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Thread: Donít go private *just* because you have private health insurance

  1. #1

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    Default Donít go private *just* because you have private health insurance

    Iíve been around BellyBelly for a few years now and I never really ďgotĒ Kelly banging on about choosing who you birth with is choosing how you will birth. If you donít want an episiotomy donít have a private obstetrician, if you donít want a managed third stage, donít go to a private hospital, blah, blah, blah. I just didn't believe that it mattered that much. I really thought the private model of care was the best type of care, I thought it was flexible and I thought I could get the care I wanted within it. Well, itís expensive, thatís for sure, but as for the rest of it.... well I guess itís OK. But for the birth of my child, is OK good enough?

    Iíll go easy on myself for going private with my first child because everything is so unknown, but why oh why did I go back for more of the same with my second? I am so thankful that I finally woke up, made some great decisions about who would care for me and that I did have a truly beautiful birth in the end.

    The private model of care is just so pervasive, but itís so expensive and itís just not that ďgoodĒ for low risk women like me. Of course there are women who really, desperately need the services of obstetricians during their pregnancies and for the birth of their children. So why waste those precious resources on people like me? Midwives are the specialists in normal, natural birth, which is really the most appropriate care for most of us. Why are they so constantly sidelined and why do women like me see the private obstetric model as the default option?

    Anyway, I just want to share my letter of thanks to the NSW Minister for Heath for the midwife-led, woman-centred care that I was lucky enough to be able to access for the birth of my third child.

    I finally get it now Kelly!

    29th June 2011

    Jillian Skinner, MP
    Level 31 Governor Macquarie Tower
    1 Farrer Place
    SYDNEY NSW 2000

    Ryde Midwifery Group Practice at Ryde Hospital

    Dear Mrs Skinner,

    I am writing to you to tell you about the amazing and beautiful experience I had birthing my third child at Ryde Hospital. I was cared for by a truly exceptional midwife, Martin Griffiths, as part of the group midwifery model of care. I want you to understand how valuable and important group midwifery at Ryde Hospital is for women, babies and our community.

    I had my first two children at the SAN at Wahroonga with a private obstetrician. I chose this model of care because I have private health insurance so I thought, well thatís just what you do. My first two birthing experiences were good, but there are many aspects of my care under the private model that I now believe were much less than ideal and much more expensive to me personally and to the taxpayers of NSW and Australia.

    By less than ideal I mean I that I had care providers, treatments/procedures and interventions that hampered my experience and recovery. Under the private model of care I built a relationship with my obstetrician throughout my pregnancy, but during labour and after birth it was the midwives at the hospital that provided almost all of my care, people I had never met before and had no opportunity to get-to-know during such a busy and somewhat stressful time. The treatments and interventions I received include: internal examinations, ďstretch and sweepĒ, direction into a birthing position I did not want to be in, coached pushing, episiotomy, immediate cord clamping, managed third stage (syntocinon injection), stitches and poorly managed 4th stage pain relief. These are all minor interventions but in my opinion they were unnecessary and detrimental to my experience, recovery and birth and mothering journey.

    By expensive I mean at every obstetrician visit (of which there were many) it was clear that every single Medicare fee/rebate that could be accessed was. I believe that much of this was unnecessary and a waste of taxpayers money, not to mention a waste of my money as there would always be an additional ďgapĒ cost to me. After giving birth I stayed in hospital for four days at huge cost again, to me personally, my family (husband taking time off work) and to taxpayers (subsidising private health insurance). I could easily have gone home much earlier but there is no out-of-hospital care under the private model. Once you leave hospital you are virtually abandoned and left to fend for yourself. If I wasnít being over-serviced, I was being under-serviced.

    In contrast, the birth of my third child with Martin Griffiths under the group midwifery model of care at Ryde Hospital is incomparable, just so much better. Martin favoured a completely hands-off, wait-and-see approach and it has worked so well for me. Throughout my pregnancy and especially during my labour and birth his presence was perfect, he allowed my body to do what it was meant to do, but he was there with me, supporting me the whole time. I felt comfortable, in control and free. This excellent care and support didnít end when I left hospital, the in-home visits by Martin in the days and weeks after birth were invaluable.

    I know I have experienced the very best care. All of the careful, evidence based decisions we made together about my treatment options have meant that my recovery has been brilliant. I was able to go home the day I gave birth, breastfeeding has come easily and naturally and there has been no disruption at all to our family life, I went to the shops and did the kindy pick-up the next day! My older two children (2 years and 4 years) have happily welcomed their new little brother and my husband has been able to confidently and quickly return to work.

    I regret that I chose the private model of care for my first two births. Itís not that my experience in the private system was bad, it was good, but for something as special and important as welcoming a child into the world, why would you settle for good when you can have awesome! I am so thankful that I educated myself and finally found the best birth care model for me, better late than never. It is such a shame that women like me see the private obstetric model as the default option. There are women who really need the services of obstetricians during their pregnancies and for the birth of their children. Our health resources are precious, why waste them giving sub-optimal experiences to people who donít need them?

    I passionately believe in birth rights and birth choices and that midwife-led, woman-centred care should be the gold standard for maternity care in Australia. I feel frustrated and angry that important decisions about access to birth services are seemingly not based on evidence and I am left wondering about the protection vested interests. I feel so lucky that I have been able to access the group midwifery service at Ryde Hospital and I hope so much that it will be able to offer such a valuable and important service to women and families long into the future.



    Thank you for taking the time to read about my experience. Please do not hesitate to contact me if you would like further information.

    Yours sincerely,



    Rachel _______

    cc: Martin Griffiths, Midwife, Ryde Hospital
    Nicola Roxon MP, Minister for Health and Ageing
    John Alexander MP, Federal Ė Bennelong
    Victor Dominello MP, State Ė Ryde
    Debra Thoms, Chief Nursing and Midwifery Officer, NSW Dept. of Health
    Rosemary Bryant, Chief Nursing and Midwifery Officer, Dept. of Health and Ageing
    Dr Michael Nicholl, Director Women's and Children's Health, Royal North Shore Hospital
    Dr. Colin Gunter, GP, Carlingford Ė Epping Surgery
    Dr Steve Hambleton, Australian Medical Association
    Last edited by Epacris; July 1st, 2011 at 01:22 PM.

  2. #2

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    You know I totally agree with you

  3. #3

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    I hope that you also sent it to your midwife! Great letter and a great positive way to talk about the importance of birth choices!

  4. #4

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    Thats awesome hun! I'm always here to share the wealth, but I know people have their own journey and the right time to hear something. That's why I will keep banging on... and one day others might spread the word too, if its true for them
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    Follow me in 2015 as I go Around The World + Kids!
    Forever grateful to my incredible Mod Team

  5. #5

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    Great letter!

  6. #6

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    Good on you!!

    I have private health but would never give birth in a private hospital.... no thanks!! You'd have to pay ME to give birth in a private hospital. Even then, not sure I would do it!!

  7. #7

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    So great to read your thoughts and your letter.

    I especially like this:
    So why waste those precious resources on people like me?
    Totally agree!! So glad your birthing journeys led to a happy place

  8. #8

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    What a great letter!!

  9. #9

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    Love it and I totally agree with you. I have private health insurance and used it for my first two babies, but my third was under midwifery-led care and I would never ever go back!

  10. #10

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    i went private first time and second time and if there is a third time i would go again without a doubt! I can't complain! and i am now doing my prac in that same hospital and love it!

    Really nice letter though!

  11. #11

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    Thanks everyone!

    You know jackrose, I thought damn it, that is a good point, but I didn’t really say it in the letter. So I made one final change and put that bit in about resources and posted them all off yesterday. So I’ve edited my OP with the final, final, final, version.

  12. #12

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    Awesome letter! I completely agree that midwifery lead care is the ultimate method for low risk women, (and even some "high risk" women), especially if it's continuity based.
    I went private with my first child, for the same reasons as you really. And it was a huge mistake in hindsight. You can't have much more intervention than a CS under a general, all of which could have been completely unnecessary. And it affected my birth choices greatly second time around.

    For my second preg I started out going through the public system as I wanted a the best chance of a VBAC. Unfortunatley though, there were no Continuity of care options in the public system for me as I was seen as "high Risk". I did not enjoy seeing a different midwife/ob/registrar at each visit and was told different things each time. I really wanted to build a rapport with my care provider. It was so so imporetant to me that I had a known person caring for me who knew my story and my wishes IYKWIM. So I ended up seeing the senior public hospital Ob at his private practice ( I had heard that he was very hands off and also very pro birth centre) and clicked with him instantly. And although my second birth ended up being a CS (my choice in the end) in a private hosital. It was positive and wonderful and I don't think I would have had as much control if it were in the public system because I wouldn't have had a "known" care provider.

    So I guess for me, first preg, going private was a huuuge mistake, but it was a wonderful experience second time around.

  13. #13

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    Continuity of care is an absolute must, I think. It's shameful how few women in Australia can access true continuity of care. Even if you go private and are planning a caesar, you still end up with random midwives for your post-natal care.

  14. #14

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    Quote Originally Posted by MadB View Post
    Continuity of care is an absolute must, I think. It's shameful how few women in Australia can access true continuity of care. Even if you go private and are planning a caesar, you still end up with random midwives for your post-natal care.
    So true MadB. In my experience I found that the lack of continuity-of-care options for "high risk" women is a real big issue.

  15. #15

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    On a positive note. I went private and my dr and midwives were 100% natural all the way. Even when I had an urge to push and my middie wanted to check I was fully dilate before I did actually push (I had progress alot faster than expected) I asked for gas (to help me hold the push) she encouraged me to wait and that I could do it without it and showed me how to pant.
    My dr even stood back while my midwives delivered our baby

  16. #16

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    While I believe every pregnant woman should have continuity of care with known midwives (in additon to obstetric care where required), it is surely an even greater imperative for those classified as high risk? How much gets overlooked or forgotten about as women get bounced from one carer to the next?

  17. #17

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    Quote Originally Posted by MadB View Post
    While I believe every pregnant woman should have continuity of care with known midwives (in additon to obstetric care where required), it is surely an even greater imperative for those classified as high risk? How much gets overlooked or forgotten about as women get bounced from one carer to the next?
    So true MadB! There were countless times where I had to tell THEM where everything was at. I guess that is the big benefit of having a private Ob in a high risk situation, and part of the reason I went that way in the end.
    It would be sooo nice for all high risk mums to have access to a continuity-of-care MW who collaborates with an Ob. It would be the ideal situation IMO.

  18. #18

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    Sadly, the current attitudes of teh AMA et al make this very unlikely. Who loses? Mothers and babies. This is why we need to tell OBs, and hospitals and the government what we need and why.

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