Public or Private - I'm torn!

Hi ladies,

I'm sure there are a thousand different threads on this topic. I'm just so 50/50 on the public/private debate. And I know there are many factors which I haven't even considered.

DH and I have private insurance. My sister tells me if we have private insurance, we'd be mad not to use it, and if we decide to go public, we'd be using a bed that someone who doesn't have private ins might need.

I understand it's good to have an OB if there are complications, but how is anyone ever meant to know (early on) if there will be?

I'd love to go to the RBH (Brisbane) to get into the birth centre, which is by ballot for a healthy pregnancy. And I don't think it really bothers me if I'm in a shared room if I don't get into the birth centre.

Am I missing something major that will make me think differently?

I have private health.
I chose to have both babies public.

I like the supports and the backup the large tertiary public hospitals have.
I also choose midwife care not doctors so i didnt see a dr with even birth (#2 was at home after all anyhow!).

So i figure what is the point paying for an ob when i want midwife care.

My sister chose private - and didnt even see her ob.
the midwifes looked after her until it was time for a c-s and then the ob came in.

SHe will go public next time too.

I have always had a private room for both babies.

I've got private health too, but chose public

Everyone to their own, but in the end i just can't justify spending soo much money on seeing a private ob, when i can see a public ob for free? Would rather put all the upfront and ongoing costs towards the baby.

I shared my room with DD, and i'll be honest, it was a pain in the butt- but not that big of a pain in the butt for me to choose private second time round ;)

Goodluck with your decision - but by no means don't think that public health is second to private (i had complications after having DD, and had to be rushed into emergency theatre, i was later told had i been at the private hospital, they would have transfered me anyway).

Its a personal choice - do what you feel comfortable with!

I have private health insurance but chose to go public and ended up getting into the rbh birth centre and had DD there. I don't think that you should go private purely because you have private health insurance and the idea that you would be taking someone else's 'spot.' Everyone should be able to give birth the way that they want to and if you wish to have midwife led care then go for it. Good luck for the ballot! I would register for it just in case, even if you end up going private you can always turn it down.

I agree with not worrying about going "private" because you have the insurance...........many of us have private health insurance for so many other reasons.
I have it & chose to go public with DS & will again this time. For me it's simple, we live in small rural community & don't even have the option of getting an ob anyway. So there is no point spending the $$$$ to be a private patient. I will always get a room to myself & the care I need. Infact any time we go to the hosp we go a public, unless we need to see a specialits or do not want to be on a waiting list etc.

i would go public because a) i cant afford private, there are ALOT of out of pocket costs involved. b) private patients seem to generally be induced, or c-sects (very general statement i realise) c) you arent guaranteed a private room anyway d) i went public twice and i didnt have any dramas or issues.

hi loupy,

i'm going private with our private cover cos i figured that's what we've paid for and I am not keen on sharing a room afterwards. But we have extenuating circumstances and i probably would have just gone public if i'd been able to conceive naturally etc

as it was we hit the 80% medicare rebate by february thnaks to IVF and are only $400 out of pocket for our private obs and hopstial (which isn't a big deal given we both work full tme and have no financial burdens). Also we chose our obs because she was the doc who transferred the only embryo that has ever stuck - so we felt a connection to her and she knew us.

i really think there's pros and cons for both and its such a personal choice. maybe it would be better to ask around locally in your area of some mums and see what they say. I know one of our public hosp in my area you wouldn't touch with a stick, but the other is very very highly regarded in terms of maternity etc.

if you are really in doubt, i'd go public cos at least you aren't out of pocket any money. i suppose you've got to look at the reasons to go private and whether they are really improtant to you or not.

good luck hun.

What difference is there in appointments during the pregnancy between public and private?

I am going public, and have already had a few appointments due to being 'high risk' (my health, not bubs). I know i couldn't afford the treatment if i went private, but for those with 'normal' pregnancies, do you spend less time in the waiting room if you go private? Do you get the option of more out of hours appointment?

these things could potentially sway my decision.

I went public with my daughter 4 years ago. I had to attend the hospital for all my app's and there was usually 3 others booked in at the same time. I did have my own room after the birth, but apparently this was because I'd had an Emergency C.
The only out of pocket expenses I had were for my scans (difference between there charge and medicare rebate) and that was it.

I went private the second time as I'd had alot of issues getting pregnant and I wanted to use the specialist I had been seeing the whole time.
My fee to see the Specialist was $3500. $2000 at 20 weeks and $1500 at 30 weeks. I then had to pay $350 excess for private hospital. I paid for the scans myself and claimed back the money later.
After paying the $2000 we were able to claim back 80% after the initial medicare gap was paid. after that we got back 80% of all out of pocket expenses except for the $1500 we paid at 30 weeks. (we claimed this at tax time and got about $150 back).

After paying everything, we ended up worse off going private, but if I have another baby, I would like to go Private again. I like the doctor I used and I also had a Caesar the second time.

Hope this helps with your choice

Sorry I forgot to add, I used to wait at my Ob/Gyn appointments (Private) for sometimes up to an hour. This was due to 15 minute appointments and the Dr running behind!

Hey all,
We also have PH due to fertility reasons and have decided to go through the public system but as a private patient. We are having bubs at a public hospital, have been seeing a public ob (due to the fact that private obs in my area are very strict with available hours). The private doctor who will be there to deliver bubs works at our local doctors and is seeing us as a public patient until bubs is due. Then he will switch us over to private for the only reason is I want to have my own room.

Also as he is seeing us as a public patient up until just before bubs is born so we don't have any out of pocket expense.
When we do go in under private (just for the birth) there will also be no out of pocket expense as our doctor is going through the access gap system (where he bills our PH direct). we also have no excess on our hospital stay.

Hope all my rambling makes sense.

:)

i should also add that we have no excess to pay either and my private ob charges $2000 neat for the whole kit and kaboodle - which i think is pretty reasonable.

i can't give you a comparison on waiting times... but we do spend a lot of time waiting for our ob. Once it was 2 hrs and mostly it's an hour.. that's cos she's super busy, they book the appnts too close and women keep having babies on our appnt days (our obs told us she thinks we might be causing all the deliveries to arrive once a month when we visit her lol). i've never asked for out of hours appont as i get time off work for them.

we pay up front for everything and then claim it back through medicare. as for value for money... ask me in dec ! lol.

:)

This is a bit of a saga but it might help you weigh up a few things that might be factoring into your decision ;)

I originally went private because I had heard many bad things about the local public hospital. I had also had a rather unpleasant experience in a shared ward in a public hospital (not the same place) when I had my appendix out so I decided I wanted the benefit of a private room and my husband to stay with me.

When DS2 was born we had moved further out and as we still had PHI, the closest hossie to us was private and the same OB worked there too so we went there. I was labouring in the bath and due to the no birthing in the water policy I was dragged out by the armpits when I started pushing.

When I was newly PG with DS3 the flashy new public hospital opened but it was a low risk facility which meant they wouldn't take me because I had a retained placenta and a PPH with DS2. Had they taken me I would have gone there without a doubt because they have nice big baths that they let you birth in. I also considered going to a different public hospital because of being dragged out of the bath and I was still a tad bitter, but because DS2 came rather quickly I decided we didn't need the stress of birthing in the car on the way there. So we went back to the same private hossie.

So when DD was born we went back to the same hossie, again for the same reasons. My OB didn't make it for the birth but did when I had a PPH 2 hours later.

In 4 pregnancies I only had 2 appointments rescheduled due to him attending a birth which I think was pretty good. I did have a few times when there was a bit of a wait but after having him tend to me with 2 complications post birth for hours, I totally understand why they run behind some days.

The fees can be quite a shock to the system I agree but they all go toward your safety net.

Loupy - if you would like to try to get into the birth centre at the RBH I say go for it hun. Just because you have private health insurance doesn't mean you have to use it.

I gave birth in a public hospital but had a private OB just for appointments. I felt I would feel more secure having the same OB see me for all my appointments but was happy to have the midwives deliver the bub. I was only out of pocket about $20 for each appointment. No pregnancy management fee. No hospital costs. I don't know if I'd bother with an OB again though as they don't do any special - just order tests & measure you. The midwives at the practice took my BP each time. I'd see him for maybe 5 minutes a visit.

If your pregnancy becomes high risk in the public system you will see an OB.

Regardless of what way you go midwives are the ones who you spend your labour with. The OB only comes in right at the end (or if it's a long labour will pop in to check on you here and there). You have no guarantee your own OB will arrive in time, or that he/she will be on call if it's out of hours.

My pregnancy was low risk throughout but an OB was required to deliver bub. It was the on duty OB & he did a fabulous job of it.

I never minded having to share a room. I never had to wait to use the loo or the shower. Food was fantastic & I'm mega fussy.

If I was to do it again I'd go public in a heartbeat.

I have done both public and private.

The level of care I received in both instances was great.

What was good about my public experience: You really don't pay for much at all. You get to see an OB anyway if you're deemed high risk, even for all your appointments.

What was bad about my public experience: Long waits for appointments, only 2 ultrasound scans and both on site at outpatients with no facilities to print a nice pic or record a dvd of your bubba in the womb, and I shared a room with a woman who had a toddler and lots of noisy family visiting constantly, I just didn't get any peace.

What was good about my private experience: got to have fab one on one chats and didn't feel rushed with my OB at most visits, got a little mini ultrasound each visit so lots of bonding with baby, got my own room in private hosp for 6 nights - heaven - own bathroom and no one else's visitors.

What was bad: Long waits at appointments, sometimes he was out delivering a baby so you just didn't know when he'd be back - do I stay here waiting or rebook? My OB had the weekend off when I delivered so I got his fill-in guy, who was fabulous, but I had never met him before and I felt a bit ripped off, and I had to show my bits to this strange man I'd never met !!! Pfft!!!


All in all - it's private again for me this time round but only because I really really want my own room and peace and quiet in a nice hospital. I really feel the level of care across both was the same, and even though you get lots of money back going private, you do pay a lot more for stuff that comes for free going public.

My local public hossy is a disgrace (in terms of service, ammenities - tho i hear SOME midwives are great) and I wouldn't go there (for non baby reasons) unless I was dying and didn't think i'd survive the trip to Syd/Newcastle. So I didn't feel like I had much of a choice to make. My experience with my Ob and private hossy was AWESOME and I wouldn't hesitate to go back with my next bub. My room was lovely, food great, always a midwife when I needed one eg when I needed help to feed. My Ob did deliver Blake via ventrose and did a great job stitching me up. Also got to stay till I felt ready to go home (5 days). My local public has also got some very bad press lately regarding crap/inadequete meals and forcing women to go home before they are ready (ie after 4 hours - when they WANTED to stay in). I have also had a local GP tell me to drive to Westmead (about an hour away) - don't go to local - if DS needs medical attention

Going private was $$$ ($80 per visit + $1000 preg planning fee + $200 excess + scans) but such a great, positive experience before during and after birth - priceless.

If you have a good public option - you will have a harder decision to make than I did.

I have PHI and went Private. I had a brilliant experience. Having a private room and the ability for my partner to stay the entire time was what swayed me over.

i just wanted to remind you of something:

Just because you are a PRIVATE patient - does NOT guarantee you have a single room. Unless your hospital only has single rooms (well then... chances are high arent they lol).

Both public hospitals i attended (yes different ones for each child) were only single rooms - which i thought was great for a public.

I too had long waits in my clinics though.
but both boths did not cost me a CENT. nothing.

xx

I went private and loved it, will do the same again. But my Ob has been my specialist for 10 years, and I trust him and feel extremely comfortable with him. I think that's really important. Also I delivered at a private hospital that is within the women's hospital, so I felt comfortable that all the facilities one could possibly need were right there in the same building. Yeah, my Ob runs late sometimes, but you get that everywhere, and he never rushes you in an appointment. You get the feeling that he has all the time in the world for you, which I love.

Having my own room and my DH being able to stay the entire time was a massive bonus, but was not my main reason for going private. I just have control issues, and I hate the thought that if I went public, and I needed an Ob that I would just be lumped with whoever. I want to CHOOSE my specialist. But that's a personal issue of my own :lol:

I totally understand why many people prefer public, but it's not for me.

I went public, don't see any need for private personally. Still the chance you'll get *****y midwives either way hehe.

I didn't mind being in a room with three other girls - it was nice to be able to chat with them as it can get so boring even when you're dead tired. Swapped a lot of tips, had a laugh etc. Was great, looking forward to it again in December.

i went public for my son
I had the gold standard care with my DD with a private m/w, apponitments were about an hour long at my home i could ask any thing any time and not get pushed out the door. she was with me from the moment i called until a few hrs after birth.. then visited again that evening the next few days and weekly until 6 weeks!.

I went private with first pregnancy and was so glad because it ended in miscarriage. Instead of going to local GP or midwives or emergency, I was able to contact my ob on his beeper at any time and he scheduled a scan for me ASAP. When I found out I had m/c, he booked me in that night for a d&c as opposed to waiting in emergency department.

We went private for DD and loved it all - personal care and own room. I know you're not guranteed private rooms but you may stay one night in a shared room thenget moved anyway.

After having DD we did consider public because provate can be expensive andI knew friends who went that way and still had good care. However, after visiting a friend in a room with 4 beds i thought NO WAY! After giving birth you're so sensitve "down there" and need to go to the toilet a lot and I wanted privacy for that. I also wanted 4 nights not 2 so I could relax and enjoy getting to know our baby and what to do rather than being rushed out.

My friend who gave birth on a Friday morning slept that arvo, had visitors as well as midwives giving overload of information on the Saturday and then home Sunday morning. Her milk hadn't even come in yet. My 5 day stay meant more time to catch up on sleep, leanr feeding techniques and enjoy the help provided by midwives.

So that's why we chose provate again - maybe small selfish reasons but good enough for me! In saying that lots of public hospitals have excellent reputations too and it can sometimes simply depend on which midwife is on duty on how good they are.

I was the same as you and in the end decided to go private. At the time my key reasons were:
- I wanted the extra time in hospital with the midwives so that they could help me learn to breast feed when my milk came through
- I really didn't want to be in a shared room and if I had to be I wanted it to be for as little time as possible
- I wanted DH to be able to stay with us, I think the bonding he did with DS while we were in hospital has been the key factor in him being such a hands on Dad (particularly cos I had to have an emergency CS and he had to do everything for the first night, I can't imagine what it would have been like if he had to go home, I guess it would've been a midwife doing it)
- I wanted to see the same person for my check up appointments throughout my pregnancy.
- I would have a midwife with me the whole time I was in labour at the hospital (one on one ratio) and wouldn't be having to share them with whoever else was in labour.

I had a really good pregnancy with no real problems and I must admit towards the end I was thinking that next time when I had a better idea of what I was doing it wouldn't be worth paying the extra to go private. Well that was until everything I had planned for the birth went out the window, then I was so glad to have my OB who I knew and trusted.

Basically my waters started leaking. Because my OB knew how much I wanted to have a natural labour he gave me 96 hours for spontaneous labour to start (the midwife told me that in 99% of cases you will be induced that same day). I was on antibiotics and had to have monitoring each day to make sure everything was okay. But unfortunately DS never engaged and while I had a show right after my waters started leaking I never progressed to labour. So four days later I had to be induced. Not what I wanted, but I was happy because I felt that we had given it a good amount of time.

Unfortunately 11 hours after I was induced my labour still wasn't progressing very well. I had dilated to about 7cm, but the minute the syntocin was stopped my contractions stopped. A VE revealed that DS had turned and become posterior and that his head had lodged in my pelvis at the widest possible point. It was at this point my OB told me that he thought that it would be best to do an emergency CS. Because he had been through the pregnancy with me he knew how much I wanted a vaginal birth. At that time when I was at my most vulnerable I was so glad to have him advising me because I had a good relationship with him and trusted him completely. I think that if it was an OB who I had never met (as it would've been in a public hospital) I would not have had faith in them and wouldn't have been so trusting of their advice.

While an induction and a CS is the last thing I wanted I am totally at peace with the way that it worked out. It happened the way it happened because it was medically necessary and I'm thankful that my OB gave it every opportunity for us to have the natural labour that I wanted, even though in the end it wasn't possible.

So next time I will definately being going private and going with my OB. Not only for the reasons I listed to start with, but because if things don't go to plan having someone who you know and trust managing your labor means you can focus on doing what you need to do rather than second guessing an obstetric registar who you've never met.

I think the girls have well and truly covered all aspects of public and private but here is my two cents worth:

We chose private for the following reasons:
- our local private hospital is only 10 minutes from our house and it is LOVELY. Everyone who stays there refers to it as the 'hotel'. The rooms are really nice, the service is great and the midwives get a really good wrap
- they only have 2 shared rooms (max of two per room) and 35 private rooms so the chances of getting your own room is high. If they are busy and you do have to share, it's usually only for a night then you are moved to your own room
- DH can stay - woohoo! If you don't have a double bed in your room, they bring in a rollaway for DH.
- the rooms have bar fridges and tea and coffee facilities so it's a lot more homely. They have normal TV's with a movie channel too.
- I can take in my iPod dock and play music in my room - a big plus for someone who always has music playing
- the hospital runs various classes for mums and dads outside of visiting hours
- you have access to physios who specialise in women's health during your stay (they are actually my physios and are brilliant) who can help with laser and ultrasound treatment for tears, cracked nipples, swelling, etc.
- I can stay for up to a week if I choose. Some girls say I will get bored and maybe I will but I do like the idea of being in hossi until my milk comes in at least! I plan on making the most of the experience that is only a 'buzzer press' away too.
- my pregnancy is very low risk (so very healthy and a tad boring I guess!) but my OB is brilliant and I love seeing the same familiar face (and same midwives) at each appointment
- I have never waited any longer than 10 minutes to see my OB
- we hit the Medicare threshold a while back too so our out of pocket expenses to our OB are probably only $200 total
- they supply everything for bubs during our stay. I only need to take a couple of outfits and a blanket to take bubs home although I am taking in several wondersuits and newborn nighties cause I just love them!

So they are our reasons for going private and so far we are so happy with our decision.

It can help out the hospital if you use your private insurance.

I have had some recent experience in a public hospital (not for giving birth) where they ask that you use your insurance to help them out financially. They said that it helps them to help more people and I guess it takes the pressure off the public health system in general.

The hospital has a policy that they only charge as much as your insurance will cover so you don't end up paying a gap. Also they were happy for you not to use your insurance if you would have to pay an excess.

I'm sure it varies at different hospitals, but in my case it seemed to be the socially responsible thing to do. I have already paid for my insurance, so why not use it? My insurance can cover my costs and the public system can then help out another woman in my situation instead. Maybe it isn't as simple as that, but it makes sense to me.

I have private health insurance and chose to go in as a private patient in a public hospital.

I would see the public hospital OB (whom also worked at the local private hospital) if there were any concerns during my pregnancy so my care was always of great standard as far as i could see.

Like Raven mentioned there are no guarantees you will get a private room if none are available in a public hospital. If i had DD only minutes later i would have missed out on the last private room available as another patient (public patient) was about to get the private room but cause i wheeled my baby there 1st and i was a private patient i got it 1st.

I have many friends whom had their 1st baby at a private hospital and their OB didn't even make it to their births which they felt let down so chose to go public with the next baby.

GOOD-LUCK with your decision :D

P.S - Like Holly suggested ask your local hospital if they have a policy or program as such where you can pay just the excess (which i did) ... my local public hospital had a program (or maybe scheme is a better word for it) where they are encouraging private patients to use their hospital. I was even given a choice of a voucher as a gift from the public hospital in doing so for example there was a day spa voucher worth $300 ... but i chose a $500 gift voucher to spend at a local baby/child's clothing shop :dance:

Just wanted to add that if you get into the birth centre you will have your own room -they have double/queen? beds and your partner stays with you.They aren't strict on visiting hours either so DP could go out to get food and home to get me clothes and come back in to the hospital after hours. Although they do try and get you home as soon as possible after the birth. I had DD at 8.50pm and we stayed that night, she was pretty spewy and we weren't having much luck with attachment so when they wanted to discharge me the following day I told them that I wanted to be transferred to the maternity ward as I wasn't ready to go home. Regular maternity ward has shared rooms with 4 people and some private rooms I think. I don't think they were able to get me a bed up there so we ended up staying in the birth suite for 2 nights. You do get continuity of care with the midwives. I had 2 midwives that I saw for all of my appointments after my intial book in and one of them was there for the birth and we saw the other one for after care. I did have to wait for some of my appointments when there had been a baby delivered (same situation if an ob is on call for a delivery) - max of 45 mins and sometimes they were running late as they spend heaps of time with you and answer all your questions. They also have another system with rotating on roster midwives as opposed to on call. We moved to the south side during my pregnancy but if you live on north side you get home visits from a midwife after the birth when you go home.

The only thing I would be wary of is if you do have complications you will be transferred from the birth centre. I hadn't really considered this myself but when I have a second bub I think I will have a doula as well. The midwives were fantastic and if you are transferred during labour your midwife will stay with you but when it comes down to it they have to follow hospital procedure and they can only be your advocate if you advise them of what you want. You can't guarantee that you will be able to make decisions regarding intervention when you are in the heat of the moment so I would like to have that extra support just in case. (FYI I had a textbook pregnancy, went 7 days over, wasn't induced, had a waterbirth without any pain relief)

I think the main thing is that you feel comfortable in your decision and have the support to have an empowering birth experience.