How important is an obstetrician?

[Babyluv]

Hi girls,
I just found out my 1st obs app is $200 and then at the 3rd app it's $1500 i will get some back from Medicare but I'm starting to wonder how necessary an obs is?
What will I get from an obs that I wouldn't get without one?
Is there a diff between the care my baby will receive at birth?
Will I miss out on necessary pre natal care?
Who had an obs and who didn't and what were your experiences, would you make the same choice again?
Thankyou ladies

[Lulu]

I can't see the point of having an Ob unless you have complications with your pregnancy.

[Arimeh]

I had an OB with my first and second pregnancy because I wanted to go to the private hospital on the sunny coast, as the public hospital didn't have a very good rep when it came to maternity and i would have done anything to avoid having to go there.

But since I elected to have my first baby by c-section, you sorta need an OB for that - and you don't really get to "elect" to have a c-section if you don't go private - well with most hospitals anyway.

I had DD2 with an independent midwife in an independent birth centre, and if I knew with DS what I know now - I wouldn't have had an OB at all - I would have gone with a birth centre like that one I had down here in Tas.

[~me~]

If you gave a good midwife system in the hospital you are going to give birth then as Lulu said you probably wouldn't need an OB.
I think under the MW system you still see an OB once during the later stages of pregnancy.
I had an OB for all my pregnancy's. I went private so I think I had to have one? I went private as I wanted to stay in hospital as long as I could. So this was 5nights.
I probably could have done without as mine were all non complicated pregnancy's and births. It was what I felt comfortable with.
What I did like about an OB as I was pretty much in control of how I wanted things to go (baby co-opereating of course). Most MW are like this too, although I had a friend who went public without an OB and the MW were not great at listening to her and her needs.

Some hospitals now have the KYM (know your midwife)scheme which is fantastic, you get to see the same MW through the whole pregnancy and she/he will be there at the birth too. Worth investigating.

Also..the amount you are being charged by your OB is very reasonable. Before this new change 1st Jan most OB'S were charging double that so perhaps the new system has done what it intended it do and bring the price down OB's charge and make them more available and give people a choice of MW care of OB care.

I look forward to hearing everyone else's experience's.

[Peg]

i've had 3 children (14, 10, 4yrs) and i did not have an ob with any of them. I went thru 'shared care' with my first two and midwife care with my 3rd. Even though i had 3 c-sect, I had no pregnacy complications and so there was never a need to see an ob...until delivery time of course.

I am now seeing an ob for my current pregnancy because I have some specific requests with regard to my next c-sect so i wanted to make sure that those requests were met. As a public patient i would have to accept which ever ob was on duty at the time of my delivery and I wouldnt have an opportunity to make sure he/she knew my specific requirements.

But for healthy normal pregnancies and labor, a private ob would not be necessary. A lot of women dont even get an ob at their delivery unless things are not going well. So its really up to you. The cost is due to going private...so its not really because you will get better care IMO.

I also have $2,000 confinement fee to pay along with the regular $70 checkup fee. I havnt paid that fee yet but im curious to know what happens to that money if my Ob is not available for my delivery or i loose the baby in the meantime (im only 22 wks)...i'll be asking that on my next visit.

[Indadhanu]

If you are going private I think you HAVE to have an Ob.

If you go public it's unnecessary in a normal pregnancy.
If you have a complicated pregnancy and would prefer continuity of care then I'd go for an Ob.

I went public, no problems during pregnancy, and when I needed an Ob at the endof my labour the hospital just called the Ob on duty, who came in and also performed the emegrgency c/s, and the hospital paed and midwives did the once over on Jazz after the c/s. I think thats all a private Ob would do, as they aren't a labour support person IYKWIM. Oh and the postnatal care, which was done by my midwives. A hospital Ob never saw me or looked at my c/s wound after I left the operating room, the midwives were great with that and an Ob would have seemed like a bit of overkill.

[Arcadia]

I didnt see one at all. My gp organised all the blood tests and then I had an independent midwife from 14 weeks (which isn't cheap but so worth it...I got 6 weeks worth of after care also and she was an LC so helped with all the breastfeeding stuff too).

You should be able to do shared care with your gp to keep costs down.

Have you considered a homebirth or midwife lead birth? (I ask with trepidation in case you think I am a homebirthing evangelical)

[~Raven~]

An OB is only really important if you have a high risk pregnancy or elect to use the private system. If you want to go private then you need to have an OB. Unfortunately they go hand in hand as there is no midwife led care in the private system

An OB will give you continuity of care and in most cases will be there for the birth but it's not a given.

So from there it's a matter of deciding where you want to birth and why and going about and finding your care providers that will support you in your choices!

Speaking from a personal point of view, with my first birth I went private due to the reputation of the local public hospital after speaking with friends who had been there. Due to that choice I had to engage an OB who I was happy with and I chose to see him again for subsequent PG's. A public hospital with midwife led care did open up in my area when I was expecting my bub #3 but due to complications with my 2nd birth they didn't accept me because they are a low risk facility. This had a lot of bearing in my "choice" (wasn't really a choice TBH) to go back to my OB and private hospital for #3 and then again for #4.

I feel like one of the few that has had good experiences with an OB Make sure you know what you want and talk about stuff early on in regards to how you want your birth to go. Not all OB's are the same and it's important to find out early on if they will support your choices. If he/she doesn't then find one who will!

ETA forgot to mention the fees! A lot of how much you get back depends on your medicare safety net which accrues from Jan-Dec. Find out how much yours is (they vary a lot depending on your income and if you get any centrelink benefits) and if you go past it, which is quite easy once you pay for scans and appointments, you get the majority of any further Drs fees and some tests refunded for anyone on the medicare card.

[~mamaspice~]

The best way to help you to decide on what type of care provider to have would be for you to read about the "Obstetric View" and the "Midwifery View" of birth, and go with whichever resonates better with your own beliefs. Google Obstetric View and Midwifery View and you should find definitions. Better still I can highly recommend an Australian Book called: Better Birth - the Definitive Guide to Childbirth. I sooo wish I had have read that book before I had my first baby.

Based on what you've mentioned about your management fee being $1500, you'll get about $460 of that back from medicare. When you factor in all your out of pocket antenatal costs, any gaps for scans and bloods, hospital excess, gaps for paed or anaesthetiest fees, it would be feasable to say you will be out of pocket approx. $2-3000 going private. IMO about the best part of going private would be getting your own room at the hospital.

FWIW, I went Private with DD, but I'm going public this time around. I much prefer midwifery lead care and if you can go to a hospital that has a "Know your Midwife" program" I'd definately pick that over a private OB any day.

Best of luck with your decision.

[fionas]

I had an ob because I wanted to use my private cover - I never get sick and don't like the idea of paying for it for 30 years (because it makes sense tax-wise) and never use it. Plus, I'm an anti-social witch who hates sharing a room at the best of times so wanted a private room. Plus, I'd had a few depersonalising experiences in public hospitals with previous miscarriages, didn't like being treated like a number, didn't like waiting around for hours to be seen and wanted to see the same person throughout not whoever was on duty.

But that's why I chose one. Are they necessary? ABSOLUTELY NOT!

If I had my time again and if I knew I was going to have an uncomplicated birth, I'd either go a homebirth or with midwifery care (and look into having a private room because I know I wouldn't sleep in a shared room, just me).

As it is, I'm having an elective caesar and don't fancy a rigmarole of trying to lobby for this in the public system especially when we will be moving house late pregnancy so I'm staying with my first ob.

[Lulu]

When you factor in all your out of pocket antenatal costs, any gaps for scans and bloods, hospital excess, gaps for paed or anaesthetiest fees, it would be feasable to say you will be out of pocket approx. $2-3000 going private. IMO about the best part of going private would be getting your own room at the hospital.

Never, ever assume private covers means you get your own room!

I had a great Ob for my 1st, a lovely man.....but I didn't need him

[~mamaspice~]

Never, ever assume private covers means you get your own room!

Okay, IMO, about the best part of going private would be the high chance you'll have your own room. Thats about the only positive thing I can think of about going private It certainly influenced my decision first time around. If your own room is important to you check with the private hospital you intend to go to and they can verify it your own room is guaranteed or not. In the hospital I went to there were only single rooms in maternity.
This time around, my own room isn't so important

[Melbournemumma]

I had a private Ob with my DS. As someone else said, I don't really use my private health insurance for hospital and DH and I felt like we wanted to make use of the private hospital in our area. Neither of the public hospitals in our area had good reps so we were happy with our choice. For me, I loved the continuity of care that we got from having an OB and my Ob was fantastic. He was so supportive and calming and I called on him whenever I was concerned. He would always return my calls and reassure me when I needed it. He was so encouraging of helping me to birth naturally, however, for reasons beyond both our control I ended up having a c-sec. Again, he was fantastic and I have not had any problems since then.

I will be going private the next time I have a baby, however will need to find another OB as we're moving at the end of the year. I'm really sad about this as I really wanted to use my Ob again. I just can't speak highly enough of him

As others have said, going private is not a guarantee of a private room, however there is a greater chance of that. Also, depending on the hospital there are additional benefits. For us, my husband was able to come and go whenever he liked and he even stayed at the hospital with me on 3 nights. I've had friends who have had babies in the public hospital next door recently and they had less freedom with visitors and their husbands presence than I had.

I also found the additional one on one support I got from the mid-wives post birth was fantastic. From the lactation consultant who came and sat with me and helped me learn how to hand express, to the nurses who came and showed us how to bath DS in our room, I couldn't fault our hospital.

Also, those costs sound about right. My ob was $3000 for labour management and $45 each visit. Also, with private don't forget to add the costs of a Paed and anesthetist if necessary.

Hope this helps and goodluck.

[~*Niadalla*~]

In my case.... NOT AT ALL. Didn't have an ob with me during either of my births, and saw one once face to face each pregnancy... AND I was 'high risk' (but that's an arguement for another thread. LOL).

[~Kim~]

Depends at which hospital you want to deliver.
If you want to go to a private hossy - you have to fork out for an Ob. If you're happy to go public, no worries - totally unnecessary.
I've had one preg with and one without and Ob. Both high risk. With #2 I was allocated the best Ob they had and he saw me all the way through. Care I got was the same in terms of continuity, except the benefit with public was that you got to know the midwives who will deliver your bub and look after you post birth. With private you won't meet them until you go to the hospital in labour.
If the private room thing concerns you, you can always pay for priorty for a private room in a public hospital (for most that I've come across), but remember sick pts always come first.

[HotI]

I went public, and had my own room with a double bed.

However, next time i'm staying home.

[Fleur]

I never had an Ob (public for all) & truthfully can't see why you need one unless it's more for convenience... a few posters have mentioned elective CS, or knowing who they will have for the delivery.. that kind of thing, I get, but apart from that, even if there are complications (as there were with my third labour) you just see the Ob who's on at the time. With my second & fourth labours I never saw a doctor of any sort, just a midwife.

JMO and of course I speak from the POV of never having had one but I don't know what pre-natal care they would give that would be any different?

[Peg]

JMO and of course I speak from the POV of never having had one but I don't know what pre-natal care they would give that would be any different?

from what i've seen so far, the visits are no different to seeing a public hosp midwife.

I guess if you have any conditions the ob, also being a dr, is able to treat you for those conditions and provide you prescription medication that a midwife could not.