Public vs Private

[Justin]

Hi All,

I am new to these forums but look forward to particpating (as much as a male can :) )
We only recently confirmed that "we" are pregnant for the first time. My wife is now at 7 weeks and coping reasonably well with the sickness (using dried ginger and dry biscuits - she says Sao's are the best).

On the weekend we went to Monash Medical Centre in Clayton (Vic) to look at the facilities at the Private section of the hospital (Jessie MacPherson Hospital). While we were there, we had a look at the birthing centre section of the public hospital (recently moved there from Moorabbin).

We are thinking that the birthing centre (run by mid-wives) might suit us better.
The only thing that is concerning us is that you only stay at the birthing centre between 6 and 24 hours after the birth. You then go home :eek: . A mid-wife from the centre comes by your home for the next 2 - 3 days to make sure everything is ok.

The advantage to the private hospital is that the normal stay is around 4 nights / 5 days giving you time to get used to the baby while the mid-wives are around 24 hours a day.

As this will be our first baby, we don't know how scary it would be to bring him/her home after only a short time and fend for ourselves (they do have somebody available via phone 24 hours a day)

Any thoughts / experience of either way would be much appreciated and will hopefully help us decide which way to go.

Regards,
Justin.

[bubbalove]

Hey Justin
Just my two sents you understand, but I think staying in for a while, especially seeing as it's your first bub, is a really good idea. Breastfeeding sometimes isn't as easy as it's made out to be, and going home before your partner's milk has come in could make things really difficult once you don't have the on-hand support. In the end, you guys need to do what you think is best. Everyone will have their own opinions on EVERYTHING to do with the preggnancy and ensuing baby, so take it all in, but in the end make up your own mind.
I'll get off my soap-box now...;)

[razzle]

No no no... stay in hospital for as long as you can!! The 24 hour midwives are an absolute godsend. I was in hospital (public) for 7 days after my (emergency) c-section (complications breastfeeding) and they were fantastic. They encouraged me to stay as long as I needed to (as did my doctor) which was great. My doctor came and saw me everyday and I had midwives/nurses on call 24 hours a day.

The other thing is - midwives are great, but they're not doctors. If anything goes wrong - God forbid - and you need a doctor to perform a c-section or give you an epidural, are there doctors on hand 24 hours at this birthing centre?

Don't want to scare you or anything but think very carefully before making a decision.

Good luck with everything!

[Eleni's Mum]

Hi Justin,

From a midwive's point of view there is nothing better than midwifery care! From my experience as a Mum I can doubly vouch for it. I would assume that you can probably transfer from the birthing centre to to a postnatal ward for after care if you want (this happens in NSW) and that obstetricians partner with the birthing centre if anything apart from the norm happens. Just check out the full story, back up plans etc before deciding. By the way Obstetricians don't always make the birth in a private hospital either and then your wee one will still be delivered with a midwife. ;)

[jakobsmum]

I can only let you know about my experience.
I enjoyed being in the private hospital, I stayed for 6 days after a C section.
Advantages:
I had my Dr visit every morning
I had a lot of different midwives who were great
I had lots of help with breast feeding
They were on call 24 hrs
Being able to put Jakob in the nursery if needed overnight(not needed)
Chris stayed with me on a fold out bed before we were moved to a deluxe room (double bed)
Disadvantages:
Lack of privacy(visitors, tea, dinner etc)
Too much conflicting advice from well meaning midwives(though I took what suited me)
It was good being at home afterwards as I felt more relaxed breast feeding there

I was sad to leave hospital as it was lovely. It was a small private hospital. If you have any questions on any of this feel free to PM me. It comes down to what you feel comfortable with, and your wife for that matter. I can't wait to go back to the same hospital. :) Good luck with the rest of the pregnancy!

[Angel]

Personally, you couldn't pay me to go to a private hospital!

For normal, low-risk pg midwife care is proven to have more positive outcomes for babies and mothers, and is proven much safer. It is also much cheaper for the Government.

Having a doctor set foot in the room with you increases your chances of everything 'nasty', and you can multiply that risk dramatically if you're in a private hospital where the statistics are much worse than public hospitals.

If I was having a normal low-risk pg you wouldn't get me near a private Obstetrician because my chances would be naff that way. At my local private hospital there was a Caesarean rate last year close to 80%, an 18% spontaneous labour rate and a 92% epidural rate. I don't need to take those kinds of risks, thank you !

If you are expecting to have issues then you may well prefer the route that allows you to choose your practitioner.

On the hospital stay thing... because the midwifery model of care is normal in the UK where I had my DD there is the option of a 6 hour discharge. I was desperate to go home! There is nothing like being in your own environment when in labour and when you have your new bundle. Birth is NOT a medical process, it is spiritual, loving and involves the whole family. It is surely easier to view it as a natural process if you are at home rather than surrounded by medics. The midwifery model always allows for them to visit you in your own home in the days after the birth and that's a great way of allowing yourself to settle into your own changed environment but still have a professional to hand. M/w are trained in everything and even if you can't see one when you need to for the likes of breastfeeding there is always the Australian Breastfeeding Association's helpline and counsellors. Many hospitals have b/f clinics too that you can visit.

I couldn't get out of hospital quick enough but was forced to stay for 24 hours as DD was 13 days overdue and full of meconium which was sucked out of every orrafice for two minutes before she made a sound. Any chances of problems as a result of the delivery mean you'll be kept in anyway so that they can monitor heart rates, breathing etc. If this goes beyond the 24 hours then I don't doubt you'd be transferred to the main hospital.

I'm not a hospital hater by the way, I have no fear of them so that's not why I wanted out! But I do feel nothing but disdain for doctors as I'm in my second low-risk pg and I'm darn annoyed at what Obs are doing to the birthing stats and outcomes in this country. It's no wonder the population isn't growing! A study of a couple of years ago found the single biggest factor in whether or not a normal low-risk pg results in caesarean is whether or not the mother has private health insurance.

Enough said I feel.

Passionate :p

[mamafelix]

I also was absolutely begging to get out of hospital! I really just wanted to be home in familar environemnt with my new precious bundle, I found the hospital to be an environemnt where everything was medicalised- so the midwives and doctors were constantly looking for problems with me and my baby rather than letting us just get on with it.

Another major problem was that they didn't allow my partner to stay overnight and that was heartbreaking for us. I felt really alone and isolated, whereas once I was home I had my dh, my mum and my midwife all there to help out. Not to mention a wonderful group of friends who provided lovely homecooked dinners every night for two weeks (without expecting to hang around and annoy us).

I had a homebirth and transferred afterwards cos my placenta didn't detach. So I was lucky enough to have one on one midwife care throughout my entire pregnancy and home visits each day for up to 10 days after birth. I am pretty sure that at the birth centre in Perth you can organise for this kind of care as some of the midwives who work there are also homebirth midwives.

Certainly you could always employ a midwife to support you and your partner throughout the pregnancy and birth into post natal care even if you went the public option. they can attend the birth as a 'doula' or support person even if they are not employed by the hospital.

[Gemma]

Hi Justin,

You will find that every mum is different and have different feeling re public/private so in the end both of you will have to choose what is right for you.

I loved private. Firstly I wanted a private Dr, as I didn't like the idea that each time you went for a check-up publically you saw a different Dr (and usually a Registrar not a consultant). I ended up having so many pregnancy problems having my OBGYN was fantastic.

Secondly, due to health reasons I wasn't able to have a vaginal birth at all, so it had to be a planned C/S which can only be done in a private hospital. Public won't do planned C/S only energency ones unless you have already had a C/S.

I had a really bad time of it trying to breatfeed so being able to stay in hospital for 5 days was great. I really missed my nurse call bell at home. Having a midwife around 24/7 is priceless and very reasuring.

So I advocate private.

In addition, it really annoys me when people have private health insurance that they don't use it (I am a nurse in a public hospital). There are only so many beds in a public hospital and they should be left for the people who don't have private cover.

Hope that helps and sorry about my last speal but it really annoys me.

[Angel]

That's not strictly true... my friend had a planned CS publicly because she had a breech first baby.

Also, having a baby in a private hospital costs the tax payer at least double what it costs in a public hospital, and the Government has just licenced private Obs to pass ANOTHER $2000 of their fees to the Safety Net (what a nice windfall for them, and what a waste of MY money when midwifery is so much cheaper and safer!). If I was paying private health insurance (which we're not, we choose to pay the Medicare Levy in our tax return instead) then I'd be furious that a) we were paying for a cascade of intervention b) it was costing me even more in the long run because of the huge amount that is passed onto Medicare and the Safety Net.

Nobody denies that facilities are usually better in a private hospital and health insurance usually affords you a longer stay, but there is a bigger picture and there are are greater implications.

Consider everything!

"It is inherently unwise, and perhaps unsafe for women with normal pregnancies to be cared for by obstetric specialists, even if the required personnel were availabe" (Enkin et al, 2000)

[rebecca]

Hi there

I really do think that this is trully a personal choice.

I know being a new mum that my husband and I have found it very difficult to decide on which way we should go.

The problem for me was this...my obgyn also delivers at the public hospital where I have now chosen to go.
I found it hard to digest that I would be charged ($3600) a management fee by him, then my fee for each visit, plus any additional costs if I required theatre, or drugs if I chose to go Private.
Yes my accomodation is free because I pay private health insurance, but if I am in need of an OBGYN I know that he delivers at the public hospital that I have chosen and why pay extra when he does it for free!

I know that I may not get him on the day/night of my delivery, but just knowing that he delivers there shows to me that there are well trained and qualified staff available at the Public Hospital, which was my main concern for my delivery.

Again, this is a personal choice, and thought that I would share the decision making process we went through with you. Hope that this is of some help.

Congratulations and Good Luck

[I'mAMum?!]

It seems everyone is giving their opinion so I thought you might appreciate another opinion... I work in nursing agency and 99% of the nurses I have worked with would opt for Public hospitals with neonatal wards in case the baby needs it. I opted for home birth with public hospital back up and must say midwife care was wonderful, but then again I had no complications in pregnancy. I wish you and your partner many rewards with the welcoming of your special person into the world.

[Tys_mummy]

Hi, Firstly congratulations on being pregnant! Its good to see another father taking a keen interest in all aspects of the pregnancy, my husband was very involved too so good on you!
Anyway I'm sure by now you are probably sick of other peoples opinions so I'll try to make this short and brief...

I was told the pros and cons of both sides by a lot of people (some more passionate than others) but for us going private wasnt a financially viable choice for our situation... however the public hospital we went to was great ... We had midwifery care with Drs on standby if needed and our midwives were great, I found that for myself I wanted to stay in hospital until I was comfortable with doing all the day to day stuff with my new little man so I stayed for 5 days (though I did also have some issues with a tear but dont worry about these things).

Another thing to think about, is there any other hospitals in the area or nearby enough that you cold have a look into where you dont have to be private if your wife wants to stay in until she is comfortable and confident in doing everything... Ultimately the decision is up to you both on what you feel comfortable with doing and if you do make a choice its still early enough that you can change your mind to the other side if you arent comfortable, Also its not really sides but more the kind of care that you want... check out what the care ratio will be in the ward after the birth as well, if you want a more one on one care then perhaps you should look into private... but I suggest that you check all options out in more depth before choosing! I hope this has helped! Also here is a link to hospitals in the metro Melbourne area, I hope this helps. http://www.health.vic.gov.au/publichospitals/metrohos.htm

Natalie

[OopsieDaisy]

Once your bundle of joy is born, you will be amazed at how much natural instincts kick in and how much you know!

I had my children both public, one at age 15 so I can relate to feelings of "How will I cope" etc. I stayed in for 5 days.

Do lots of research into all your options and ask as many questions as you feel you need to, if you think of things at home be sure to write them down too!

Let us know what you and your wife decide!

Good Luck and Congratulations!

[Justin]

Hi All,

I have to thank every one of you for your thoughts and advice.

We have taken in all of your advice and our decision is to go with a private hospital. For our first baby, we think we will feel more comfortable staying in hospital with somebody around if we need them 24 hours a day. Having said that, the decision isn't final until the time comes.

Having chosen to go the Private way, we were very surprised to find that when we wanted to book into our hospitals of choice (St. Vincents and Freemasons in Melbourne), that we were waitlisted despite my wife only being at 7 weeks. Apparently you need to book in even earlier which seems a bit odd as you can't really be sure much before that.

We are however booked into a very good hospital and we will see how the waiting lists go.

On a more exciting note, we had our first Ultrasound a couple of weeks ago. Such amazing technology. We could see the brains, heart, etc. It's just so frustrating that we have to wait so long to see it in real life. But I'm sure when it does get here, we will be wondering what we have gotten ourselves into :D

Thanks again and take care,
Justin.

[louie22]

What does this management fee cover? I am just trying to come to grips with the obstetric fees I will need to pay in the coming months and I can't work out whether all the obs charge this fee or only some of them? My doc has quoted $700 pregnancy management fee but up until now, I've never heard of such a thing.

Whatever it covers, $3600 seems huge!

[Sholmes]

Hi Justin, we didn't know all the options available in a public hospital until after I committed to having an OB and delivering in a public hospital. The birth centre was appealing to us too. I stayed in hospital for 3 nights, but could have stayed for one more if I wanted. I had no complications and a natural birth. Second time around I will go with the birth centre. I stayed 3 nights because I felt I would be more comfortable at home and wanted to get settled with bub. I guess the only consideration your wife has in hospital is whether she wants to stay for the support provided there or come home once she is fine. My OB cost $5k. I paid $4k, he claimed whatever he needed to from my private healthcover and I got $2.9k back from Medicare and $100 back from my OB.

One downside of staying in hospital longer is that every nurse will give you different advice on breastfeeding and I found this quite stressful. I came across about 8 nurses in my 3 night stay.