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Private or Public for first birth
North Shore/North West Sydney


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#1 Zanbam

Posted 19 February 2013 - 12:57 PM

Hi

I have just found out I am pregnant. My DH is more than happy to pay for private (we have health insurance) but I kind of figured that we'd save the money and I use the Midwife Group program at Hornsby Hospital.

Today I found out that I would have to use the midwife clinic at Hornsby instead so rather than have the same midwife the whole way through I would see various midwives and sometimes see Drs instead at the clinic. I would still be ok with this and would consider hiring a doula for constancy of support/care but I thought I would check out local Obs anyway just so I have all of the facts.

My main concerns with going public are the quick release after the birth, I'm nervous that if I do have issues with feeding then I won't get the support I need when I need it if I leave hospital after 2 days, maybe it would be better to go private where I can stay for 4 days.

I'm also concerned that the care and support isn't as good in the public system, as this is my first I don't know if I will be confident to just get on with it on our own until the grand finale and I have heard that it can be hard even finding someone to come and check on things when that is wanted.

So if you think I should go private please let me know (bearing in mind this is my first) and if you can recommend a Ob at the San then please pm me.

TIA

#2 Anonymous12

Posted 19 February 2013 - 01:22 PM

Not something anyone can really recommend for you, but I couldn't fault the breastfeeding support I had when I had my baby at a private hospital.

I often wondered if breastfeeding would have got off to such a good start if I hadn't gone private. For this reason alone I thought it was worthwhile.

Edited by Anonymous12, 19 February 2013 - 01:23 PM.


#3 opethmum

Posted 19 February 2013 - 01:32 PM

If you can afford to go private then do so.

#4 Beancat

Posted 19 February 2013 - 01:33 PM

Again, agreee with PP, only you can decide.  But in the meantime, book in with a private ob now for your  10 week appointment, while you are making your mind up.  Many of the good ones are booked out by the time you reach around 6 weeks.  You can always cancel the appointment before the first visit if you decide to go public

Personally I would never go public if I could afforde private.  This will be my third child but i have had three miscarraiges, 2 of which required D&Cs.  I have also been hospitalised for mastitis and post partum preclampsia.  I have had GD too.  My perception is that if you have a trouble free pregnancy and birth you may not feel like private was worth it, but believe me, once things go wrong and the s$%t hits the fan, you want to be in the care of a private ob.  Also, as per your concernes re breastfeeding, I stayed in 5 days with the previous two and had tremendous help.  i found this to be most useful as I dont have a Mum and at the time didnt have any friends or family who could help with the breastfeeding

Edited by Beancat, 19 February 2013 - 01:34 PM.


#5 CallMeFeral

Posted 19 February 2013 - 01:34 PM

I had both of mine at Hornsby and cannot fault the care.

What's the story with the midwive group as opposed to clinic? It was 4 years ago so things may have changed, but I did the midwife clinic and saw the same (WONDERFUL) lady each time with no guarantee she'd be there at the birth - or I could have done the 'team' thing and seen different ones BUT one of them would have likely been on shift at the birth.

Also, when I was there, the 2 days was if you wanted to be visited at home by the midwives (which I believe is not available in private), you could stay 3 days if you didn't want this.

I haven't been private, but the care and support at Hornsby was excellent. I'd say better than private, because the lactation consultant was free for however long afterwards you needed to come to see her, and she was absolutely wonderful. They also had the free physio and other classes post birth.
I think it's mainly the swishness of the facilities you pay for by going private - Hornsby is lovely but they are short on cash and the food might not be as good etc (I don't eat hospital food anyway). I don't think you compromise on care at all.

Personally, unless you have an excellent obstetrician that you want for the birth, I would save the money and go public.

I will pm you the name of my wonderful ob, if you do go private. At the time he worked at both Hornsby and the SAN so it wouldn't limit your options.

Edited by lucky 2, 19 February 2013 - 06:09 PM.
r/o names of staff, although only the first name was given it is still identifying enough, see red writing above


#6 cheekymonkeysmum

Posted 19 February 2013 - 01:38 PM

I have only birthed public and couldn't fault them at all.

Ds needed to go straight to Nicu and our private hospitals only have scn not NICU and the doctors nurses and midwives were brilliant I was able to get a lactation consultant at the public and she helped so much as ds was tube fed for the first couple of days then the LC helped me feed ds and I fed him till he was 12 months.
The midwives helped at all hrs and even let me sleep and they watched ds for a couple of hrs.
Then I got this itchy stress rash and the midwives got me some cortisone lotion and helped so much and made an appointment with a dermatologist at the public hospital so see if it was something more (which luckily it wasn't).

I really could not fault the public system at all everything and everyone was great and I even stayed for 2 wks and they weren't shoving me out the door (ds was in Nicu for 2 wks) they did ask if I wanted to stay at Ronald McDonald house but since I just started feeding ds and he needed to be fed every 3 hrs they were understanding and let me stay on the ward.

#7 CallMeFeral

Posted 19 February 2013 - 01:41 PM

QUOTE (Beancat @ 19/02/2013, 02:33 PM) <{POST_SNAPBACK}>
My perception is that if you have a trouble free pregnancy and birth you may not feel like private was worth it, but believe me, once things go wrong and the s$%t hits the fan, you want to be in the care of a private ob.


Just to clarify on this OP - there is nothing holy about a private obstetrician - most of the ones who work at the public hospital also have private practices. The difference is that you don't know who you are going to get, at the public, until the day - whereas at private you know. And at public, you may be seen by a trainee/registrar and the consulting obstetrician gets called if there are issues.
So if it is someone good, you know you are getting someone good by going private (unless they are on holiday that day, or attending to another birth as happened to my SIL, etc etc). So I guess it's more that you increase the chances of having someone good - there's still no certainty.
But if it is just someone who you have found in the yellow pages and have no idea about, you might as well get that for free at public wink.gif  



#8 Chief Pancake Make

Posted 19 February 2013 - 01:43 PM

If you have a straight forward pregnancy and birth there is no benefit of going private over public except you will get your own room and better food.    If you are having trouble breast feeding they will let you stay longer (I stayed 4 days) and give you plenty of follow up to make sure every thing is going ok.

#9 SnazzyFeral

Posted 19 February 2013 - 01:46 PM

I gave birth at RNSH. I had breastfeeding trouble and was kept in for three days. I was very ready to go home when I did. I had twice weekly appointments with the LC for a few weeks post birth too.

There are generally better birth out comes in public hospitals.
http://www.abc.net.au/radionational/progra...ocument/4432252

#10 epl0822

Posted 19 February 2013 - 02:14 PM

Giving birth can still cost you many thousands of dollars, even with health insurance. You still need to pay any gap payment for an anaesthetist or assisting surgeon (should you require their services), and there is the pregnancy management fee (around $3-5k depending on where you live) which is not covered by insurance, and you will only get a couple of hundred bucks back from Medicare.

Spending lots of money isn't a guarantee you will have a good experience. Look at the hospital itself and their reputation and stats and feedback from other mums, not just whether it is public/private. I went to an excellent public hospital and they were really attentive to first time mums, and in fact they were advising me to stay longer due to feeding issues.

Hope you find a good hospital you like original.gif

#11 elizabethany

Posted 19 February 2013 - 03:08 PM

I have complicated pregnancies, due to a number of conflicting health issues.  I have gone the public route twice due to the level of communication between various specialists, and the ability to see them all at my appointments, not having to run around to see each one seperately in their rooms.

Since I at one point had 5 specialists I was seeing fortnightly, it would have cost me a fortune as well.  DS was sick when born, we would have been transferred to the public tertiary hospital after the birth anyway.

I was lucky the first time and got a single room in public, and now they have renovated and they are all single rooms for public, so I wouldn't even get that bonus.

You can get both good and bad experiences in both public and private, and neither is a promise of a easy birth.

#12 CharliMarley

Posted 19 February 2013 - 03:18 PM

My daughter had her baby at the SAN and they were marvellous. She was able to stay as long as she liked to get the breastfeeding up and going, as her daughter was in the NICU for a while being tube-fed, but she managed a suck feed before she went home and the staff were just so supportive. So, if you can afford it - go private. Better food, private room and longer stay than the public hospitals give you.

#13 Lickety Split

Posted 19 February 2013 - 03:18 PM

We went private with DD. It costs us nearly $10k in out of pocket expenses, even with top level cover (anesthetist fees, pediatrician fees, OB management fee, etc). We went public this time and it's been great. No complaints from me so far (yet to birth him though!).



#14 axiomae

Posted 19 February 2013 - 03:23 PM

I really don't think private is necessarily any better - it may be newer and more aesthetically pleasing perhaps but the care isn't necessarily superior - talk to other mums and take their advice on board. Consider your finances too, it's a lot of money.

I had a great experience in the public system seeing the midwives and I never once saw an OB during my whole pregnancy or labor. I didn't need to. Straightforward pregnancy, straightforward birth. Would have been a waste of money for me! I did go home the first night (my choice, there was no pressure at all to leave) and in hindsight would have stayed to help establish breastfeeding etc.

You can have a great experience in the public system - sounds like the PPs recommend Hornsby so that's something to consider original.gif



#15 katniss

Posted 19 February 2013 - 03:30 PM

I went public for both my boys and had no issues at all. With my first I stayed 6 days - no pressure at all to leave. With my 2nd I did leave the next day but only because I wanted to and I had a midwife visit me everyday for 4 days after to check on things. The food was fine, staff were great and I had a room with just one other woman.

I would only go private if I wanted a specific OB to deliver but even then it's not guaranteed if they take holidays or get sick.

Edited by katniss, 19 February 2013 - 03:32 PM.


#16 MrsLexiK

Posted 19 February 2013 - 03:35 PM

QUOTE (Chief Pancake Make @ 19/02/2013, 02:43 PM) <{POST_SNAPBACK}>
If you have a straight forward pregnancy and birth there is no benefit of going private over public except you will get your own room and better food.    If you are having trouble breast feeding they will let you stay longer (I stayed 4 days) and give you plenty of follow up to make sure every thing is going ok.

That is not true for all hospitals.  Everyone I have known at my local private has been kicked out after 6 hours unless it has been birthing complications.  

The only difference is not the food and your own room.  I would not be seeing the same midwife and OB at all of my appts if I was going public where I live, nor would I be 100% sure that I could stay in for 4 nights.

OP only you can deciede.  I have said to DH that if we do have another, whilst I would get my OB again I would probably go to the local public hospital because I don't mind too much if he can stay, if I have to go home early or whatever because I would have gone through it before.  I am a typical nervous anxious first time mum who has been calmed by seeing the same dr and midwife at all appts, and knowing my DH will not be thrown out.

#17 Gentrified

Posted 19 February 2013 - 03:44 PM

We had our first baby at Hornsby in 2011. My experience was that we had excellent care and I can't fault them at all. We were very happy.

The absolute best thing for us was the lactation consultants who visited after the birth. The two ladies who came to my house were both absolute geniuses at their job, and I had such fantastic one-on-one care (in my opinion, much better than the lactation consultants I saw while I was still at the hospital). I had as many visits as I needed and the visits were never rushed.



#18 Fairey

Posted 19 February 2013 - 03:56 PM

QUOTE (Zanbam @ 19/02/2013, 01:27 PM) <{POST_SNAPBACK}>
Hi

I have just found out I am pregnant. My DH is more than happy to pay for private (we have health insurance) but I kind of figured that we'd save the money and I use the Midwife Group program at Hornsby Hospital.

Today I found out that I would have to use the midwife clinic at Hornsby instead so rather than have the same midwife the whole way through I would see various midwives and sometimes see Drs instead at the clinic. I would still be ok with this and would consider hiring a doula for constancy of support/care but I thought I would check out local Obs anyway just so I have all of the facts.

My main concerns with going public are the quick release after the birth, I'm nervous that if I do have issues with feeding then I won't get the support I need when I need it if I leave hospital after 2 days, maybe it would be better to go private where I can stay for 4 days.

I'm also concerned that the care and support isn't as good in the public system, as this is my first I don't know if I will be confident to just get on with it on our own until the grand finale and I have heard that it can be hard even finding someone to come and check on things when that is wanted.

So if you think I should go private please let me know (bearing in mind this is my first) and if you can recommend a Ob at the San then please pm me.

TIA


Really??
I had my baby in a public hospital. They were fantastic. I had different doctors throughout my pregnancy in my rural town. Then drove to the capital city in labour (well, my husband drove and I had contractions and laboured away). I'd never even met the docs / obs or midwives who helped deliver my daughter. And quite frankly, in labour I wouldn't have given two hoots if an entire footy team was down the business end watching.
I had lots of after care support and home visits.

#19 lclb

Posted 19 February 2013 - 04:25 PM

As a couple of PP have said there is alot of out of pocket costs involved with going private. I would investigate these costs further, don't assume your private health insurance will cover everything.

I was approx $10 000 out of pocket going private at the Mater  for the birth of my DD in 2011. This was with top level health insurance. I had to pay $5400 for my OB ( approx $1500 back from medicare), had to pay for the assist OB for my C section, the anathesiologist, the pediatrician, $500 excess for the baby's stay in SCU for jaundice, blood tests for baby  and all of my scans. I did get some money back for these things from Medicare but not a lot.

For me this was worth it because I have a history of complications with my pregnancies and I want to see the same OB who has delivered all of my children.




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