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Elective Cesaerean but no insurance
Options for c-section


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#1 nollaig

Posted 31 January 2012 - 06:55 PM

Hi I recently found out I was pregant and am struggling to find information about options regarding an elective c-section. I don't have full private health insurance so I am wondering if the cost for private care is prohibitive i.e. for an elective c-section? I am assuming private care is my only option for a c-section as I believe public hospitals will only do it if deemed medically necessary.

Does anyone have any idea of how to get this info? I'm curious to know possible costs (although it probably varies depending on how long in hospital etc) but even an idea of minimum cost would be useful so I'd know if it is a runner or not.

Thanks a lot,

#2 Jacapanthus

Posted 31 January 2012 - 06:59 PM

If you call a private OB their secretary should be able to give you their costs over the phone. They should also be able to tell you roughly the cost of the anaesthetist, assistant surgeon etc. Then you'd need to call the private hospital and ask what their nightly charge is, theatre costs etc.

I'd say you are looking at something in the order of $10k but I am no expert.

#3 Steggles

Posted 31 January 2012 - 07:02 PM

Wouldn't touch private without insurance. Is this your first birth?

#4 paris-stella

Posted 31 January 2012 - 07:03 PM

I was a public patient and had an elective CS. I had no medical need to have a CS except for a previous traumatic birth

#5 item

Posted 31 January 2012 - 07:04 PM

If you have mental health reasons for wanting a c-section (anxiety etc) my understanding is you could be catered to in the public system.  Hopefully one of the midwives on EB will chime in.  Which state are you in?

#6 AnotherFeral

Posted 31 January 2012 - 07:06 PM

There is the cost for a straightforward CS and recovery, and then there is the potential blowout in costs if it's *not* straightforward. Not a risk I would want to take without PHI.

You haven't given your reasons for wanting a CS, but you obviously feel pretty strongly about wanting one over a VB. Why not research whether your reasons fall within your public hospital's CS policy?

#7 lorak

Posted 31 January 2012 - 07:08 PM

I did this in 2008 (bub was breech and the public hospital wouldn't let me have a cesarean until I'd gone into labour, so went private instead).  Hospital stay was around $5K for 5 nights. Anesthetist was around $1K.  Private OB fees would vary a lot - I'd suggest ringing around.  At the end of financial year you can claim some back thru medical expenses tax offset - you get around 20% back of everything that you spend, after the first $2K.
Also, try getting on the public hospital elective CS list - it was full by the time I tried.

#8 JaneLane

Posted 31 January 2012 - 07:14 PM

Call around the private OB's, their secretaries can give you a breakdown of costs and how much medicare will re imburse.  Prices differ enourmously between hospitals, My 2 births cost $6000 and $6500 in OB fees alone where as a friend who went to a different hospital further fron the inner city only paid $2500.  My private anaethetist fees were just over $2000, private paed around $500.  The same OB can also charge different fees if they use different hospitals.  I know of one who charged $6500 for inner city hospital and only $3000 for another hospital they also worked at further away.


I had top private health and extras and had a private room in a public hospital fully paid for by PHI but I found that they hardly covered any other expenses, something like $171 back for my $6000+ OB bill.  I received a lot more back from just medicare. But still I hardly got back any of the money I paid out.  Private insurance was only really any use for me with paying for the private room which was over $400 a night for the 4 nights I was in hospital.


Also if you want to go with a private OB you really need to book as soon as possible, they book out very fast.  You can always book and cancel later but if you don't make an appointment asap you probably won't get in.

#9 annasue

Posted 31 January 2012 - 07:20 PM

I had an elective CS  as a public patient. It depends where you are and your circumstances but it can be done.

#10 nollaig

Posted 31 January 2012 - 08:31 PM

Wow, thanks so much for all the responses. I'd love to go public if I could for an elective c-section. I am petrified of the mere thought of a v.birth. Since I can remember I have always been adamant I could never ever go down that road. I am kicking myself I did not know the Aussie system and have a year's worth of private insurance in place to avail of it before now, and I have got the impression that being petrified of the thought of it wouldn't be considered a good enough reason to have it done in a public hospital. I can't even focus in work because of it nor look forward to the baby as a result. I got pregnant on 1st attempt and being 34 I assumed it would probably take ages (maybe even years) so I do realise i am incredibly lucky but just have been totally caught off guard as a result.

I am in Sydney east and first pregnancy. I am only 6 weeks in so hopefully I am not too late to book in with an Ob. I see the Dr. for second time this weekend so hopefully she can shed some light on this for me but she didn't really talk much about being pregnant at all when I went for initial tests to confirm the pregnancy, she didn't even suggest what I should or shouldn't eat, do, exercise etc so not holding out too much for her guidance on this. May need to look elsewhere for who I deal with. Being newish to the country means I don't have much background knowledge of the system here or a family dr. etc so appreciate your feedback.

Sounds like different public hostpitals may have different policies which is interesting. I've toyed with going to different states and even back home overseas if it was an option(which sounds a bit drastic I know)!
D

#11 *mylittleprince*

Posted 31 January 2012 - 08:34 PM

My friend had an elective c-section in a public hospital. She chose one due to a family history of bad births and didn't want to go through the same thing. THey did try to sway her at every appointment but she stuck to her guns and got her own way.

Good luck!

#12 Azadel

Posted 31 January 2012 - 08:35 PM

QUOTE (item @ 31/01/2012, 08:04 PM) <{POST_SNAPBACK}>
If you have mental health reasons for wanting a c-section (anxiety etc) my understanding is you could be catered to in the public system.  Hopefully one of the midwives on EB will chime in.  Which state are you in?


It depends where you go.

I requested an elective c-section on the grounds of past trauma/abuse and was turned down.

#13 IsolaBella

Posted 31 January 2012 - 08:41 PM

I am in Melb, but my private hospital stay alone for 5 nights was $10k. OB was cheap at $2k. Then another $1k for Anaethetist, plus Paed, Bloods etc were another $500.

Then if bubs has issues and has to go to SCN you would be up for another $1k per day for bubs accomodation alone.

I would not be using a Private hospital without private health insurance.

You never know what could go wrong. My sister went for her usual 35wks appt, was sent to hospital and had an emerg c/s that night (HELLP Eclampsia). She was in ICU herself for 4 nights and then another 4 nights on the Maternity ward, bubs was sent to NICU at another hospital then spent a further 14d at the Private SCN. Her hospital bills alone were over $30k



#14 Water lily

Posted 31 January 2012 - 09:03 PM

QUOTE (lsolaBella @ 31/01/2012, 09:41 PM) <{POST_SNAPBACK}>
I am in Melb, but my private hospital stay alone for 5 nights was $10k. OB was cheap at $2k. Then another $1k for Anaethetist, plus Paed, Bloods etc were another $500.

Then if bubs has issues and has to go to SCN you would be up for another $1k per day for bubs accomodation alone.

I would not be using a Private hospital without private health insurance.

You never know what could go wrong. My sister went for her usual 35wks appt, was sent to hospital and had an emerg c/s that night (HELLP Eclampsia). She was in ICU herself for 4 nights and then another 4 nights on the Maternity ward, bubs was sent to NICU at another hospital then spent a further 14d at the Private SCN. Her hospital bills alone were over $30k


Yep I agree with this. I would not recommend going to a private hospital without private health insurance unless you have a big chunk of savings ready to dig into in case things go pear shaped and you need to fork out an extra $20-40,000 for medical bills for you and/or the baby.

Can I ask, what it is you are afraid of in terms of having a vaginal birth? If it is pain, you could request and insist on having an early epidural, early on in your labour so you can spend most of your labour pain-free. This is very commonly accommodated, and most public hospitals would be happy to do this for you.

As others have mentioned, whether or not you will be 'granted' an elective c/s based on not wanting to have a vaginal birth will depend on the public hospital you go to. My recommendation would be to go to a big tertiary hospital such as Royal Hospital for Women or RPA, the doctors there are more likely to agree to an elective c/s for non-medical related indications, than a smaller, low risk hospital that perform less caesareans.
Regardless of which public hospital it is in Sydney, the hospital doctors will most likely need to have a referral/recommendation from the hospitals social worker and mental health team stating that it is in the best interests for you psychologically to have an elective c/s.
You have a very small, to no chance, of just insisting that you would prefer to have a c/s, with no back up from the mental health team or social workers. If it is an issue that is causing you a lot of stress and anxiety and you really feel that having a vaginal birth will compromise your psychological well-being, then you must say this at the appointment when you book in at the public hospital, and that way they can put you in touch with the social workers/mental health team, and then they can help put in place what is best for you, and if that means an elective c/s, then you should be cleared for that, which is usually performed at 39-40 weeks.

All of that will cost you nothing at a public hospital, you usually only need to pay for a 12 week and 18 week ultrasound.

Have a chat with your GP about it, she may be able to suggest a few things. But again, I think the number one recommendation would be to not go to a private hospital without PHI

Edited by midwife&mum, 03 February 2012 - 09:55 PM.


#15 Wigglemama

Posted 31 January 2012 - 10:06 PM

If you go to RHW you haven't got much chance of getting an elective LSCS for those reasons unless the mental health team and social workers are successful in "proving a VB will harm you psychologically. There is a huge push at the moment in NSW Health, and this hospital in particular to normalize birth.

You do have every chance to have an early epidural. No matter what stories you hear, most midwives in the delivery suite are very supportive of womens' choices in pain relief.

I wouldn't even think of trying to pay for an obstetrician and a private hospital stay (as well as possible antenatal and special care nursery admissions)anywhere in Sydney without private hospital insurance.

#16 Princess.cranky.pants

Posted 31 January 2012 - 10:31 PM

I have 3 CSs. There is no way I would even consider going private for an elective without insurance. The cost would be huge.

You need to think about the risk of complications and the possible costs blowout if you have no insurance. I got an infection in my C/S wound (infections are common). I had to go back to hospital two weeks after giving birth for another 6 day stay. I had a second operation and a midwife had to come to the house daily for a few weeks for wound dressings. I also had weekly checkups with a specialist. Thank god it was all on medicare. I would hate to think of the costs involved.

With my 3rd child I had a 12 day stay in hospital. DD was in special care for over a week. Not C/S related this time but again it was unexpected complications and would cost a bomb if I was paying for it all out of my pocket. I went public and didn't cost me a thing. All my C/Ss have been though the public system.

I think going public is really your only choice. If it's pain your scared of you can have an early epidural as the PP said. A C/S is not pain free and it's not an easy thing to go though. I would really recommend you talk to your GP again and get some counselling. Don't just rush into making a decision based on fear. Talk to someone about how your feeling and you might be able to have a vaginal birth with support or an elective.

#17 trouble n paradise

Posted 11 December 2012 - 06:03 PM

QUOTE (annasue @ 31/01/2012, 08:20 PM) <{POST_SNAPBACK}>
I had an elective CS  as a public patient. It depends where you are and your circumstances but it can be done.


Hi annasue,

I am a new member and interested in which hospital you had this done at and perhaps how long ago? I am 34 wks pregnant with a huge baby, small body, and my hospital - Sutherland - wants me to labour prior and then do emergency c if required. I'd prefer to do an elective c with less risks - but they won't allow me.

Am now considering being a private patient in a public hospital as do not have private insurance, this would unfortunately mean taking out a loan to do so though ;(

Any  help would be appreciated.

#18 whale-woman

Posted 11 December 2012 - 06:36 PM

I would jump up and down and have an absolute hissy fit and demand a elective c/s in the public sytem. Be persistant, get your GP or some mental health backup. Tell them of your anxiety and fears if they're not listening tell you've considered suicide as an alternative if you're forced to have a VB. Ultimately you will find someone who's sympathetic and will support you to get what you want.

Patient choice elective C/s are pretty routine in the private system. There are enough guidelines out there supporting patient choice elective Caesars, such that though they are often actively discouraged ($$$$ reasons) in the public system, you should be able to get one if you create enough of a fuss.

#19 123tree

Posted 11 December 2012 - 07:27 PM

I would persist in telling them your concerns and try to back it up by talking to anyone about it who will listen and support your choice.  I went to the Royal Women's in Melbourne, a public hospital for an elective C section as a public patient.  It was on the basis of a previous traumatic labour.

However I would talk to your health care professional about the size of your baby.  Do they agree it is going to be a big baby too?  I was told that sizing scans could sometimes be as much as 30% inaccurate and sizing scan's wouldn't be done until quite late in the pregnancy.   This was a few years ago so things might have changed.

#20 Lainskii

Posted 11 December 2012 - 08:23 PM

If you've only recently come here from another country, do you qualify for medicare?
If not then I'm pretty sure you'll be out of pocket in a public hospital regardless.

I had to have a Ceasar for last baby and am up to $9k (without paying for hospital visit) - I've received just under $3k back from medicare & PHI (so out of pocket just over $6k).
The $9K doesn't include the hospital stay which was $6.6K paid by PHI) and the 4 weeks DS spent in SCN (was about $50000 for my DD but haven't seen the bill for DS yet)

I wouldn't go private without insurance unless you have about $15k you're willing to part with. Th private hospital I went to takes a $10k deposit if you don't have PHI and refund you if stay was less or you pay the difference.




#21 IsolaBella

Posted 11 December 2012 - 08:32 PM

Also going to say the tax medical expenses threshold is now$5k not $2 k.



#22 Vinti

Posted 11 December 2012 - 08:51 PM

Hi, with my second pregnancy, my health fund had change to no longer cover hospital stays in regards to  obstetrics, I didnt have full cover to deal with obstetric and private hospital.

In summary, I went with a private ob in Sydney, found out that he works in a public hospital as well as some private. So I was booked into a public hospital as a private patient. I paid my obs costs, visiting fees, and management and delivery fees. I only had to pay for the room stay at the public hospital, no other costs in relation to the delivery etc.

First baby was emergency c-section, 2nd was elective.

You probably have to call around to the obs surgery soon as often Sydney obs book out rather early.

Good luck. Dont be too scared, pm me if you need details.

#23 spitzmum

Posted 12 December 2012 - 07:26 AM

QUOTE (whale-woman @ 11/12/2012, 07:36 PM) <{POST_SNAPBACK}>
I would jump up and down and have an absolute hissy fit and demand a elective c/s in the public sytem. Be persistant, get your GP or some mental health backup. Tell them of your anxiety and fears if they're not listening tell you've considered suicide as an alternative if you're forced to have a VB. Ultimately you will find someone who's sympathetic and will support you to get what you want.


I wouldn't recommend crying wolf about suicide - an easy way for your child to be flagged by staff at the hospital as one who might go straight into the nursery care of DOCS after the birth. Has happened at Westmead (not to mention that you're devaluing those who actually reach out with pre-natal depression)

#24 premmie_29weeks

Posted 12 December 2012 - 08:11 AM

I gave birth twice at prince of Wales private with an ob, both were uncomplicated vaginal deliveries. My ob delivers at both the public and private hospital. So you would have the choice, though giving birth in a private hospital without insurance is a huge risk. Pm me if you would like his details I had great experiences both times, though the out of pocket costs are about $5000 regardless of where you deliver and a little more if you have a cs.

I think it's really worth having a detailed chat with an ob or midwife about your fears, if you can do the vb and its reasonably straightforward it is much better for you in terms of recovery...my sil was induced and the epi was put in prior to her having a contraction...so no pain at all. There are ways around the pain if circumstances allow it

#25 JECJEC

Posted 12 December 2012 - 08:18 AM

QUOTE (lsolaBella @ 11/12/2012, 09:32 PM) <{POST_SNAPBACK}>
Also going to say the tax medical expenses threshold is now$5k not $2 k.


The threshold is income dependent. If you earn less than $168k as a family it is still $2k - otherwise $5k and only 10% back.




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