Care in public hospitals

hi there,
I had my 24 wk appointment with the midwife at a public hospital today. I was a bit worried afterwards because I was in and out within about 5-10 minutes. She just did blood pressure, measured my bump and listened to the heartbeat....and I had done the protein etc urine tests and weight myself. I'm just wondering if this would be all that would happen if I was going private? I had considered going private initially but my doctor said the care in public was very good and that there wasnt a huge need to go private - basically the $8k it would cost would be better spent when bub arrives. I'm wondering if I've made the wrong decision now. I don't have any actual compaints, it just seems like there isnt much to it and if something was wrong would they even pick it up with such a cursory examination?

Also, the fact that there are no more scans after the 19 week scan seems bizarre to me - surely they'd want to see the size of the baby and make sure everything is ok? Do you have more scans if you're seeing an OB?

Any advice would be appreciated!

Kitz

I can't give advice on private, as I too went public. But I just wanted to let you know that my app with the hospital was the same as yours. I still go to my gp every 4 weeks until 36 weeks, then it's weekly at the hospital. They way that I see it, is that they are doing all the sufficient blood tests etc during your pg, and if something was wrong, they would pick it up that way. Ultrasounds aren't a necessity, unless you're high risk or something. You would be getting an ultrasound viewing with each ob visit, but it's not necessary. They can do all the required measurements without ultrasounds.

I went public with my DD and did shared care with the hospital (200k's away) and my GP. Visited the hospital for the first time when I was 32 weeks, then again at 37 and 40 weeks. All other visits were with my GP, who would check my weight and BP, ask how I was etc, receptionist would check protein. The only ultrasound I had with DD was at 18 weeks.

Nic

Hi Kitz, to make a long story short (well ill try anyway!) i had my own OB, but when dp and i moved out, (45 mins away from where i was at home, and booked into the hosp.) i decided id better contact the local hospital and book in just in case i had to get somewhere asap.. ihad to have a routine checkup with there doc and had a horrible time! i had to wait an hour, i had to pee in a cup and leave it on a bench on front of the entire waating room, get weighed and measured right next to the bench, then saw a horrible doc who hurt when he felt my tummy and that was it.. thanks for coming.. see you when ur in labour..

i was sooo upset!

i went back to my private OB, and had my checkups in his room, and felt much more comfy giving birth with him helping, not Dr Rough-hands.

sorry of thats off topic! i dont have experience with private hospitals, that was just my public experience.

in regard to having more scans, i asked my OB if i could have another scan at 32 weeks.. just for the sake of seeing the baby again, he said i was welcome to as many as i want, although not necessary! my best friend worked at the radiologists, so i was bulk billed for my 4d scans :D

Hiya Kitz, I'm not sure if I'm the best person to post, as I really loved my public hospital experience.
Just wanted to say that my friends who went private had great experiences, most got on well with their OBs, but found their appointments weren't long either, and from discussions I've had the waiting for the appointment isn't any shorter, KWIM? Also many OBs don't perform ultrasounds routinely after the 19 week one either.
Personally, if you don't have any complaints, I'd say you've made the right choice :)

i went private, but, also found that the appointments went all that long either. I did have scans evey check up, but, i dont think that is the norm. I dont know of to many people that went private that still had scan every visit.
Your visit sounds very similar to the private ones really. Public or private, i guess they can still only check the same thing, its just the people you see, and where you see them, and how much money you do/dont have to hand over.
We are considering, sorta, going public next time around.

Kitz your appointments sound fairly standard. There is no real need for ultrasounds every visit unless there is a pre existing problem, it is normal for the 19 week one to be the last one you have. I find the most important thing to get out of visits is discussing the actual birth. Get an idea of what you want and what they can accommodate you with. Remember to speak up at the visits if you any concerns.

Just remember by the time you get around to the 2nd bub you will probably appreciate the short appointments and not having too many, as you just don't have a lot of time with another to look after.

What Astrid said.
Its also normal not to be weighed at all throughout pregnancy (unless there is an issue) nor to have any urine test for protein. Many OBs will only do a urine test if you BP goes over their 'warning sign' level.

My ob weighed me at the beginning and said he wouldn't weigh me again. My appointments have also been very short, the nurse will take my BP ask me how everything is going. The OB will come in, have a feel of my tummy, last time he measured fundal height, but hadn't before. He put the ultrasound on my belly to have a look, but quickly took it off after having seen exact position as we don't know the sex. He is happy for me to still keep seeing him every 4 weeks so far as I live out country and there aren't any problems. He knows that I would see my local GP if I felt there was a problem. I feel fine apart from the usual complaints. I am going to the city a few weeks before the birth so expect that I will see him weekly then.

I figure if everything is going to plan they don't need to spend lots of time with you, it is just a check up to check your BP etc to make sure you are ok. It is when things go off track that is when appointment time increases. Use your appointment to ask questions if you have any.

It all sounds very normal

This is my first and I chose a private ob. So far I have seen her at 10 and 14 weeks and I see her again at 22 weeks.

I had scans (referred by my GP) at 5 and 8 weeks (ectopic risk). The 12 and 18 week scans were arranged by my ob. I think I'll have to go for another scan around 30 weeks due to low lying placenta.

The ob did a quick scan at the 14 week appt just to check heartbeat cause she couldn't find it with the doppler. My appts so far have been asking lots of questions, giving a urine sample and that's about it. She also gave me a call on the weekend to see how I was after having my appendix out (she missed it as she was on holidays so saw the on duty ob).

Just thought I would chime in here and agree with what everyone else is saying...

I went public last time and am private this time and I honestly think I got more care and attention from the midwives at the public clinic that I am getting from my OB. And it costs me $60 a visit! :)
At my private OB, a midwife checks my BP then the OB feels my tummy, does a quick u/s (only because I'm having twins and it is easier to see their heartbeats than to try and find them both - he usually wouldn't do a scan at all). then he asks if I have any questions. That's it.
As long as they check your BP, urine (my OB doesn't even check urine regularly) and listen for the HB, you can be pretty sure that all is going well.
Remember being pregnant doesn't really mean you need lots of medical attention - your body mostly knows what to do - regular antenatal checkups are just there to catch anything that might go wrong.

Also - I find waiting times for appts are much longer at my OB than they were at the public hospital. I loved my public experience last time and only went private because I am going to be in hospital for a little longer with twins and I wanted my own room. lol.

I agree that the appts don't have to be long, public or private. I really think it's the things like a room to yourself & so on that make the difference between public & private. The same things get checked throughout your pregnancy & doc, ob, whatever they are all busy & some have different manner to other regardless of if it's private or public & they will be a quick, take as long etc as they please if that makes sense?
I went public & can't fault it! My doc was great, had all the checks needed, etc & so on.

You could always get an OB if you are concerned. I am seeing one but am going to a public hospital to give birth. My reason for getting an OB is my age (41) and my history (infertility & 3 m/c's so I want to make sure I'm well monitored. The OB will not be at the birth as it will be handled by the midwives and any docs on duty and I'm happy with that. I've so far had 2 OB appointments - I didn't have ultrasounds at either but had the doppler thingy at the last one at 14 weeks. I'm currently 15 weeks 1 day. My visits have been longer than yours but as there were things like NT scans, risks at my age, and the amnio to discuss, that is to be expected. I did notice when I was waiting that some ladies are only in there 5 or ten minutes so I guess it could be normal to have short visits even with an OB.

I have had three ultrasounds at other locations - one because of spotting & to check my dates, one for the NT scan and a quick one at 15 weeks to see if an amio could be done yet. I will be having my 4th scan next week whilst they do the amnio.

You can always request another scan through your GP later on if you want one. My hospital doesn't provide any scans at all so they have to be arranged through a GP or an OB.

Thanks everyone for all your replies. Its very reassuring to know that I'm not missing out on anything important!

Yeah, this sounds quite typical of a public hospital antenatal appointment. Most public hospitals expect that you will get your emotional support and education from family and/or antenatal classes, and so the actual appointments themselves are pretty perfunctory. Of course, this assumes that a) the antenatal classes are on at a time that you can attend, and b) that they are being taught by someone who is competent and experienced. As far as I am aware, appointment times and content with OBs varies from doctor to doctor, with some doing 5 minute appointment and some doing up to 30 minutes.

An option I can heartily recommend is going with an independently practicing midwife. You don't need to have a homebirth to book in with an independent midwife (although that's something else I can highly recommend, as well), but they can do all of your antenatal care. We have 90 - 120 minute appointments with both of our babies, comprising clinical care, emotional support, and education, at times that suited us, with someone who was really in touch with our needs and wants. It was awesome.

I'm a mum of one, and I had him in the public system. Because I'd had a cone biopsy a few years earlier, and maybe cos I was older (41 then, now 43) they kept an extra close eye on me. I had ultrasounds every month to make sure the cervix wasn't trying to open early (and then to check on a low-lying placenta), and they were most insistent I not travel overseas for more than 4 weeks at a time. I got the impression that the attention each pregnant mum got was very much determined on a case-by-case basis. Not sure if you're allowed to name hospitals in this forum, but I had a great experience there, as did other friends of mine who had lower-risks pgs. Meanwhile, a friend of mine who went private had the very WORST experience with an ob who promised her a C-section at either 32 or 34 weeks (can't remember now) because of her high risk due to previous miscarriages, he went on leave and his assistant let my friend keep going til 38 weeks, at which point her placenta gave way and she lost the baby and almost her own life from blood loss. Private cover doesn't necessarily mean top cover.