Private vs Public (Interventions etc)

Hi Ladies,

Hubby and I made sure I got my private cover for when we have a baby.
I'm not UTD yet but reading alot about hospitals, assuming i'll have a successful preg soon and have been told you need to book your hospital asap to secure a spot.
I've been reading up on the hospitals near me via google and I read a post from a woman saying intervention at private hospitals can be 50% or more and epesiotimies 30% is this true?
I would like some advice from ladies out there who have had experience with public or private and what the pros and cons are.
I am going to be a first time mum, I don't want intervention or a c/s unless bubs is at risk.
I basically want a natural drug free Vaginal birth.
I don't want to feel pressured into doing things I don't want to do. I want to be able to labour the way I feel comfortable etc, not stuck on a bed with my legs in the air.
Can anyone recommend good private or public hospitals in the Sth east subs of Melb?
My closest are Casey, Dandenong, Sth East Private, Jessie Mcpherson, St John of God.
Can you please tell me why you chose the hospital you chose, public or private?
And when you're in the moment do you get to say no if they want to intervene?
Thanks everyone
xox

I have stickied the stats for Vic somewhere in a birthy section...

Ahh ok thankyou, i'll try and find them :)

I chose private first time as I wasn't happy with one of the public hospitals and what they put SIL through and the second was too far away. I had private health insurance and we decided to us it so I ended up at Mitcham private I ended up having an emergency c sect at 34 weeks as I went into pre term labour, my waters broke and DD was breech. I was more than happy with the care we had afterwards DD was in SCN for the weeks and had lots of check ups with a pead and a pead ortho surgeon for hip dysplasia.

With DD2 we went back to Mitcham, again I went into pre term labour at 35 weeks but was closley monitored for two weeks beofer going to into labour the only intervention I had was having my waters broken, DD2 was born naturally after a very short labour ( about 3 hours). I had gestational diabeties with the second pregnancy and I was given the choice of having a c section at anytime after I first went into labour at 35 weeks but my ob and the midwives supported my decision to let nature take its course unless I went past 38 weeks and DD seemed to big.

I am going back to Mitcham again for no 3 and my ob is happy for me to have a natural birth.

I've had a baby in both, yet for my third it still makes the decision hard. My first daughter was public at the GCH - we did have phi at the time but my dr sent the request through to GCH and told us we didn't need to worry about a referal to an ob because I was low risk. We didn't know much about any of the other hospitals in the area, so we just went with the flow. I read lots, researched lots, did everything I felt I could have done to prepare not only my mind but also my body. BB was a wealth of knowledge. I did my birthplans etc and stipulated I wanted no drugs, no intervention, active labor etc. It was a fabulous delivery, more than I could have ever dreamed of... I absolutely loved it. The midwives really didn't do much, they just sat back chatting allowing me to follow my instincts, helping me with shower for pain relief etc. And when the time came and the baby started crowning they came over to assist, but they encouraged me to grab my baby from between my legs as she came out (I was on all fours) and offered to hold a mirror so I could see. They were wonderful and I was on a brilliant high! Aftercare was ridiculous, I didn't even get checked, saw a middy only a couple of times and that was when I buzzed for one. I buzzed for help with bf'ing and one came in turned off the buzzer, told me she'd be back to help me and never came back. I really struggled with bf'ing I was very close to giving up as I struggled for weeks. I had my baby 9am one morning, was out the next. I didn't realise till my second baby, but they never checked my bleeding and the first day I went through three packs of pads and had to ask hubby to get me more. I didn't even use one pack of pads my first day in hospital with my second and they were so concerned about my bleeding they checked me half hourly because they said it was heavily (it was just like a period for me, nothing compared to my first - yet I still needed a d&c). My body also was suffering from shock after my first, I was told because it happened so quickly) I couldn't walk by myself until the evening, yet it was so hard to get a mw that I had to keep trying to get to the bathroom myself, everytime I stood up I'd go woozy any my legs would just give in (not to mention the shakes), so I'd try and make it to the toilet by myself with blood all over my pants because I was bleeding so heavily in front of everyone and a couple of times ending up on the floor! My husband wasn't allowed to stay with us either, he was only allowed to be there during visiting hours.

Second baby I had her at st. Vincents. I had another really good birth but it was much different to the first. It was again a very quick one and the ob didn't get there till she was almost out. I really talked with the ob alot with the type of birth I wanted, did the birth plan thing and everything else I did with dd1. The labor itself was very different to my first (contrax didn't hurt like I remembered they did - resembled period pain the second time) but the labor in hospital I felt was very instructed. I wasn't left to follow my own body instincts like my first, they kept making me get up on the bed to have to baby checked, I wasn't allowed to get in the bath, I wanted to get on my knees but they'd only let me birth on my back which I genuinely felt was much harder. They told me they don't have as much control of things any other way but when on back. I had a troubled third stage which took more than 30mins of my 2hr delivery, but they were very thourough. Aftercare was amazing, I had so much help with everything! Breastfeeding I was constantly offered help, my babywas checked by a pediatrician daily, my husband and dd1 could stay all day even over night if we wanted, whenever I buzzed a mw came straight in. I stayed 5 days in total and feel the aftercare could not have been better to be honest!
Now I'm expecting my third, I'm trying to decide where to deliver this time. I feel there are downsides to both and wished there was a best of both worlds.

I guess you can't really take my poor public hospital aftercare experience, because there might be public hospitals with wonderful aftercare! But they are my honest experiences.

Best of luck with yours. :) (I hope my post wasn't too all over the place, I'm on my iPhone and I find it painful to type posts on)

Hi Catherine,
I'm on my iPhone too, they are a bit of a pain to type on!
Thanks for your post it was very informative, guess I'll have to do alot of research and get advice from ppl with personal experiences at specific hospitals! It's scary, I don't Want my birth experience ruined because I can't do what feels natural for me! It concerns me I will be made to give birth flat on my back, just don't think it would be right for me!
Hope all goes well with number 3
xo

It was my own fault, I should have talked about the position I wanted to birth in with my Ob, but with my first I got the impression that delivering on a womans back was outdated. Clearly it's still common practice in some hospitals - maybe clarify that when you see your provider! Thanks for your well wishes. :)

I've gone private for both my pregnancies & both times i've had drug free vaginal births.
My first time i went to South East Private, it was nice I had fantastic midwives & the rooms are nice and big.
My second time i went to St John of God & i love it there, I had wonderful midwives who were very caring. They left me alone most of the time because i was second time mum & they didn't want to interfere, but would always come very quickly if i needed help.
They were always helping out the first time mum in the room next to me :)
They believe in rooming in at all times at SJOG as well.

At no times did my OB's interfere & my midwives were very respectful of me having a drug free birth :)

I went public at Monash Clayton, they were very pro natural birth so I didn't have any problems with them pushing drugs, interventions etc. Although that being said I went into labour early so I don't really know their thoughts on induction etc. My labour went very smoothly and had a wonderful midwife who was very supportive of my active birth positions and was quite happy to sit with me on the floor. I had some trouble pushing at the very end and DS's heart rate dropped dramatically so he was quickly delivered with forceps but apart from that I had a very hassle free birth. The midwives and the OB did all they could to try and get me to birth naturally before they considered the forceps, in the end they had no choice, I just didn't know how to push properley ;) I think they made the right decision.

My suggestion would be if you go private do your research and find an OB who has a good reputation for being pro natural birth. Private hospital's high intervention rates have a lot to do with the doctor, some are more scalpel happy than others. If you go public get a doula, they can help advocate your wishes for a natural birth with unfamiliar midwives/doctors. Actually I'd say get a doula either way, they're great:dance: Mine told me that Casey has one of the lowest intervention rates in Vic, so might be something to consider?
Good luck with your choice

i'd love to read the sticky Kelly mention if anyone knows where I could find it?

Hi, I don't need to send in my booking/registration for the public hospital straight away, I thought I would need to book but apparently my OB does it and as long as the hospital receives my paperwork 2 weeks before delivery everythings ok. I also chose this hospital because they have such a great rep for low intervention.

Re intervention, I think it's a common belief that private OB's and hospitals push intervention and CS to make more money and for time convenience... I'd like to shine an different light on that, consider that public hospitals are even more pressed for time, beds, scheduals and they want money too etc than what a private hospital is... For example i was told an interesting story of a ladies birth only a few weeks ago in the public hospital here... There were 8 births that day and only one natural (hers) and that was only because she insisted that she go it natural! The midwife came back to her a next day and told her about the other 7 births and how unnecesary the CS's were and congratulated her for sticking to her birth plan. I think the moral of the story is you will need to be confident enough to stand up to whoever is giving you advise on the day and ask as many questions as you need to without jumping into surgery or getting drugs. Goodluck

Babyluv - I'd do two things. Have a look at the stats obviously and if you do decide to go private, ask the ob for their caesar rate - that would be a pretty good indication of how pro-natural birth they are. It's not just about the caesar rate obviously, there's also interventions such as inductions, episiotomies etc. but I think their caesar rate would be a pretty good indicator.

Then compare that with the public hospitals. As someone else said, when it comes to private hospitals there could be a big variation between doctors. For instance, my ob has the lowest caesar rate in Melbourne but the hospitals he delivers at still have quite high caesar rates (I think one of them may even be as high as 50% but it's a while since I looked - that's going on what someone told me recently). If his is quite low (so say 20% which is not that low but just for the sake of argument) and the hospitals is 50%, there must be obs delivering in that hospital whose caesar rate is much higher than 50%.

I imagine you wouldn't see a big difference in caesar rates between obs at the same public hospital but I could be wrong and I'm sure someone else will pop in with more knowledge about that.

Wow thankyou girls, I have alot to think about.
We are not UTD yet but hoping it will happen very soon.
I definately want a natural birth without drugs or intervention unless medically necessary.
When I find an Ob I will now be asking what their Ceaser rates are.

Good for you Babyluv - I don't think they are used to being asked that question (but it's a personal mission of mine to get more women asking) so expect them to be a bit taken aback. But I think their willingness/unwillingness to provide you with an answer will also speak volumes.

Thanks Fiona :)
I guess if they are for natural birth they won't be concerned hey?
If they have an issue with the question maybe that's saying something ;)

Hi Babyluv,

The gals have given you tons of information, particularly Catherine.

I'll quickly share my story as I went to SJOG in Berwick. This was in June of 2007. I chose SJOG as I live 5 mins away, have private health insurance, had heard mixed reports of South Eastern (two terrible reports being from a very close gf of mine - PM if you want the details). I also heard from a GF that at the time Casey would not admit you if your BMI was in the obese range, which mine was and that you would have to go to Dandenong hospital.....

Started pre-labour on Thursday night - up & down, timing contractions, calling the hospital, going to the hospital then being sent home as contractions would slow down. This was constant over the weekend too. Went in Saturday & had internal done, only 1cm. Was told to go home, rest as much & if contractions come on quicker/more intense to return - never bothered, nothing really changed. Went in very early Sunday morning as I was buggered from lack of sleep & they asked if I wanted a sleeping tablet but had to remain in hospital so they could keep an eye on me. Must have dozed off then ended up in the bath/shower at about 5am on & off until OBS (not mine) came in about 8am (?), again only 1cm dialated. Grrrr! Was given option of going home to continue labouring & seeing fill in OBS (mine was on holidays) the next day about 4pm or have my water ruptured / put on the drip. Chose the later after much consultation with DH & sister. Full on labour started 10am labour progressed to about 6cms dialation at about 4pm. Ended up trying the gas & had an epidural for pain relief. DD heartrate was becoming difficult to find & when they did it was all over the place. She seemed wedged right under my ribs, rather than down & engaged (?) OBS gave me choice of continuing to labour or c-sect. Again, after much consultation with DH & sister decided on c-sect. DD was 'born' just past 6pm. Care during theatre was amazing. Everyone kept talking to me, telling me what was going on, m/w & other surgical team kept stroking my hair, holding my hand. Went to recovery for short time before being t'fered to a room where I got to properly cuddle & feed DD. Next day was transferred into a double room - DH quite welcome to stay and stayed for 8 days due to bf difficulties. They offered for me to stay another day but I declined & went home.

I agree with choosing an OBS who is supportive of your birth choice but also you want to go to a hospital where the m/ws are supportive of the after care and parenting choices you want to make. SJOG m/w were really quite supportive. Some I didn't 'click' with & one when I decided to ff DD chose to ignore me (WTH?!), other than that I couldn't really fault them.

Many hospitals offer 'information sessions' where you get to tour the midwifery unit & meet an OBS & m/ws. If you can, go to them and get as much knowledge as possible. Best of luck with your decision.

Thankyou so much rhichichi,
I was considering SJOG and have heard good things, I will definately go to an open day! Sth Eastern was recommended by hubby's mum, do you mind telling me what happened with your friends who went there?
Sounds like SJOG gave you the freedom to make your own choices and try for a natural birth which I really like :) I've also heard since the renovations the rooms are big and hubby can stay and that bubs stays with you the whole time! Anything else you can share about SJOG?
Thankyou again for your response
xo

I've PM'ed you about Sth Eastern

In total there are 16 rooms in the maternity ward - 8 for c-sect and 8 doubles. The doubles have access to a balcony and there is a bath in each room to bath the baby. (So good you don't have to leave your room to bath bubs!)

Rooms are larger at Sth Eastern from what I can remember & fairly seperate from the general admission ward. At SJOG the general admissions ward links up with the maternity ward (no doors to walk through), although you can tell they are seperate wards. Parking is a bugger at SJOG if you choose to park in Gibb Street, otherwise there is parking on Gloucester Ave.

DD stayed the majority of the time in my room, although the m/ws gave me a break & took DD for a little while so I could try to sleep.

One thing I think all mums should do is put the sign on the door that says 'Do not Disturb'. That way you only get m/ws coming in when you call for them or they have to check something and to drop off your meals. I remember cleaning staff coming in really early to clean my ensuite & change my towels - which was awful, so I ended up putting the sign on the door & closing the door. They come back later in the day to clean & change towels.

I actually went to the hospital today to see my nan & they also offer at home midwifery service if you go home early. That is a new thing, they didn't have that when I was there.

If I think of anything else, I'll let you know.

I had DD in a public hospital (not a large hospital) and it was a wonderful experience, pre and post natal!! Midwives very helpful.... from my research and understanding, you have much less intervention in publics. I had a drug free birth and the hospital was very baby friendly. I also had a birth plan to give to midwives so they knew my wishes. (don't offer me drugs etc).

My DH is a registered nurse and has worked in both public and private. The thing is that many nurses have worked in both so you still get the same quality of care. Most public hospitals actually have better more upgraded equipment than private hosps as they have government funding too ;) remember that.

Again, it depends on the hospital too. Good luck with your decision. :D

I will birth #2 again in the same public hospital and even though I'll have private health cover with bub #2, I will still go to a public hospital. I don't want an OB :D