Private OB or Public Birth Centre?

[marlie]

I am so confused...! :confused: :o

I have finally got around to making an appointment with an OB (first appointment when I am 12 weeks - I am just over 8 weeks now) after ringing around a zillion places here. But when I was speaking to them I asked about any support after the birth - and there is zippo, nil, nada if I go with private OB and in Private Hospital! You get to stay in hospital longer, and see your own OB during delivery, but it is the after care thing that is worrying me, especially as we don't have any family nearby.

So just to hedge my bets, I am also booked into a public birthing centre, supported by middies, and I suppose on-call OB registrars etc if things go pear-shaped. The plus side is that they offer support in your home after you are discharged for around 12 days, longer if you need. If I do this it would be a shared care arrangement between my GP and the midwives, with no OB, in a public system. The down side is that you see a complete stranger if you need intervention, which is often managed by less experienced registrars and the like.

We have private healthcare, and the money isn't particularly the issue (but of course, not spending oodles always helps). I suppose I am just a bit confused as to which is the best option? Private OB or birth centre? It is my first pregnancy, and I have no idea how things will progress...

What has everyone else done who has kids already? Are any of the other 1st-timers confused like me? I know it is probably a matter of personal preference, but it does really help to hear others thoughts.

(And I sooooo need that "Dummies Guide to Pregnancy and Birth"... :D )

[WeloveHarriet]

Hi Marlie. My older sister and I have been through the private sector with an OB. I found them unreal for a first time mum who had no idea. I was in hospital for 6days and they showed me everything - sometimes twice - until I was comfortable on my own. Even though I had nephews and nieces I had never changed a nappy or bathed a baby so it was great that the nurses on duty could spare the time to show us again and again if needed. Although you don't tend to get home visits once you are discharged with my private hospital they will send out a lactation consultant if you have any problems plus have regular meetings every two weeks with guest speakers that were free to go to for more information. My younger sister goes through the public sector due to not being in a health fund. Whilst her care is fine, the difference I found was that there wasn't always enough staff to help with mundane things - they normally have a hell of a lot more patients to look after then in private system. She was never offered any home visits with her first however was early discharged with her second after 2dys so they did send a midwife to check on her twice. Personally for me, it has never been a choice - with my history I would only every go to an OB and a private hospital. My friend sums it up like this - it is the only time you get to choose between stopping at a pub or a resort, which would you prefer after pushing out a baby? :laughing: She cracks me up everytime.

[~Emmylou~]

I went through the public system with my first, but I didn't need any after care.
I brought DD home three days after she was born and we did really well - I honestly had no reason to need to see midwives or any thing like that afterwards.
Had a couple of problems breastfeeding in the early days (and if you're going to have problems that is the most likely thing to give them to you) but the ABA are there for that.

Birth centres provide after care because most of them stipulate you have to be out 24 hours after the baby is born. So they do provide some back up. Private hospital you can stay 4 nights, sometimes longer after a regular VB if you want to. So the need for help after this point is less likely. If you require intervention at the birth centre you would normally be transferred to the public hospital it is attached to, OB's don't go to them.

I'm going privately with this baby and while I can't comment yet on the birth I have already been admitted to hospital once a few weeks ago and the difference between the public and private hospital is pretty drastic (and private was definitely better for about a million reasons I won't bore you with). It's also been good having continuity of care with my OB through the pregnancy - being shoved between midwives and OB's at the public hospital clinics was not something I coped well with first time around. I always worried that with so many people seeing me someone would miss something.

You're right it is personal preference, I've never been to a birth centre but having done public and private I know which I'd rather.

[WitchHazel]

Hi Marlie. I went through the private system, and did receive good aftercare from my OB. After I was discharged from hospital, I had a big bleed a few days later. My OB got me in straight away.

Also, you'd most likely get a visit from the CHN days after discharge regardless of whether you went public or private. There's advantages to both systems, and I'm sure you'll make the right choice.

Research other sources of support before you have your bubs. You can always call the ABA for bf support, and there are other organisations set up to help new mothers.

Good luck with your pregnancy!:)

[twitch]

Marlie, I am in the same boat as you. I took out private insurance when we first started ttc, purely to cover me for the birth. I didn't really think about it, I just thought "Well if I want the best care, I suppose I'd better have private cover". Thanks heaps for the asking the question and for the responses Hazel, Emmylou and WeLoveHarriet, you have cleared it up a lot for me :yes: . Marlie, if you do get that Dummies Guide, pass it this way, I was as confused as you!

[nemosmum]

If you want to go private and have your own OB but also want the support of after care help why not look into getting a doula (a personal midwife)?

They can help with the preparation for birth bit, the actual birth and offer an after birth support program too!

Good luck, im going for my second soon and am just as terrified LOL:yes: :o :D

[WeloveHarriet]

Hey Marlie and Twitch as an aside - there is actually a book "Pregnancy for Dummies" - I have it (although much prefer Kaz Cooke's "Up the Duff" at least it makes you giggle :yes: )

[Pink73]

Hello Marlie

I also went private for my 1st and will do so again with this bub that is due in may. I had a normal VB and thay normally give you 4 nights for a VB and 5 nights for a CS but I was having a lot of trouble feeding my DS so thay let me stay an extra night to sort out the feeding.
There are classes to do before the birth that I would recommened and I recieved a full refund from my health cover for those.
For me it was more a case of having my own room the thought of sharing a room with 3 other mums bubs and there vistiors was my worst nightmare.
Also having the same OB the whole way through was a big selling point for me.

P.S you should get Kaz Cook Up the duff very funny

[nut]

:wave: I had the exact same decision to make as you do! I want a birth free from as many interventions as possible, so looked into the birth centre. I also want the guarantee of a private room after the baby is born. If I was to get transferred from the birth centre (not all that unusual I hear) I would have ended up in the ordinary public system and couldn't face being in a room with other women, their new bubbas and their visitors. I thought i might get transferred as I had a look at common reasons for transfer from the BC I was interested in, and high blood pressure, and meconium in the waters were two (of a whole list) reasons that alarmed me. My DS's waters had meconium in them and I was under the impression that that was no big deal- but it is enough to be transferred.... Also, being a big girl, I worried that my BP might get high (didn't happen with 1st preg. but you never know). Anyway I found myself an Ob. who is supportive of natural birth and am really happy with my decision.

Best of luck with your decision making- I really wrestled with it for ages.:)

[marlie]

:yelclap: Thank you everyone! It has been great to hear other women's opinions about this - you have all helped so much! :yes:

I must confess that I was leaning toward the Birth Centre option when I first posted this thread... but now I am thinking that Private may be the way to go. After all, we may as well get my money's worth out of it! But it was the line about "stopping at a pub or a resort" that really swayed me... :laughing:

I can't thank you all enough for posting on this thread. We are still yet to decide 100%, but your opinions have really helped. You Bub-Hubbers are great! :hugs:

xox

[DoulaFelicity]

Hi Marlie,

For the birth of my first child, I went through a Birth Centre at a well-known public Hospital in Melbourne. If homebirth is not an option for you (I personally consider homebirth the Gold option in pregnancy and birth; your very own skilled midwife, home visits of an hour or more and lots of them both before and after the birth; all the comforts of home; in home breastfeeding support; a lack of unnecessary intervention; optimal statistical outcomes...what more could a woman want! :D ), and your choices are solely between a Private Obstetrician and a Public Birth Centre, I would recommend the Birth Centre. It depends, of course, on what is important to you in your birth experience; for me, a lack of unnecessary intervention, the support of women who trusted birth and believed in my ability to do it, and an environment that nurtured natural birth and breastfeeding (as much as possible in a busy institution with it's own protocols, policies and restraints) were all important. Statistically, outcomes in these areas are better with Midwifery care than with Private Obstetric care. Intervention (etc) may not be a focus for you, however, so obviously your decision may revolve around different factors. :)

The after care was quite good, better than I expected. The midwives called me at home almost every day, kept a close eye on me, and visited me a few times. We stayed 2 nights (3 days) in the Birth Centre and whilst the transition from Hospital to home is always surreal (another reason I'm staying home this time :laughing: ) it was as gentle and simple as possible. The room was huge and the bed was double, the care was as good as any Hospital care. A really nice room and cooked meals is good, but for me the actual care in birth and the outcome is more of a focus - I have a comfy room and nice meals at home. ;) Depending on whether you're planning to breastfeed or not, breastfeeding rates are also statistically better with Midwifery care (and even better at home, ok I'll shut up now...).

Good luck with your choice!