How does the process work if your going public?

[MummyPig]

Hi

I'm from the UK, where everything seemed to be really straight forward with my first pregnancy: HPT at 5 weeks, phoned GP and made midwife appt (they work as a team visiting surgeries in the UK so you rarely go to the hospital to see them). First appt they do your weight, BP, urine proteins, take a medical history of you and the father, register you so you will receive an appt for your first scan, give you an NHS card to prove your pregnant (free prescriptions and dental treatment for all pregnant women) and loads of info. You also get booked into antenatal classes (or parenthood as they now call them!) if you are interested.

You have monthly midwife appts until 3rd tri then fortnightly (weight, urine proteins, BP, heart beat). A scan at 12 wks (combined dating & NT - everyone has both but you don't need to be told the results unless you sign a disclaimer) and another scan at 20 wks. The scans are done at a local hospital.

At some point during the pregnancy you decide what you want to do re: the birth, but usually you have plenty of time for this. The main thing is to express a preference for home births, so they can book you a midwife, or hospital, so they can let them know to expect you round about that time. Some places you need to say if you want a water birth as they have limited pools, most places it's first come first served. Not that it matters, because you just call and say 'my baby's coming now!!' and any hospital with a maternity unit will admit you.

I was also referred to an OB at the hospital where I'd have the baby because I was overweight and they needed to test me for gestational diabetes at 34 weeks. The OB said I should never have been referred as was perfectly healthy and unsurprisingly the test was negative. I did get to have an extra scan though, which was brilliant

I now live in Boronia, Victoria and have found out I'm expecting my second baby. I've been told I need to go see my GP asap as I need to be booked into hospital straight away because they get full (they never turn you away surely? what happens if I move??). I will be calling my GP to make an appt on Monday just in case!

I've been reading through some threads and found loads of stuff on HCG tests. Whahh?? In the UK they don't do these at all. If your HPT says your pregnant, unless you have any doubts about this you're not expected to get your GP to confirm it. It just sounds like there's so much variation on what people's HCGs can be and it's just another thing to scare all us expectant mothers with! Is this normal practice and will I be expected to have one? I don't think I could cope with them telling me it was low and probably meant I would lose the baby.

When do you normally have scans? I've seen a few people say not until 16 weeks I think...?

Please help. I just need any general info or perhaps some summaries of what normally happens here (preferably local to me) so I can try and understand what I need to do and what to expect.

Thanks!

[Lolli]

Hi

I'm in Nsw but I can run you through what happens here...?

GP does a HCG blood test (I'm pretty sure you can refuse this) and offers a dating scan if you're unsure of your dates. Gives you a referral to local hospital.

when you call the hospital, they might give you options of the midwife clinic, a caseload midwife, or shared care with your GP. The midwife clinic is seeing whichever mw form the team is on, the caseload gives you one specific mw, the shared care splits your appointments between the mw clini and your GP. If you are high risk, you generally have to use the mw clinic in consultation with the hospital ob's. Depending on the issues, you might the see the ob's only once or twice, or quite often.

Appointments are every 4 weeks until the 30 week mark, the every 2 weeks until 38 weeks (or 36?) then weekly.

You are offered the NT scan st 12 weeks, if you want it. A routine scan is done at 18-20 weeks for everyone, but you can also refuse that.

Other tests offered are the blood glucose, at about 30 weeks (I think?), and they check your iron levels then as well, and again at 34 weeks. A swab for bacteria is offered at 36 weeks. I think there might be a few others but I refused most of them this time (various reasons) and can't remember from last time. Anyway, the u/s are generally done at a clinic away from the hospital, the blood tests are done at the hospital clinic.

I think that covers it..? Let me know if I missed anything Good luck. FWIW, I've been very happy with the care I've received in the public system.

[Schmickers]

HCGs get done over here is there is some doubt over whether a pregnancy is viable or not. They don't need to be done routinely, and I think most GPs or antenatal clinics would take your word for it that you'd done a HPT that was positive.

As far as hospitals are concerned, private hospitals and smaller hospitals where there are larger hospitals within a safe distance, have the option of turning you away if they are "full", so to speak. All areas have at least one large public hospital which will accept your care at any stage during your pregnancy.

As far as scans, you have the option of a nuchal translucency scan which can determine your risk of having a baby with trisomy 21 (Down Syndrome) or a 20 week morphology scan, or both.

Good luck with your pregnancy, I hope the public system reats you kindly. I suspect you'll find you had more options in the UK than you have here, though, mores the pity.

[Tinks]

I'm not sure about the blood test side of things.

If you're going to Ferntree Gully Hosp you'll be referred to an OB by your GP. The OB will book you into the hospital etc. You will be able to choose an Ob from the list of ones who go to that hospital.

Box Hill Hospital is different, it works very much like LoriRae described.

[RoyaUK]

Hi Kerry, Welcome to Australia and congratulations on your being pregnant again!

I'm also from the UK, been here nearly 5 years and just found out i'm pregnant with bubba number 3. Both DD1 & DD2 were born here - both in a public hospital. I found the quality of care fantastic. I'm based close to Melbourne CBD so had both girls at the Royal Womens.

I found my care options were:

1)Completely free (Medicare covered) - all appointments at the public hospital - team based care but means dragging along a toddler to hospital - not always easy! (there is a creche available though)

2) Shared care (may incur cost if your GP doesn't bulk bill) - regular appointments with an accredited GP and a few appointments/scans at the hospital

3) Private (expensive and not an option for either of us!!)

I chose Shared care which meant i went to an accredited local GP (as recommended by the hospital) for all my check ups and then into the hospital only 4 times during the whole pregnancy - the final time to give birth. I found this a great system as the doctor is a walking distance away and rarely more than 15 mins late whereas any hospital appointment can up to 1.5 hrs late (in my experience) and you may see a different person each time.

I've not had a HCG test but for each pregnancy i've had a full blood test early on for infectious diseases (HIV, syphillis etc etc etc) and blood type even though it hasn't changed between babies! This is free on Medicare.

The 12 week nuchal fold scan (combined with bloods) is to test for chromosomal abnormalities (Downs syndrome amongst others).

The 18 - 20 week scan is to check for correct morphology of the growing baby. This is covered by Medicare.

I also had more scans later on with DD1 when there were concerns about her growth. Also covered by medicare.

if you're close to Box Hill, a friend of mine had both her kids there and was very happy.

With Medicare you are under a reciprocal agreement that emergency care is covered - and pregnancy is included in this definition.

Some women also choose to hire a doula or independent midwife who may meet with them a couple of times or so before the birth and then be a support during the birth.

This is something that i'm certainly considering this time round as my husband may be tied up for a little bit with sorting out our girls and i did find that in the hospital (when giving birth) man power can sometimes be scarce during the night shift! I'm also hoping for a VBA2C so may need the extra support.

Good luck! oh, and unfortunately NO FREE DENTAL HERE!! Wish there was!

[MummyPig]

Wow, thank you for all the replies guys - especially RoyaUK as it is good to have the process described by someone who's gone through the same thing!

LoriRae - I will be refusing the HCG as it seems like unecessary trauma to me. I can't see the point of it, other than to scare already nervous pregnant women! There's nothing they can do if your HCG levels are low anyway, is there? I doubt I'll need a dating scan as I know I was ovulating on the 23rd July, but if it means getting an early sneak peak...

Schmickers - thanks for clearing up the hospital concerns. I think my nearest hospital with a maternity ward is the Angliss. I've read a fair few reviews from people using this hospital and it seems to be well liked. Well, as much as you can like a hospital! It also has a birth centre and I would really like to have a non-interventionist birth. I'm still deemed to be clinically obese (bah!) and I also had to have a manual placenta removal last time, which I was told would happen again.

Do you guys think I would be accepted or turned down based on my last pregnancy and birth?

Tinkerbell - I think one of the OBs for the Angliss is actually one of the GPs at the practice I'm registered at (Boronia Medical Centre, on Boronia Rd, by the road into the MCHC..?). Is it likely that I would be referred to that OB (Chris Davenport), because I've read on several forums that he's pretty good and very well respected?

RoyaUK - if I'm not offered the nuchal fold scan, am I allowed to ask for it and roughly how much would it cost? I would like to be prepared were there the chance that my baby may need special care. I did the same with Freyja.

My husband was excellent during the birth of Freyja and was incredibly supportive. Poor lamb was pretty scared the whole time too and became terrified when my waters broke. It wasn't the meconium (sp!) in it that scared him, just that there was soooooo much of it and it exploded out of me after I decided to push. Just as well I did because Freyja had been in distress for sometime and they'd never have noticed otherwise

Anyway, we don't really know anyone here or have anyone that we could leave Freyja with whilst I go to the hospital, so I'm a little concerned about having to go on my own right now! How much does a Doula or independant midwife normally cost and how do you go about arranging one?

Thanks again everyone!

[HotI]

RoyaUK - if I'm not offered the nuchal fold scan, am I allowed to ask for it and roughly how much would it cost? I would like to be prepared were there the chance that my baby may need special care. I did the same with Freyja.

Hi

You usually organise the first trimester screen (NT scan and blood test) through your GP. Not sure how much it costs, but there are some out of pocket costs for this screen.

cheers,

k

[Daydream Believer]

I went to the Angliss.
You need to book in for the hospital tour & they will give you a list of GPs & OBs who work there then you can choose from that list who depending on if you want a GP or an OB and whether you want shared care or not

The GP or OB will then book you into the hospital & let you know what tests should be done

HTH

[Tinks]

Tinkerbell - I think one of the OBs for the Angliss is actually one of the GPs at the practice I'm registered at (Boronia Medical Centre, on Boronia Rd, by the road into the MCHC..?). Is it likely that I would be referred to that OB (Chris Davenport), because I've read on several forums that he's pretty good and very well respected?

Yes you could request to be referred to him. You'll need to find your ob quickly because they are each allocated a number of beds, the good ones tend to fill their beds quickly. So the earlier you organise the referral the better.

[MummyPig]

Just called my GP to make an appt this morning and I have one with Dr Davenport at 11.40am, so he is at my practice like I thought!

Fingers crossed this means he will be my OB