Private/Public??? help

[tippytoes]

I am not even sure if this is the right forum to post thread in. I feel a little overwhelmed at the moment.

Okay.... Had BT today all look good - as clinic is closing they were a lil pushy about the next steps (ie what type of care I wanted) bascially so I could get booked in for a scan etc! I originally wanted to go public Midwifery but I am a little hesitant. I read on the website that you basically leave 4 hours after the birth. I may be reading this wrong etc. I feel really ill-informed. I don't know where to start. I know what is important to me.
That is:
1. trying for natural vaginal delivery
2. learning to breasfeed with support if I need it
3. not being rushed out of hospital when I don't feel ready.

I know everyone has different experiences and strong opinions. I am open to suggestions but I have things that are important to me too.

So far, I booked in to see a Dr that I think is wonderful - OB/FS. I really trust him and I know he wouldn't force CS on me unless necessary. We have a scan on 29th Dec.

Do I speak to GP?? Tried to talk to public hospital, basically was told the midwifery program does strongly encourage you to leave 4 hours after birth. She said the midwifery practice made her nervous too??? ! I think I need to speak to someone more informed? She said I could go as a private patient in the hospital - but then I may as well have my own Dr anyway.

If someone could just tell me who I can get some proper information from??? my GP????

Thanks

Rach xx

[Janie71]

Rach - I know how overwhelming it all is. I would suggest talking to your GP to obtain all your options.

I have decided to go with a private OB, but I think the next time I come to do this I would consider all other options. I sort of felt like it was the expected thing to do after falling pregnant by IVF (sort of felt like my IVF clinic encouraged it).

In saying that, the only thing I haven't enjoyed about going private is the fees! Everything else has been fantastic. My OB is wonderful and I feel so well looked after.

Sorry I couldn't be more help.

Janie xxx

[Snacks]

Congrats on the pregnancy!
OMG, who did you speak to at the hospital? She wasn't actually a midwife then?
Personally, I'd be speaking to a midwife at that hospital if that's the way you want to go - they'll know exactly what kind of care you'll be getting
If you want to spend a good few days in hospital after the birth then I'd suggest going private. Most people I know who've gone public tend to only stay a couple of days (though you can always tell them you don't want to go home yet and they won't physically kick you out, LOL. They might just pressure you a bit because obviously in public the beds are scarce.
For the other reasons you've listed, I'd think midwife led care would be great for you, but given the hospital preference you'd need to see an OB (can't go to a private hospital and have midwife led care as far as I know.)
If you are comfy with the Dr you've booked in to, what's the reservation? Is it cost? It'd be good to get the costs directly from him straight out so that you can prepare for it, if that is the issue.
Some GPs are great with this stuff, others are not. For instance, I was made to feel irresponsible by one GP for going through the midwife clinic. I am glad that I was already secure in my decision before I went to see her (it was for a different matter anyway), otherwise I would've been very confused! But my current GP is great and this time round I have to go to a different hospital which is huge and busy, so I am having shared care with my GP and so far I'm loving it.
Hopefully you find something helpful in all this waffle. LOL. GL with making your decision.

[Tobily]

Leaving after 4 hours is completely voluntary - and usually only happens in birth centres or in caseload midwifery. People going general public with midwives will usually stay 2 or three days after a vaginal birth, as opposed to 3-4 in private. Your chances of a natural birth are much better with midwives than obstetricians, all things being equal. We see this year in, year out in the perinatal data in every state in Australia.

I'm very wary of FS/OB's for mum's wanting a natural birth. We tend to find that the inflexibility of their fertility clients (who require treatment at very specific times of the month that can't be "rescheduled" easily) compete with the more flexible needs of their obstetric clients - so they seem to push inductions of labour or caesareans more so than OB's who only practice obstetrics/gynaecology. It enables them to juggle competing commitments better - they can "plan" their labour attendance so that they are available to do fertility treatments when they need to do them. So this is something to be aware of and to ask your FS about. How does he/she manage this?

Good luck

[smiles4u]

I did a Midwifery program and it was the most wonderful experience of my lifetime ... the two midwives even came to my daughter's 1st birthday party and when we all run into each other in town we actually get emotionally teary ... that how beautiful these two midwives are !!

I was a private patient in a public hospital ... and even if i were a public patient i was still able to stay the 3 nights

Me, too .. i think the 4hr suggestion 'must' be voluntary

I couldn't have imagined in my wildest dreams leaving that early after giving birth !!

[Nixon]

Hey Rach,

I'm booked in Private with my own Ob. Figured if something does go wrong and I do need a C/S then I want to know the person operating on me.

I also want a natural birth - I would suggest calling a few hospitals and asking if they do tours. The one I am going with does a tour ofthe birthing suite and rooms every Sunday - you can go along and ask all the questions you want. I've been twice - once before my Calm Birth classes and once after to ask more questions that related directly to how I want to have my baby and if they had any problems with the techniques I would be using.

I also found it really hard to know what to do and felt REALLY stressed about making a booking so early on, but I am feeling really good about things now.

We have private health insurance and figured why not go private when we are covered for it. The only thing we can't get any cash back on is one payment to out Ob of $1900. The rest is fairly well covered by medicare and our insurance - especially because we were over the medicare safety net.

Anyway - I think next time we may look a bit more into homebirth and birthing centers, but for my first precious baby I am happy that we are going private/Ob (even if it is only for my own piece of mind)

Good Luck.
X

[tippytoes]

Oh wow guys thank you so much for your help.

Basically, I was discussing it with DH and decided to go through the public midwifery delivery at the hospital.

I feel that the last year we have been scrimping and saving for IVF, AP, storage fees etc. it will be great to just have a birth experience without the financial worry. Also I am a big believer in what midwives do! So there we have it I am booked in at hospital to see midwife on the 22 Jan. I am also having an early scan on 2nd Jan (got referral from my GP).

Snacks - basically yes, it was really the cost thing. Also, the whole IVF stuff is so so medicated/controlled??? (can't think of right word) I like the idea that my body can do this and I want it to be as calm as possible.

Tobily - totally agree about the whole FS thing!

Smiles - glad you had such a great exp

Nixon - I hope it all goes to plan hun. You'll have a great birth I am sure!

Janie - with you all the way re: IVF clinic encouraging it etc!

Thanks you guys are awesome!

Rach xx

[Ellibam]

you can do shared care!
just another option to throw in
so see your OB but have your bub in a birthcentre

[~Saram~]

Rach - yep my GP went through all the options with me and recommended a couple of different people they knew of personally.

reasons I choose to go private

- my own dr and set appointments, the public system I was faced with was an open clinc (ie open from 2pm sit and wait)
- hospital stay 5 night vag birth 7 night csec
- family room

My experience
- hospital stay was good, gave me more than enough time to get myself together
- having my own OB gave me more power over choices in my care, ie neg my induction in both situations

In the end I figure midwives are going to be the same whichever hospital. I have had some awesome ones in private as well as some shockers. I think if you educate yourself enough about birth no-one is going to push you into having a c-sec. If you aware of the things that lead to c-sec etc than you can avoid them.

All the best making your decision

[Snacks]

Snacks - basically yes, it was really the cost thing. Also, the whole IVF stuff is so so medicated/controlled??? (can't think of right word) I like the idea that my body can do this and I want it to be as calm as possible.

Totally understand where you are coming from with all of the above. (Except haven't been through IVF, so I understand what you're saying just from hearing others' experiences.)
I chose midwife-led care for the very same reasons - I liked not having to pay And I liked that with them I was more likely to get the natural birth I wanted (and I did )
This time I am having shared care only because I have to go through a major public hospital and the waiting times for appointments are unreal!
Anyway, congratulations on making your choice It is so overwealming having to make these decisions when you are still reeling from finding out you are actually pregnant! So good on you.
Enjoy your pregnancy

[satya]

The only people I've heard of who've left hossy that early are people who want to & it's usually cos they already have kids at home and they are eager to get home to them.

I gave birth in a public hossy & had 3 nights in a two bed ward & 2 nights in a single bonding room as my bub was in special care. I had help with breastfeeding for every feed and I don't know anyone IRL who got that in a private hossy. The average stay for vaginal delivery for those who were at hossy when I was there was 2 days if no stitches were involved & 3 if you'd had them. I had one particular middy who would just sit on the end of my bed and chat to me for a while to get my mind off my worries of having a sick newborn.

I found the public system fantastic & would do it again if I were to give birth again. I've heard bad stories about how long you can wait to see middys and docs for appointments though but I avoided that by having my own OB for appointments only (although my reason for having an OB was to have one person watch me throughout pregnancy due to my age). The out of pocket cost were minimal (I think $17 per appointment) and no pregnancy management fee.

What you pay extra for by going private is a private room (apparently that's not even guaranteed in some private hossys) and the choice of who delivers your baby. Even so the doctor may not arrive in time to deliver your bub, or may send another OB if they are not available (busy delivering another bub or on holidays etc). If you aren't fussed about those things it's just not worth paying the extra money.

I'm sure you will not regret your decision to go public.

[farmgirl77]

Hi Rach,
Before I was diagnosed with APLS I went through the same thought process, and had decided that I wanted to go through the midwife program as a preference - for many of the same reasons you have identified, and because I wanted something 'normal' post IVF (that is my mental picture of it anyway). However after being 'high risk' we are going private. I think we still could have gone public, but not through the midwives - we would have ended up seeing different obs depending who was on duty.

Good luck with your decision, and I'm sure if you need to you could always change your mind or get second opionions if you have any doubts during the pg.

Good luck
FG

[dusty]

I have decided to go with a private OB, but I think the next time I come to do this I would consider all other options. I sort of felt like it was the expected thing to do after falling pregnant by IVF (sort of felt like my IVF clinic encouraged it).

Janie that was my experience too, the IVF clinic gave us an early pregnancy handbook and the only recommendation was to book an Ob ASAP - no mention of the multitude of other options. There seems to be this assumption that because it took so much effort to get us pregnant in the first place then we must need high level of care in pregnancy and birth. Sure some women going through IVF will need a higher level of care because of any pre-existing conditions, but in our case there is absolutely no reason we couldn't have a fairly intervention free pg and birth (except for my age which increases my risks).

Rach as you know I am going the midwife care program through the birth centre adjoined to our region's biggest hospital. We have PHI of the highest kind, but I figure ALL women should have access to the best care and the public system shoud (and in the ACT) does cater for us all. We don't have the option of shared care which DH was very very keen on, but the more he learns about midwife care from others the happier he is we have chosen this option.

It is such a personal choice but I do wish that IVF patients were given more choice, abilityand encouraged to ask questions in the transition of their care from IVF clinic to the next step of pg and birth.

Like you I have found AC all too invasive and now I am choosing to take a different path for our pg and birth. I am glad you are comfortable with your choice.

Happy to chat anytime.
xx

[Malyna]

Hi Rach,

I went through IVF, but am going through midwifery program attached to the largest hospital in the region.

Plus I've had experiences with private hospitals in the region, and if we did go private and the worst case scenario happened then all of the specialists are in the big public hospital. Also the midwifes reassured us that all of the specialists you could ever need are just 90 seconds away.

My advice to you is to think about what model of care you want, and just pursue it. If you feel comfortable with an OB, then get one. If you want a midwife, then use one.

The midwifery program has one midwife who cares for me all the way through my pregnancy from 15 weeks onwards. She organises all the tests, and spends at least 30 minutes with me each visit. I call her anytime day or night if I have a problem, and get personalised advice. She will be with me during the labour (depending how long it is to how long she stays with me) and then she comes to visit for up to 4 weeks afterwards to make sure we are doing well.


Midwives can have just as many years experience in baby delivery and probably have more experience in 'normal' labours more than OBs who usually get called in when things get hairy.

[tippytoes]

Hi Tarkine,

DH and I made a choice to go through midwives at the Womens and Childrens Hospital, which is public. We are really happy with this choice and feel at ease with midwife guided care. I am a big believer that women should be able to birth their babies as naturally as possible, should they wish to do so, and if it is safe for mother and child of course! I am excited about my first appointment in January.

Thanks for you advice and response all the best with your little bundles arrival - NOT LONG TO GO!!!

Rach xx

[Malyna]

Rach,
I have heard many really good stories about the W&C in Adelaide. My SIL had her baby there, simply because of all the specialists there, and they went public and didn't have any problems!
Enjoy your pregnancy. I hope it goes smoothly for you

[farmgirl77]

Rach - congrats on your decision - sounds like the right one for you! Good luck!