How important is an obstetrician?

[FabFiona]

I viewed having an OB as a bit of insurance. Whilst I was aiming for a low risk, no complications pregnancy in life there are never any guarantees. IF there turned out to be a problem I wanted an OB that knew me and my case history rather than whoever was on duty that night. The attraction of a private room and staying in hospital a bit longer if I needed were also strong given it was my first baby and I had no idea what to expect.

As it turned out, I did have complications at the end of my pregnancy (pre-eclampsia) and I did need an OB. Things were quite hairy for a while yet because my OB knew me and my birth plan I still got the vaginal birth I wanted. Therefore in hindsight I'm glad I went with an OB and therefore in the private hospital system despite the cost.

I'd second the recommendation of the book "Better Birth". I had made a conscious effort to find an OB that was more in tune with the 'midwifery view' of birth as opposed to the 'obstetric view' and that was the difference for me having a good OB experience.

I'll definitely be going back to my OB for future babies.

[Olive]

my BF had an elective c/s for her second and third bubs and had them both public with and OB

its completely uo to you as to what YOU want! if you want an OB then have one, if youd prefer midwife care then definalty go public and dont worry about sharing a room, you never know, you may end up making new friends like i did!
sharing a room i found wonderful, i was never bored, had others to talk too when the partners had gone home etc..

[~Hestia~]

I think it's definitely up to you & it's a very personal decision.
I wanted to go through the public system despite having PHI. My local hospital offers Midwifery Group Practice which is seeing the same midwife for all your appointments, having that midwife deliver your baby & gives you up to 4 weeks of home visits. My midwife was also an LC so was very helpful & it wasn't unusual for her to spend 90 minutes at our house. I also had her mobile number & could contact her anytime during the pregnancy & beyond.
Although, due to circumstances beyond her control she actually missed DS' birth but we did have her backup midwife whom we had met previously. But an OB could also miss your birth so no difference there.
I will go through the same program with future babies, hopefully get the same widwife again.

[Juliette]

I have gone private with each of my pregnancies, and haven't needed an OB. Living in a country area, my only real option was a GP obstetrician, and to elect to be a private patient in our local public hospital. I've had my own room with the first two, and am expecting the same again this time (not guaranteed, but more than likely). My GP has delivered both my babies so far - emergency c-section first time, and elective c-section for the second. This one will be another elective, and he will perform the procedure again. I LOVE having this continuity and familiarity. My GP knows me and my family really well, as we see him as our family GP too. There are also a couple of midwives at the hospital that I will be requesting for my delivery, because they made me feel calm and cared for the last two times. I guess that's the beauty of small rural communities. Having said that however, if there were any major complications expected, I wouldn't muck around - I'd be travelling the 3 hours to Brisbane for OB care in a private hospital.

[*Beema*]

Most pregnancies don't require an OB, unless you want to chose the hospital you birth in (ie Private or Private Patient in a Public Hospital), you want to chose the OB caring for you.

I would definitely look into the Birth Centre/Midwife programs in your area.

OB feees can be very high and you don't get as much back from Medicare now

I chose to go with an OB with my first pregnancy as I thought it was what you did and I wanted to birth in a private hospital. In the end it was thr right decision for me as I have an abnormal uterus and had a few complications during the pregnancy and ended up having a prem and ended up delivering in a public hospital, but my OB was there for the delivery.

This time I have gone back to my OB as I am a high risk pregnancy, her support was great her fees reasonable and for me it is the right decision and I have many more complications this time around and am getting the close attention I need, but I don't fit into the "average" as such.

And if you can go through a MW program they will assess your "risk" as such and if it is low, and they have room your will go through and should something arise and change your risk you will be referred through to an OB through the public system, with the only difference being you may see different one each appointment, but the group of midwives would be consistent in the MW program

[Roryrory]

Like the others have said, whether you have/need an OB depends largely on the model of care you feel most comfortable with.

For my first, I was initially scared and saw childbrith as a possible life-and-death moment for me and the baby, so I insisted that I needed an OB. He was the "expert", after all (DH thought I was being ridiculously paranoid but let me go on my merry way). But during the pregnancy I came to feel that birth was natural, unlikely to lead to death, and a could be managed in a non-medical manner. But I had done my cash already and ended up in my chosen private hospital and OB-led birth. It was "safe", medicalised and produced a good result.

By the time number two came around, I was a full convert to the "birth is natural" vibe and went though a midwife-led model of care with the Family Brith Centre at the Mercy. It was a totally different experience, but the care provided was no less "sound" by virtue of it being delivered in a public setting.

This time I am planning a homebirth with the Sunshine Hospital's HB program. Again, a totally different model of care, but one which is no more risky to me or the baby than having an OB in a private hospital (in fact, on many measures, it is a SAFER one!)

So I think it comes down to comfort levels. If you are fearful of the birth process, you probably will want an OB to steer your boat - if you believe in your heart it is a natural thing that your body knows how to do, you will most likely choose a midwife-led model of care. But your level of comfort has A LOT to do with the level of education you seek out about pregnancy and birth.

[Loula]

For me i chose an OB mainly due to being in the IVF system for so long, (7 years) and felt comfortable with someone in that role taking the lead,

I found it very helpful with my anixety and after so many losses the fact that i could send him an email and he would reply straight away and also being able to see him when i needed, somtimes my appointments were 3 weeks apart.(while i was bleeding from 4 weeks to 15 weeks) Hi mannor has helped me to feel a bit better about things.

Now I am 25 weeks i look back and think gee ive spent a lot os cash! but as my friend said to me i may need his expertese towards the end of the pg again.

I was happy to birth in a public hospital, and i have chosend a private hospital attached to a public as the public fecilities are usually better, with regards to special care ect. but i felt with this pg after so long i wanted someone i could call and they would be there to answer, and i wanted it to be the same person every time so i wasnt getting conflicting information

my OB is also very pro natural del and VBAC also high risk

GL

[Tegam]

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

Same here, had a great hospital birth for my first two bubs with OBs...it took til my third bub to use my brain and realise i didnt need them. Tom was born at home the it was meant to be. This one will be at home too!

Good luck, best advice, do what feel right for you and your family, so many people have very stronge opinions on matters of birth!

[Miss.September]

I'm private so I had an OB but I'm thankful that I did, because I had issues that didn't arise until into my pregnancy and by then I felt totally comfortable with him to be guided by him. I liked being private because the hospital I went to does have mostly private rooms and for the five days I was in there DH was able to stay with me, which was really lovely.

It's hard on the pocket though, but at the time I was working, so we were okay. Don't quite know how we'll afford to do it again though

Corelly x

[Alina0210]

I'm pregnant with my 3rd baby and have never had an Ob. For a trouble free, no problems pregnancy then why would you go to an Ob who is technically a surgeon.

The only thing I have paid for is ultrasounds at 12wks and 20wks which I did get some back from Medicare.

[black_rose]

I had an ob for my first as we wanted to private and I had the phi so we made the most of it. For us it was money well spent dd was born by emergency c sect 6 weeks early, breech with dislocated hips and hip dysplasia so we had acess to a great pead and after care when she was home. With dd2 she almost came at 35 weeks but with the support of my ob we got to 37 and I had a vbac. He was also able to find me help with spd when my physio wouldn't treat me at 22 weeks.
So we are with him again for no 3 given that I have pre term laboursr I wouldn't to go through the public system.
My thoughts are that it's hard to know when you may run into problems first time was a dream run until my waters broke at 34 weeks, if you have doubts use an ob.

[Babyluv]

Wow thankyou so much for your responses ladies, I guess I will need my Ob afterall as I'm going private, wasn't aware that was a necessity in private. Also good to know he is reasonably priced, I had no idea.

[JellyBean]

For a normal, low risk pregnancy? Not important at all.

Its important to remember that OBs are ultimately surgeons by trade. They are the experts in surgical birth (aka c-sections). And thank goodness we have them for TRUE emergencies (albeit much rarer than the statistics would have us imagine).
However, they are widely criticised by birth advocates for their tendency to favour and 'groom' women with otherwise normal pregnancies for intevention that leads to c-section (ie artificial induction, stretch & sweep). Something else to consider is that they also get paid more for c-sections.....

If you anticipate and desire a normal birth, than I'd personally recommend going with those who specialise in normal birth - midwives. They will be the ones cleaning up your sick and helping you to the toilet if you end up with a c-section anyway!! OBs get the credit and all the $$ but the midwives are the angels who stay by your side before and after, helping you to establish breastfeeding and check your stiches etc. If something does appear during pregnancy that will put you in a high risk category than the midwife will refer you to an OB.

I also just believe that birth should be free. It is a natural process and a part of life. The way i see it - why should i pay some guy in a white coat 3 grand 'in case' I need him - when i am so desperately hoping that everything goes well and he will be left twiddling his thumbs? I'm the one doing the hard work - if anyone gets paid it will be me, thankyou!!
Whatever you decide - make sure you read the book listed in my sig!!

(PS - you can get your own room in public hospitals too - or even better - look into Birth Centres - there is a thread on them here somewhere).