: An Australian Population-Based, Retrospective Cohort Study.Birth (Berkeley, Calif.) · 2026Article
- Critical care utilisation, and outcomes of critically ill obstetric patients in India: a multicentre ICU registry study (2019-2024).The Lancet regional health. Southeast Asia · 2026Article
- The Monash learning health system maturity matrix: codesign of a tool to measure and guide improvement in complex health system behaviour.BMC health services research · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveWe aimed to compare health outcomes and costs in standard public maternity care compared to private obstetric-led maternity care.
designObservational study with linked administrative data.
settingAustralian maternity care. POPULATION: 867 334 births, covering all births in three states of Australia between 2016 and 2019.
methodsStandard public care involved mainly fragmented midwifery, obstetric and General Practitioner provider care, with birth in a public hospital. Private obstetric-led care was led by a personally selected obstetrician, with midwifery involvement and birth in a private hospital. We analysed outcomes from pregnancy onset to 4 weeks post-birth. Matching was utilised to account for demographic, socio-economic and clinical characteristics.
main outcome measuresStillbirths or neonatal deaths; neonatal intensive care admissions; APGAR score < 7 at 5 min; 3rd or 4th degree perineal tears; maternal haemorrhages; mean cost per pregnancy episode.
resultsHigher adverse outcomes in standard public maternity care compared to private obstetric-led care, including 778 more stillbirths or neonatal deaths (OR 2.0, 95% CI: 1.8-2.1), 2747 more APGAR score < 7 at 5 min (OR 2.0, 95% CI: 2.0-2.1), 3273 more 3rd or 4th degree perineal tears (OR 2.9, 95% CI: 2.7-3.1) and 10 627 additional maternal haemorrhages (OR 2.7, 95% CI: 2.6-2.8). Mode of birth correlated with neonatal death. Mean cost to all funders in Australian dollars per pregnancy episode was $5929 higher in standard public maternity care.
conclusionWe have shown significantly lower adverse health outcomes and costs in private obstetric-led care compared to standard public maternity care.
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