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Private Midwife for hospital birth?


11 replies to this topic

#1 Still hopeful

Posted 19 April 2012 - 10:59 AM

Does anybody have experience with hiring a private midwife for a hospital birth? I am booked into Prince of Wales Private in Sydney, and will have a private OB. This is my first, and am very much hoping and planning to have a natural birth - I want to give myself the best chance of that. While I will know my OB, I understand that the midwives do most of the work anyway, and I don't want to turn up on the day not knowing the midwives (and whether they will be good at supporting a natural birth, given the high intervention rates at private hospitals). How do private midwives 'fit in' with the hospital protocols etc? I definitely plan to have a Doula - don't know whether it will be over the top to have a private midwife also? Appreciate any thoughts and experiences. (Please PM me if you have any recommendations).

#2 Belly82

Posted 19 April 2012 - 01:24 PM

a private midwife will be just like a doula once she steps into the hospital with you...although she will be medically experienced!?/trained.
i hired a private midwfe for my last and it was fantastic.... i was a public patient although was under the HEaD OB and was treated better than my private experience (but thats a whole other story!)...
having a private OB and DOULA and private midwife might be overkill??? an experienced doula with your own OB should be enough....
my reasons for hiring a my own midwife was i was public so all my antenatal and postnatal care was through my midwife IN MY OWN HOME (total heaven!! screw OB appts that always run late and only see you for like 5 mins!) plus i was going for a natural birth after 2 c-sections and wanted someone medically trained for support at home and then in hospital.

#3 Wigglemama

Posted 19 April 2012 - 03:31 PM

The private midwife would have absolutely no right to work clinically with you in the hospital. She would need to be an employee of the hospital, on shift. I would probably either choose a very experienced doula or the private midwife to be the other support person, not both. You may also find your hospital might have restrictions on how many support people can be present with you.

#4 Rumina

Posted 19 April 2012 - 07:09 PM

I had a private midwife and although she had no clinical rights I share cared with her and her medical knowledge was priceless both in pregnancy and during birth.
I am a bit confused by your post though as you mention you want a natural birth, are looking to hire a doula/IM but have chosen to birth in the private system where you are least likely to achieve this?

#5 Still hopeful

Posted 19 April 2012 - 07:59 PM

QUOTE (melissa1974 @ 19/04/2012, 07:09 PM) <{POST_SNAPBACK}>
I had a private midwife and although she had no clinical rights I share cared with her and her medical knowledge was priceless both in pregnancy and during birth.
I am a bit confused by your post though as you mention you want a natural birth, are looking to hire a doula/IM but have chosen to birth in the private system where you are least likely to achieve this?


The reason that I have a private OB is because, in case there are complications, I don't want to be at the mercy of whichever OB/registrar is scheduled on at the time. I feel more comfortable knowing that, if things don't go to plan, there will be a doctor who I know and feel comfortable with rather than somebody I don't know or who is not very experienced. It is unfortunate that it is an either/or proposition - I would be happiest with midwife led care and with my choice of OB, but the system is not set up that way.

Edited by Still hopeful, 19 April 2012 - 07:59 PM.


#6 Rumina

Posted 19 April 2012 - 08:59 PM

That is the reason I chose a private OB with my first burth, I also knew that his c/s rate was under 1 percent. Do you know what your OBs intervention rates are?  It really is a catch 22. Your chance of a normal physiological birth is slim in a private hospital as there are just so many policies and protocols that are so difficult to navigate and you become lost in a system that is so much bigger than one womans desire for a normal pshsiological birth. Taking a doula/IM will make a big difference.


#7 rosiebird

Posted 19 April 2012 - 10:11 PM

Still hopeful, I had a private IM in a private hospital. If you want to PM me, I'm happy to tell you all about it. The only downside was the expense - but it was worth every cent, the whole experience was fantastic and I'm doing exactly the same thing for my next pregnancy.

Melisa1974, you may have an obstetrician who has an incredibly low C/S rate, but I guarantee that he/she will not go to your home at 4am, put on relaxing music and start doing accupressure and massage on your weary labouring body!

#8 Rumina

Posted 20 April 2012 - 03:28 PM

QUOTE (rosiebird @ 19/04/2012, 10:11 PM) <{POST_SNAPBACK}>
Still hopeful, I had a private IM in a private hospital. If you want to PM me, I'm happy to tell you all about it. The only downside was the expense - but it was worth every cent, the whole experience was fantastic and I'm doing exactly the same thing for my next pregnancy.

Melisa1974, you may have an obstetrician who has an incredibly low C/S rate, but I guarantee that he/she will not go to your home at 4am, put on relaxing music and start doing accupressure and massage on your weary labouring body!


This is why I chose to home birth with my second. Once you have a taste of what private midwifery has to offer you would never go anywhere else!!

#9 No-pants Agnodice

Posted 20 April 2012 - 04:35 PM

QUOTE (melissa1974 @ 19/04/2012, 08:59 PM) <{POST_SNAPBACK}>
Your chance of a normal physiological birth is slim in a private hospital as there are just so many policies and protocols that are so difficult to navigate and you become lost in a system that is so much bigger than one womans desire for a normal pshsiological birth.



Hysterical much?

I just had a wonderful physiological birth in a private hospital - spontaneous labour with large 4 kg baby in posterior position. Still had an analgesia free labour, physiological third stage, immediate skin to skin, successful breast crawl, and bub was not taken to be wrapped or weighed for three hours - and then only because I was ready to get up and have a shower, and DH really wanted a cuddle with his new son. And this was with a normal run of the mill hospital allocated midwife and a covering obstetrician I had only met briefly once but who shared her practice with mine and obviously they communicate very very well because ALL my requests just happened without reminding or prompting.

There is a BIG difference between private hospitals having higher intervention rates, and saying that a woman's chance of having a physiological birth in private is 'slim'. All my friends who have had babies in private except one have had physiological labours, and have been very happy with the care they received. One had an emergency Caesar for foetal distress after 12 hours - she is 5 ft 2 in and weighs about 45 kg, and her baby was over 4 kg! She did not think the Caesar was inappropriate. The reasons why private hospitals have higher intervention rates is also confused - private hospitals do more elective Caesars compared to public but remember that this is a woman's choice - an elective Caesar is as valid a birthing method as a physiological labour if that's what an individual woman wants. There are also demographic differences which make the two groups challenging to compare directly. Remember that at the end of the day, Obs and midwives WANT you to have a normal labour. Anything extra is actually much more work for them - a Caesar means organising theatre, an anaesthetist etc. even an episiotomy involves a minimum of half an hour of sewing. If people won't respect the professionalism that leads to medical professionals wanting the simplest outcome for you possible, then they should at least respect basic human nature which is the path of least effort.

OP, I genuinely think the best chance if having a physiological labour is to prepare for it. I found a calmbirth class before my first really helpful. Your own support person may also be useful if that is important to you - for me DH was an adequate support person. A doula and a private midwife does seem like overkill, mainly because it doesn't matter how many 'advocates' and 'support people' you have in the room - when it comes time to dealing with each contraction, or pushing that baby out, it's all in your own head. And I personally think the value is in getting your headspace right. Having your own birth attendant is just the icing on the cake.

Good luck in your preparations and the birth, and don't let anyone scare you into thinking that a physiological birth is more challenging to achieve in a private hospital. It happens ALL the time.

#10 Guest_bottle~rocket_*

Posted 20 April 2012 - 05:07 PM

QUOTE (MsN @ 20/04/2012, 04:35 PM) <{POST_SNAPBACK}>
Hysterical much?


I don't think Meliisa1974's comment was hysterical at all.  The statistics show that she is correct.

http://www.dailytelegraph.com.au/lifestyle...i-1226240297619

QUOTE
FIRST-TIME mothers have unrealistic views about having uncomplicated births, increasing the risk of post-natal depression, a study has found.
The survey of 195 expectant mothers revealed they believe there is a 56.2 per cent chance of an uncomplicated birth, which means a baby being born without the use of forceps, suction cups, caesarean section or induced labour.

Pain relief is considered part of an uncomplicated birth.

The figure is more than double that of Victorian data, which shows the chance of having a medically uncomplicated birth is 21 per cent.

A further 30.7 per cent said they believed women would have uncomplicated births without needing sutures. The actual figure is 8 per cent.


The Victorian data includes both public and private hospital births, and shows that rates of interventions are higher in private hospitals.  Therefore the rates of uncomplicated birth for a first time mother in a private hospital would be even lower than 21 per cent.

It's great that you had such a wonderful experience, MsN.  Good for you.  However it is misleading to imply that your experience is that easy to achieve for everyone, because it isn't.

QUOTE
The reasons why private hospitals have higher intervention rates is also confused - private hospitals do more elective Caesars compared to public but remember that this is a woman's choice - an elective Caesar is as valid a birthing method as a physiological labour if that's what an individual woman wants. There are also demographic differences which make the two groups challenging to compare directly.


Private hospitals do have higher elective caesarean rates, but "elective" does not necessarily mean "maternal request".  It just means that the caesearean was done before labour has started.   This includes caesareans that are the woman's choice (but it usually isn't the woman's choice) and those recommended by the OB.

The reason why c/s rates are higher in private hospitals is not that women are requesting them, it actually has more to do with them being their OB's preferred mode of delivery.

QUOTE
Remember that at the end of the day, Obs and midwives WANT you to have a normal labour.

Sorry but this is ridiculous generalisation. There are many OBs whose rates of intervention would suggest the opposite.

Edited by bottle~rocket, 20 April 2012 - 06:38 PM.


#11 Still hopeful

Posted 22 April 2012 - 05:57 PM

Thank you all for your responses. Definitely agree with the recommendation to do a calmbirth course. Looks like I've got a bit a researching to do to find the right IM/Doula.

#12 rosiebird

Posted 22 April 2012 - 06:40 PM

QUOTE (MsN @ 20/04/2012, 04:35 PM) <{POST_SNAPBACK}>
A doula and a private midwife does seem like overkill, mainly because it doesn't matter how many 'advocates' and 'support people' you have in the room - when it comes time to dealing with each contraction, or pushing that baby out, it's all in your own head. And I personally think the value is in getting your headspace right. Having your own birth attendant is just the icing on the cake.


I'm so glad that you had a good birth! Congratulations on your new son.

In my experience, I very much needed my private midwife to deal with each contraction - my own head wasn't working right! My IM calmed me down and I felt she was always one step ahead of me - planning for the next pain-relief technique before the last one stopped working. When I was panicking in early labour (that felt like transition), she calmed me down with guided meditation and relaxation techniques. When I needed a break from contractions, she plopped me in the bath to slow things down. When she could see I had recovered suffiiciently, she got me out and moving around. When I couldn't cope with the pain, she gave me back massages and accupressure. She anticipated my labour in a way that my partner would be able to; in the best sense, she guided me through it and was in control when I (and DH!) wasn't. I know in myself that wouldn't have managed a natural birth with just my DH and private ob. It wouldn't have happened. Maybe now I have had that experience, I could manage with just DH but I don't want to take the chance. He was as anxious as I was.



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