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  1. #1
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    Default Care in the PUBLIC health system throughout pregnancy & birth

    Hi. I a just wondering what your level of care is in the PUBLIC health system for pregnancy & birth over the last few years. I am looking for a range of types of care, especially the midwifery group practice (or similar). I am not looking for any responses about the private health system.

    I am classified "high risk" due to high BMI, however at the moment (27 weeks), I feel like my level of care is somewhat less that others. My type of care is a doctor at the hospital.

    My appointments are/will be as follows
    - 12 weeks
    - 20 weeks
    - 28 weeks
    - 32 weeks
    - 34 weeks
    - 36 weeks
    - 38 weeks
    - 40 weeks

    At my appointments I see a doctor, however it will not be the same doctor throughout the pregnancy, and it will not be a doctor who will be there at the birth. I feel like I am an animal that waits in line for my turn, I finally get my turn, they do the normal checks like blood pressure and fetal heart beat, and then its a lecture about my weight, then its time for me to go.

    I am currently reading a book about labour/birth, it keeps mentioning this and that about my midwife, yet I dont have one, and I am not allowed one due to being "high risk". I am feeling quite alone in this process, I do have a birth partner (DH), but I dont have that magical midwife who is apparently supposed to be there for me (experience wise) before the birth and during labour.

    What is your care like for your pregnancy? Do you have more/less appointments? How do you feel about the quality of your appointment? Am I missing out on something, or is it all in my head?

    P.S. The last doctor I saw (at 20 weeks) asked to see me again in 6 weeks time (26 weeks). So I went, waited 2 hours after the appointment time, then I asked to see a midwife because it was a pointless appointment anyway (either that or wait another hour or more). I saw the midwife and she had no idea why the doctor wanted to see me at 26 weeks? I checked my schedule and it wasnt supposed to be until 28 weeks when the GD test is to be done. The midwife only wanted to do the normal checks (plus the lecture about my weight yet again), couldnt help me with my questions because I was "high risk" and was supposed to be seen by a doctor. I cant win!

  2. #2
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    I'm sorry you feel this way. Those appointments all look about right to me - it's a few more than I have but I am low risk.

    Have you looked at doing shared ate with a GP? Or a private midwife? We are doing shared care with a PM and I only have two hospital appointments in total. All the rest are with her, and she will be at the birth.

    It does cost of course but is still cheaper than a private OB and, in my view, is a much more holistic model of care than the private/OB system.

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    LoveHeart  (27-04-2012)

  4. #3
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    I'm not high risk, but so far my first appt with the hospital won't be until after my 20 morph scan and then I will probably on have another 2 or 3 after that.

    I never had a specific midwife for my first pregnancy and saw whoever was on at the time, and only saw an obs once through the whole process. I also do shared care with my doctor so if I have any immediate concerns I can talk to him.

    As the PP said, if you can afford it, a private midwife would be great. If we could afford it I'd do it. You get that personal care and attention that is lacking through the public system.

    When the time came to actually have DD though, I found my experience to be really great. The midwives that were attending my birth were awesome and I can only hope I have the same experience this time round.

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    LoveHeart  (27-04-2012)

  6. #4
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    I am having twins so a bit different too, but I am also seeing a private midwife do I have some continuity of care and know that she is there for ME as a person, not as another faceless number in the system.. If you find one eligible for Medicare you just need a referral from an Ob and you'll get some money back from your appts. I feel the same at the hospital, I have to see a dr since twins are 'high risk' and I wait ages then she does blood pressure, feels my tummy, listens to the heart beats, asks if I have any questions, lectures me about the things I'm refusing (flu shor etc) and I go. I'm pretty sure a midwife could do all that!

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    LoveHeart  (27-04-2012)

  8. #5
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    Hi there, from my experience you don't get a midwife unless your going to pay for one. But it may be different where you are. As your high risk I can see that them not assigning you one would probably mean that if something urgent happened in regards to the birth (ie your sent to a bigger hospital) then you would end up with random on-staff midwives anyway.

    My appointments for both my boys were:
    8wks
    12wks
    16wks
    20wks
    24wks
    28wks
    32wks
    36wks
    38wks
    39-40wks

    But I was doing shared care with my second and seeing an ob (not at a clinic) with my first. And I wasn't high risk after the first 16wks with both. If your wanting to see your doctor more frequently and want a consistent medical person shared care is the way to go. Yes your gp won't be the one delivering your baby but they are there for you through the pregnancy and then post birth too. And gp bills are cheaper than an ob, some bulk bill also. Honestly listen to.your gut. If you need more one on one personalisation then go get it. You not obligated to use the service your currently in if your not comfortable. It's your body, your baby and your sleep you'll lose. Good luck sweetie!

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    LoveHeart  (27-04-2012)

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    That continuity of care is so important for various reasons. I was shocked when I got pregnant here and realized you don't get given a MW for your entire pregnancy, birth and postnatal care. I had no idea about hiring one privately.

    It'd probably save Australia big dollars doing things this way.

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    LoveHeart  (27-04-2012)

  12. #7
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    That looks about right to me. I was also high risk. They just do the usual
    checks at each appointment and if there are any problems they take it from there. I was admitted constantly as a day patient, it was annoying but essential. I was thrilled with the level of care I received in the public system, the obstetricians, Drs, physicians, nurses were fabulous. I would definitely have no problems going public again. After numerous day patient admittances, a visit for 5 days and 7 days when I had DS I couldn't have asked for more and it didn't cost me a cent.

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    LoveHeart  (27-04-2012)

  14. #8
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    I've had three births in three different public hospitals and onto my fourth now and your appointments sound about right.

    The last pregnancy and this one I have been on a midwifery caseload (midwifery group practice) and on both occasions I have had continuity of care with my own midwife assigned to me the WHOLE time. I see her for all ante natal visits, which majority are in my home, she is there for the birth and then the care continues post natally when she visits me in my home for 2 weeks or more if needed. The only time you *may* another midwife is if your midwife is on holidays etc, but evenso, you will meet her beforehand and know her prior to her working with you. The whole time you're in your midwive's care, you have a mobile number to her that you can ring 24/7 with any worries, questions etc which is also reassuring.

    I can't recommend it enough, however, it is usually very hard to get into as there is usually a big waiting list and they do prefer you to be low risk. When I was put on the program, I was a Vbacer for the first time and they were brilliant to me. When I found out I was pregnant with this baby, I just rung the midwife I had last baby and asked if she would take me on again and she said a big, resounding yes, so I feel very blessed.

    My first pregnancy I had shared care and it was a revolving door of different midwives, Obs seeing me at the ante natal appointments. I always had to have my appointments at the Hospital and after I had the baby there were no home visits to check on me, a completely different experience to these last two pregnancies.

    I have been very happy with my public experiences, especially the midwifery group, I cannot fault it it all and the best bit, it's all completely free!

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    LoveHeart  (27-04-2012)

  16. #9
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    I'm in a midwifery group practice. I had my first hospital appointment at about 10 weeks, then they booked me in for 16 weeks. In the meantime I was accepted for the MGP.

    For the MGP I had my first appointment at 16 weeks, then i THINK they're around
    20
    24
    28
    32
    34
    46
    38
    40

    Even though I have a primary midwife with the MGP, there's no guarantee that she'll be there for the birth (she manages to attend about 80%). If she's not there, then her backup or another from her group will be there...so hopefully someone we will have met already.

    The appointments I've had so far are pretty similar...discuss various information, run through routine tests etc.

    If you feel like your care is lacking, have you considered hiring a doula? They're not medical professionals, but can give you some of the continuity and support that you might be looking for. I've heard nothing but good things from those who've hired them.

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    LoveHeart  (27-04-2012)

  18. #10
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    i am currrently pregnant with my first and due to the fact of living on outback australia im having my first midwife appointment between week 20 and 22. and have another 6 weeks before my due date (when i arrive in brisbane) my doctor told me yester day all the apointments that i have to go and see him so far i feel like i live at the drs because of my weight (36kgs before conception 39kgs now at 18 weeks) they are always checking up on the baby making sure its in the right position and they find the heart beat each apointment i have to see the doctor every 3 weeks then if anything changes i have to go straight back to him. so far my apointments have been
    4weeks when the test was positive, 8weeks a week after first ultrasound, 11 weeks getting test for chromosonal abnormalitys 13weeks due to having hemorrhoids and constipation 15 weeks to get all my blood levels tested again as they didnt find out my blood type, the 18weeks to get my referal for my 20 week ultrasound and bloods and my referal to see the midwifes in brisbane while im on holidays. i am currently 18weeks and 2 days going by my last ultrasound. i have to see the doctor as soon as we return back to our home town Cloncurry, ( north west queensland.) then again at 24weeks then 27 weeks all to get more tests done. i feel like im getting every possiable test and my doctor is extremely thorough with everything and i thought i were getting heaps of tests as my friends who are pregnant are not seeing the doctor any where near as much

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    LoveHeart  (27-04-2012)


 

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