A steep decline in patient numbers is being blamed for the closure of the only private maternity ward on the New South Wales Central Coast.
Gosford Private Hospital, run by Healthecare, will end birth services on March 31, 2025, leaving the public facility in Gosford as the only birthing hospital available in the region.
It cited a 40 per cent drop in patient numbers over a 10-year period as the reason behind the shock decision, which comes as Australia's birth rate hits "rock bottom".
Central Coast obstetrician and gynaecologist Peta Skilbeck said the impact on her clinic and patients was "heartbreaking".
"It's an absolute blow to women's health care," she said.
"It's stripped women of their birthing plan on who and where they would be delivering their baby.
"[They] deserve the right to private maternity care, but now there's no choice."
Dr Skilbeck said Sydney Adventist Hospital in Wahroonga and Newcastle Private Hospital could be options, but were not suitable for all patients.
"Nobody wants to be on the [motorway] giving birth in the back of a car," she said.
Chantelle Vincent was booked in to give birth at Gosford Private Hospital in April and is now uncertain where she will deliver.
"I've had to postpone [my first appointment] because we don't know if I'm going to be able to use our preferred obstetrician," Ms Vincent said.
"Giving birth is the hardest thing you're ever going to do. You want it to be the best experience you can have, and I really had that experience at Gosford Private [with my first pregnancy].
"To have that choice taken away from me is absolutely devastating."
Impact on the public system
Bianca Gorgiolione is due to deliver at Gosford Private Hospital in March — a few weeks before the maternity ward closes.
"We were very lucky; we made our appointment last week," she said.
"But our baby is due at the start of March, so there are even questions for us, like how many midwives will still be around to support us?"
Ms Gorgiolione said access to private maternity care was so important to her that she would consider relocating from the Central Coast to Sydney if she had any more children.
"It might not impact my decision to have another kid, but it would definitely impact my decision on whether I want to be on the Central Coast," she said.
"I might move back to Sydney to have more options.
"It should be a basic service available for women and families on the Central Coast."
NSW Nurses and Midwives Association general secretary Michael Whaites raised concerns about increased pressure on midwives.
"It's most likely going to put some added pressure on the public services," he said.
"There needs to be a plan put in place, and both government and the Ministry of Health have a role here to see what service demand is going to be required to be met."
A spokesperson for Central Coast Local Health District said [the public] Gosford Hospital could support any women impacted by the closure of the private hospital.
Nationwide closures
Gosford Private Hospital CEO Stephen Johnson said it was a difficult decision.
"Over the past 10 years, we have seen a steady decline in the number of local families choosing to have their birth privately," he said.
"We have now reached the point where it is no longer sustainable for us to continue to operate this service."
Healthecare said eight other private hospitals had closed maternity services in the past 18 months, including Burnie in Tasmania, which it operated as a private-public model but handed back to the public in December last year.
Other private hospitals no longer offering maternity include Cairns Private Hospital, Sydney Southwest Private Hospital, Epworth Private Hospital in Geelong, and Mater Private Hospital in Redlands, Queensland.
In a statement, Australian Private Hospitals Association CEO Brett Heffernan said private hospitals were at the mercy of health insurance companies.
"As costs have skyrocketed, the insurers simply aren't meeting the costs of care in hospitals. It puts massive pressure on everyone in the hospital," he said.
"Each hospital's reasons for making this very difficult decision to close a service will be different, but certainly we have seen a trend with more maternity services adversely impacted on costs. "