Do you really need an OB?

[ElizaDee]

Or can you just use your GP and then whomever is on at the time of the birth? I am going private

Its just that they charge so much and they want us to help pay thier indemnity.... that just sounds wrong to me. But other than that my GP has organised everything and I don't understand what an OB can do that she can't (except the birth)

I may not even get the OB of my choice when I go into labour anyway so I am wondering why should I bother with them, what can they do in the lead up that my GP can't?

[H&B'sMum]

Nope I didn't.

I did shared care. Which is for most of my appointments ie monthly, then fortnightly, then weekly, I saw my GP. At 22 weeks, 32 weeks and 36 weeks I saw the midwives at the hospital I was delievering at.
My theory on this when people asked why I wasn't having an ob, was "I'm hopefully going to be having bub at the birth centre with midwives anyway, also I'm going to be in the biggest hospital in the region, somewhere, someone should be able to help me if I need it"
That's excately what happened. I saw my GP on Monday 29.03.04, she thought bub had turned back to breech and told me to go to the hospital. She rang to warn them first. Got to hospital saw the midwives then over the next 4 hours saw 3 obs and even had THE TOP OB for breech babies in Aust examine me, as I wanted to go natural. He encouraged me and we tried to turn bub but he wouldn't shift, so it was a c/s for me. I had Harry at 3:56pm on Mon 29.03.04.
As you can see I had the best of care from the obs on duty and was taken cared for brillantly.
I couldn't see the point in paying all that $$$ for an OB who may even miss the birth anyway. Had heard of this happening alot. I was very happy with my choice and loved having the midwivery care. For my next pregnancy I'm only going midwivery care not bothering about shared care.
It sounds like your Dr, Eliza, is on top of everything and if you don't feel the need for an ob then I wouldn't bother.

[Goosie22]

Hi ElizaDee

No you don't need one, but if you want to go private it is set up that way. GP's just don't seem to do it anymore(?cost of indemnity and lack of training/suppport) If you like your GP why not go share care with the GP then switch over to the Public Hospital around 37weeks(some GP's will continue to care for you to 40+ if they are comfy) Depending on the Antenatal Clinic you may only have to go to the hospital 3-4 times?(they only thing is you wont be familar with the people/routine from the hospital and the your GP usually wont be able to influence decisions (http://www.google.com.au/search?hl=en&q=decisions&spell=1) made by Hospital Consultants with regards to your care) What about homebirth with your GP as backup(you can only ask?? the GP may know some homebirth midwives in your area and be keen to help.)

[H&B'sMum]

Forgot to add, I was a private patient in the public hospital. I had my own room and other things like free parking for DH. I then tranferred over to a private hospital 12 hours after birth. The private hospital didn't do births at that time. But took new mums after birth. I had the best care from the midwives. Talk to your GP E, about it she will know the local set up and what you can do.

[cosmic]

The simple answer is NO, you absolutely do not need to pay for a private Ob. I upgraded my health cover to go private and then decided to have all my care with the mid-wives at the birth centre where I am having the baby.

I go in, they check my blood pressure, listen for the baby's heartbeat, ask how I am and I'm out in 10 minutes. Anything else I need, like ultrasounds or the glucose test is all done there, i.e. through the hospital (public) and I will have one appt with the hospital Ob at about 30 weeks. I can't imagine an Ob does too much different (in a normal, healthy pregnancy) so I'm buggered if I'm going to sit in a waiting room for an hour and fork out money I don't need to spend when the chances are they are only going to be there for the last 5 minutes of the birth!!

Obstetricians were 'invented' for problematic pregnancies and the fact is most women who have healthy pregnancies just don't need one. Add to that the fact that if you go with an Ob, statistically your chances of any kind of intervention are automatically increased significantly (only a concern if you are like me and want minimal intervention) and one intervention leads to another and another and another.. and it is little wonder that the c-sec rate is 35% in private hospitals!

Shared care sounds like a good idea. Especially since your GP sounds really switched on. :)

oh... and I am also going in as a private patient. Hopefully having my own room will make all those higher insurance premiums worth it. :rolleyes: How p*ssed off will I be if I don't get a private room!! :o

[H&B'sMum]

So true C. You sound like just like me!!!!!!!!!!!!!!!

[Peaceangels]

You have received the answer in short - no, you don't need one, so I'll tell you my story...........

With #1 I had an Ob. and was booked into a private hospital (we had private health care, so we figured - why not!). Anyway, I had a very healthy pregnancy, so my visits inside the Ob's surgery were no more than 5 mins. During the labour (which was 22hours) the Ob. was there for the last couple of hours as I had an emergency c/s at the end.
Even though we were in a private hlth fund, we were still out of pocket around $5000 (for ob and anaethetist), but the care was fantastic.

With #2 we decided to go public because we just couldn't afford the above cost's on one wage. For pregnancy care I saw the midwives at the hospital's clinic and found them to be excellent. They spent alot of time with me discussing my options (I had decided to have a VBAC this time) and my general physical and emotional well-being. During my labour a male (so lovely) midwife was there with me until it was decided that a vacuum delivery was required, then the Dr arrived and delivered my baby.
This time we paid nothing, not a cent and the care I received was absolutely wonderful.

[CrazyBeautiful]

Obstetricians were 'invented' for problematic pregnancies and the fact is most women who have healthy pregnancies just don't need one. Add to that the fact that if you go with an Ob, statistically your chances of any kind of intervention is automatically increased significantly (only a concern if you are like me and want minimal intervention) and one intervention leads to another and another and another.. and it is little wonder that the c-sec rate is 35% in private hospitals!
:o

I totally agree with these comments. Great work Cosmic!

[reAllytee]

I went public also & it was great besides one little thing.
First of all i had shared care with my GP but then as i moved to a totally different area of Sydney i had to change hospitals & was too far away anyways. I then went into midwifery care & it was great no waiting on doctors or the likes. Be careful with what options you have if you go public as the antenatal clinic is run by both midwives & Ob's so it means the waiting times can be phenomenal ! I waited 3hrs one day to get my anti-d shot ! Not happy Jan ! Was so glad i had chosen the midwives clinic as it meant i could even go on a Saturday with my partner so he was involved & i never waited longer than 10mins HUGE difference !!! So overall i only saw the Ob's twice while pregnant & was looked after by the midwives for my pregnancy & i wouldnt have seen an Ob again either if things hadnt gone wrong in labour.
My only complaint was being stuck in a room with 3 other women ! Trust me to score one of the only 2 rooms that had 4 women in it !!!!!
Remember that in a lot of public hospitals even if you go private your are NOT assured a private room & in fact besides having your own Ob you will be treated the same as a public patient except you have to pay lots of $$$$.
My only thing next time is that i will have to have things checked out more thoroughly due to what happened in labour so if that means i have to pay for an Ob to make sure bubs & i come through it all safely then i will do it. As nothing is more important than the health of my baby. Regardless of some peoples experiences not all Ob's are bad, in fact a lot are very committed to their jobs & only want the best for their patients & babies. My mum had the same Ob/Gyn for over 15yrs & he was great never believed in interventions or the likes & always listened to my mum. He delivered both my sister & myself with no problems & my mum even chose to be induced with me as she wasnt well etc & had an epidural also & i was still born vaginally with no forceps or vacuum !
My best advice would be to look into what YOU want & go check out the hospitals & see what care they offer etc. Check everything out !
Good luck :D

[alicesmum]

I booked into one too when I first got pregnant, and also nearly died when i realised the costs involved. :eek:

Maybe I'm just a cheapskate :p but I came to agree with Cosmic, and switched to public (despite having blue ribbon private health cover).

I was on a mid-wife based program of care at the RBH and thought it was wonderful (and free!!!!!! yay!!!)

[WeThree]

yup, im with the other girls, you dont need one :)
obs are there to take care of woman with high risk pregnancies, there is no need to regualry see one, or be attended by one at your birth, unless there is something wrong, so i say save your money and book yourself into your local hospital and start attending the midwives clinic, or do shared care, all of which is free and the standard of care is just as high! :)

[ElizaDee]

Ok just rang the Hospital I am thinking of choosing and they said to be admited into a private hospital I must have an OB. So that answers that, I already have an appointment and will just along and see him.

I really want to go private and not public. I am too fussy and this will guarantee me the services that I want :)

[pegasus]

There is a lot of bad press on this forum against OB's and hospitals, but I stick to my guns that I loved my birth last time (with an OB in a private hospital) and am doing it again this time. Last time I did have shared care (between midwives and OB, but this doc doesn't do it.)

I get the feeling that anytime you post a thread about this subject on this forum you will get people telling you about evil hospital births and evil OB's, but I'd much rather have an OB around than a GP with Obstetric training (notwithstanding the fact that midwives are present at all births and are wonderful nurses)- if something required intervention I want the person around who can deal with it. People on this forum also like to sprout statistics about how there is higher levels of intervention when you go to an OB, but consider the fact that if there is any inkling that you might need intervention you will probably choose to go with an OB - statistics can be interpreted however you want, but usually we benefit from more info.

As for having the same OB all the way through - when you go with an OB at a private hospital, you will have the same OB unless you pick a period when they are on leave etc (and these dates are usually made available at the beginning of you booking in).

[reAllytee]

Thats all that matters ! :D
It is your pregnancy & birth after all !
Good luck hope all goes well :D

[reAllytee]

I get the feeling that anytime you post a thread about this subject on this forum you will get people telling you about evil hospital births and evil OB's, but I'd much rather have an OB around than a GP with Obstetric training (notwithstanding the fact that midwives are present at all births and are wonderful nurses)- if something required intervention I want the person around who can deal with it. People on this forum also like to sprout statistics about how there is higher levels of intervention when you go to an OB, but consider the fact that if there is any inkling that you might need intervention you will probably choose to go with an OB - statistics can be interpreted however you want, but usually we benefit from more info.


Well said :D

[Seekrit]

the only reason I'm seeing an OB is because it's provided with my (free) midwife care through the RBH :)

[H&B'sMum]

Glad you got your answers Eliza.:)

[cosmic]

Eliza, I'm happy to hear you have made a decision you're comfortable with. :)

Pegasus, all any of us are here to do is to put forward our own opinion or experience when asked. I can give just as many examples of "people on this forum" putting out opinions that are different from mine on a whole range of subjects. That's what this forum is about.

I believe there's a place for Obs and I'm glad we have them! But I personally believe that what they do in a healthy pregnancy is no different from what any midwife can do and so I'd rather not pay for their service. If something goes wrong during my labour and I need the assistance of an Ob, I will very gladly take that assistance and I'm happy for that to be whatever Ob is on duty. That's my choice. But because I'd rather avoid the range of interventions that are much more likely to happen in the care of an Ob, I'm avoiding that scenario. So you're right.. the fact that statistically intervention rates are higher with Obs is quite likely because people who choose to go with an Ob have already decided they are happy for those interventions to be on offer or believe, for whatever reason, that they are necessary. I'm not in either of those categories, but I don't expect everyone to be the same as me.

[pegasus]

Just wanted to say I'm glad you've made a decision you're comfortable with Eliza.

I also wanted to say if anyone thought my words were a bit strong earlier, sorry if I offended anyone. What we put forward on this forum are usually our individual experiences which will differ from anyone else's and therefore must be treated as such - not as scientific fact. I did not go with an OB because I was happy for the intervention he could provide - far from it - I did not want any intervention! The fact that I did have intervention is in fact something that had me in tears many time afterwards (including when reading some posts on this forum) - worrying about whether bub and I would bond properly etc. which has to be false, otherwise how could dad's bond with their bubs, or parents with their adopted bubs. My point is that no matter how much you plan for the perfect intervention free birth, even the best laid plans can go awry.

The important thing is that we feel supported in the choices we make for ourselves and our bubs because that is what will make happier mums and bubs.:)

[Minke]

Though I'd throw my two cents in... First time around I went private only because I had private cover - being quite young and having no clue, i found it reassuring that i went to the same doctor every check-up. My doctor was excellent, as were the midwives and hospital and that i had my own room - people could come and go as they pleased (or as i pleased - midwives were very happy to act as bouncers!).

When seeing my doctor i had asked how long for first labours, before interention and he told me I had twelve hours of labour (from 4cm?) and two hours of pushing before he would intervene - strangely enough I found that reassuring. On the big day he came in to see me about 2 hours into my labour and asked was i coping with the pain (NO!!!) and if I wasn't, that i might want to think about an epidural as I was still only 2 cms - the bonus to the epidural was they put a syntocin drip in to speed everything up - so took the epi and relaxed. Fully dilated 4 hours later and the doctor was back for about two hours for the birth and for the few stitches that i needed.

My friend who was due 6 months after me went to the public hospital (which has since closed down), was allowed to go two and a half weeks overdue (even though they knew the baby was HUGE (and she was tiny)) was induced, and was left in labour for 2 days, fully dilated for 9 hours. The babies heart rate dropped, she was given an emergency ceasarean, but her bub didn't make it due to the stress of being in labour so long.

My sister had the same sort of story (her bub was fine), and is now facing an operation for incontinence at 32 because she was left to push for hours (ended up getting and episiotomy and forceps) and the pushing had done so much damage to her pelvic floor muscle (and might have had something to do with a 38cm head!), that she's never had full control again.

Mind you another friend has had all four of her babes at public hospitals and swears by them!

Would I rather have a doctor who will cut me open at the first sign? yes. Was the couple of hundred dollars (my excess only as mine was a no-gap doctor) worth knowing that? yes. Am i happy knowing this time I only have 6 hours from 4cms, 1 1/2 hours to push? yes, yes and yes... I know that what happened to my friend was rare, and that stillborn rates are probably the same for private and public, but for my piece of mind I will be going private every time. Going private makes me relaxed, which i figure is good for me and bubs, but each to their own... Like someone else said - whatever you feel comfortable with!

[alicesmum]

kelli
your story highlights some important points. i too have a friend who lost her babe after an oversight by a midwife and a long labour that didn't progress and a casaerean that was conducted too late (though it it hard to know how compromised the baby was before labour due to pre-eclampsia).

i definitely agree with doing what suits you and makes you feel comfortable. i just found this quote interesting though.

asked was i coping with the pain (NO!!!) and if I wasn't, that i might want to think about an epidural

gosh, if my midwives had have asked me that question i would have also said "NO". if they had have then recommended an epi i think i might have taken it too. lucky their policy was not to ask such a question and not to offer anything and to let you ask if you wanted something. instead they just suggested different positions etc and assumed you would cope with the pain until you asked for something. i know it might seem like a trivial point, but i really think the power of suggestion is HUGE. I am really glad myself that they did not offer and am glad i didn't have one.

However, I am sure you are glad with your decision to have the epi. it sounded like all went really well in your case. it may have in mine too, but many stories i have heard involve an epi turning into a halted labour turning into a c/s.

[Minke]

Alicesmum, so true, but I was doing really badly - starting to panic and I wasn't that far into it! I am happy to admit I am a big wuss! I guess the doctor figured I was doing pretty badly for someone who had a long way to go, and offered it. I admit (after reading some of the birth stories on here :eek:) that i was really lucky that I only came out of it with a teeny tear, but i forgot to add they turned my epi off when I was fully dilated! So I had all the feeling to be able to push my daughter out! Wouldn't recommend it - I think it was worse to go from no pain to full blown pushing contractions, but it is in my birth plan (i am doing one this time!) that if (!) i have an epi this time round, i want it turned down when I am fully dilated (i know - mad aren't I) so that my doctor doesn't say to me - i've lost count of the stitches! :D

The point I was trying to make in my last post (and took my time doing it!) I sometimes wonder whether public hospitals leave it too late to intervene - whether due to budgets or whatever. I just like that I get what I want, when I want in private (i'm pregnant, i'm allowed to be demanding! lol). I'm all for natural labour if you can do it, but not everyone can, and in this day and age of modern technology I can't believe babies are still dying for no reason :( I know intervention is best avoided, but there is a place for it, and i'm sure many women are greatful for it every time they look at their bubs, and back to the point whether obs are just looking for a reason to cut you up or are erring on the side of caution, i do like them, and Elizadee, I would recommend having one!