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Booking in to public hospital late
RPA, st George, elective caesarean

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#1 baileybunny

Posted 05 February 2013 - 09:58 PM

Hi Everyone,

I'm not due for a fair while yet (late September), but I am thinking about hospitals and so forth already.

My previous birth for DS (2011) was vaginal, 23 hrs labour, epidural, vac extraction, 3rd degree tear etc etc! The hospital (RBWH, I live in Bris) said at the time that for next time I should be having a caesarean due to the tear).

If I go to a different hospital are they all going to agree with this without much fight and let me have a caesarean?

My main question though is that we currently live in Brisbane, and may need to move to Sydney some time before the birth, I'll likely be anywhere between 13-23 weeks along when we move. We don't know the exact location in Syd as we need to find a house.

Is this going to be an issue booking in/getting a spot in a public hospital? Especially given I'm wanting to have a caesarean? Can you book in at 23 weeks, or even 30 weeks if need be? If it's any help, at the moment hospitals will possibly be RPA or St George, maybe Randwick. I don't want everywhere to be full and turn me away!!!

Ive heard of RPA getting too many early bookings that it's full and no longer accepting more bookings, is this true? One thing I could do now if I was really desperate is try and get booked into RPA now if I could just list an address (my family live in Pyrmont), provided I didn't have to physically go to appointments there in the lead up and could just see my existing GP! I guess if I am likely to get my caesarean then if I enrolled and got accepted to RPA using my family address and we ended up being situated within say 15km away it shouldn't be a big deal as I would hopefully not be rushing to the hospital in labour but instead calmly arriving at the designated time at ~39wks.

#2 elizabethany

Posted 05 February 2013 - 10:11 PM

You will have a booking in appointment, and would need a refferal from a GP, so they would be surprised if it is not a local one.  Anything before 16 weeks is generally done by your GP anyway.

I would call them, and ask to put your name down.  They will always prefer more warning to less, and you can transfer hospitals if they know you are coming when you move.

Some hospitals are required to take anyone who shows up, especially the large tertiary hospitals.

#3 Bunsen the feral

Posted 05 February 2013 - 10:12 PM

I can't answer all your questions but I am going through RPA as have several friends. As a public patient you can't book in until after 20 weeks - you do see a midwife and an OB before then but the actual booking in to birth and stay there happens after the OB review at around 20 weeks.

If you are a public patient they cannot refuse you care if you live in the catchment area. They will refuse private patients if getting too full of public patients - this happened to a friend just after the Medicare rebates changed and the number of public patients suddenly increased.

#4 Mianta

Posted 06 February 2013 - 10:37 AM

I work as a midwife for NSW Health.

The current policy on LSCS due to 3rd degree tear has to do with how far into your anal sphincter you tore. I am not sure if it is so much if they will say no to a LSCS. I think it is more for being cleared for vaginal birth after a third degree tear.

As for booking in, they should definitely take you on as a late booking in. It will also make no difference in the way you give birth. However, do it honestly. They will need to see you for a booking in appointment, as well as an obstetric review to discuss birth options and your previous obstetric history. They won't book you in to deliver by LSCS, without this being done first.

They will be picky about catchments areas, because at the later stages, they will be a bit more jam packed with women, but they can't actually refuse your care, unless the hospital does not operate to a full obstetric capacity eg. hospitals that only have low risk models of care, no high risk obstetric models.

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