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When Sarah and her husband took the first steps towards growing their family, they did everything right. They looked at their lifestyle, their mental and physical health, and increased their level of private health cover to include pregnancy and birth. They had no reason to think it wouldn’t be smooth sailing. But life is full of twists, and they hadn’t realised they were preparing for the unexpected.

To Sarah’s surprise, a combination of factors meant she wasn’t able to conceive on her own. Her plan to fall pregnant naturally would have to take a detour. The upgraded hospital cover she and her husband had chosen also included assisted reproductive services, which helped them access the treatments they needed.

“We went down a different fertility path of ovulation induction, which is less invasive,” she says. “When that was unsuccessful, we went down the IVF path.”

Certain private hospital cover can include fertility and assisted reproduction treatments performed in a hospital, such as egg retrieval and transfer. With Medicare benefits available on many outpatient services, the combination may reduce the financial burden of making a family a possibility.

Following IVF, Sarah and her husband were overjoyed to welcome their new daughter. But the process had been long and challenging, and Sarah realised she needed extra support. Having extras cover also helped her access services to assist with her recovery from pregnancy.

“I saw a psychologist,” she says. “Having a portion of that cost covered by my private health insurance meant that I was happy to go in and do it. It meant that I didn’t hesitate.”

Sarah’s story is increasingly common. Dr Stuart Prosser, an obstetrician and co-founder of One for Women, helps many patients on their journeys. He encourages them to start planning well in advance, to give themselves a better chance of conceiving and having healthy pregnancies.

“It’s about making sure that your health is in the best shape possible,” he says. That means making sure any medical conditions are well managed and that you’re living a healthy lifestyle. “Avoiding alcohol, eating a healthy diet, taking folate and exercising regularly are important considerations.”

Prosser recommends would-be parents start planning at least 12 months in advance – and says we should be starting conversations about parenthood as early as possible. “As soon as you’re thinking about trying to have a baby,” he says, “coming to have a pre-conception chat is a really good idea.”

Many people assume they’re going to get pregnant right away, but the likelihood is much lower than we may realise, Prosser says. In some cases, as in Sarah’s, intervention may be required. “Your chances of falling pregnant are somewhere between 10 and 15% per monthly cycle,” he says. “If you haven’t fallen pregnant in about six months, then maybe we should look a little bit closer at what’s going on.”

It’s a good idea to check your private health cover before you start out and make sure you have the right cover for your needs. Pippa Grant, head of health services at HBF, suggests future parents be clear about balancing their needs and budgets to get the right pregnancy and birth care. Like Sarah and Prosser, she emphasises the importance of planning ahead.

“Australia is fortunate to have a really good blended system of both public and private healthcare,” she says. “Ultimately, it comes down to your individual choice, preferences and your priorities, amongst other factors to consider. If you choose to have your baby in a private hospital, you can choose your obstetrician, meaning you’re more likely to have continuity of care with your pregnancy support team – all going to plan, you will have the same midwife and the same obstetrician throughout the pregnancy and birth.”

In Australia, all health funds require policyholders to have held hospital cover that includes pregnancy and birth for at least 12 months before they can claim for treatment related to this. Grant recommends also checking your policy for assisted reproductive services coverage.

“We recommend planning in advance and making sure you understand what’s included on your cover and any applicable waiting periods. If you’re not sure about those details, you might call a contact centre or pop in to a branch, just to make sure that the policy cover that you’re on is going to cover you adequately.”

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