[Shells78]

Hi all,

I'm 35 and expecting my first baby in October.

My very welcome but equally unexpected pregnancy news means although I have private health insurance, I won't be covered for my pregnancy or birth.

I'm therefore weighing up public at Royal Hospital for Women Vs private out of my own pocket. I'm leaning more towards public at RHW but have some concerns.

Perhaps its just my ignorance and naivety but, I've been given the impression that delivery at the RHW with the midwifery group as a public paitent means; little chance of pain relief or epidural unless absolutely necessary, a very short stay of possibly less than a day and potentially no episiotomy if required.

I would love to hear your stories and insights on good and bad experiences you may have had with the Royal Hospital for Womem in Randwick as a public paitent.

Thanks!

[R2D2]

HI there, I delivered both as private patient at RHW. I just posted in someone else's thread about it - have posted that reply below.
I too was worried about pain relief. I was offered it, but it was my ob that made it happen, even lurking outisde theatre to grab an anaesthetist where really, a midwife would have rightly told me i was just too late.
Midwives were great, and not on the natural birth railroad track, but offered pethidine or gas, as that was what they could control...
Can't comment on episiotomy, although my doc monitored it closely but was incredibly quick to do it when needed- saved me a torn urethra. He also stitched incredibly well, i can't even tell i had one - no scar - despite the stitching taking longer than the delivery..



As a private patient, your ob attends, but everything else is the same - rooms, midwives etc etc. RHW has the best NICU, so if anything goes seriously wrong, you're in the right place. THere is no guarantee of a private room, it's first in and needs based, so you may well up sharing with someone.

Due to changes to reimbursement of ob fees, RHW is busting at the seams, so prepare to be a bit cramped, likely share a room, bit short staffed etc but still great place to deliver.

I have had friends deliver at POW and say it was v nice, you will get a more "private" experience there, and i believe they have the option of transferring to a hotel for a few days post birth with a midwife on call....

Midwives were fantastic at RHW, i only booked an ob because i am paranoid, and because i knew i would need pain relief, and much easier to get if you have a doc on hand - if i hadn't had him, i would not have had the happy outcome with number two - the midwives would have (probably sensibly) said it was all a bit too late and i should just grin and bear it....

[cherrybub]

Hi

I had both my children at RWH as a public patient. Both my experiences were great.

I was with the small midwifery groups (can't remember what they're called) and the support was wonderful. I moved house between my two births so was with different groups each time and both were great.

I had access to doctors when needed and actually ended up with cholestasis with both pregnancies. Both times I had my blood tested every 2nd day and spent time in the pregnancy day stay a few times a week to be monitored.

With the first birth I was induced as my waters broke and labour didn't start in the next 12 - 24 hours. I had an epidural part way through labour and then ended up with an emergency caesarean after 18 hours of labour. The attention from everyone, midwives, doctors etc couldn't have been better.

My second pregnancy was similar in that I was seen by a small group of midwives, monitored closely when it seemed I had cholestsis again, pregancy day stay again to be monitored etc. I ended up have a planned caesarean (or sort of planned anyway, it was decided on the Monday to do it the next day). One of the midwives from my group of midwives was present at the birth to ensure I was comfortable and that everything was OK, and to help me with breastfeeding afterwards.

I was in the hospital for 5 days with both births and received lots of help from the midwives on the wards. After I left hospital for my second baby, the midwives also did home visits for me for another week.

I know other people will have had different experiences but mine was great (both times).

Good luck

[Chief Pancake Ma...]

I think you are thinking of the birth centre. To go to the birth centre you must be in group midwifery, but if you are in group midwifery you can elect to go to either the birth centre or the normal birth suites.

Even in the birth centre if you want an epidural they just take you up the hall way to the birth suites. I gave birth in the bith suites about 3 months ago and had an epidural - just be prepared to be very firm about wanting it and dont let them talk you out of it. If you do a search I have written about it acouple of times in threads in this section.

The alternative to group midwifery is GP shared care where you see your GP for most of your appts and the midwives for 3 or 4, you will get a random midwife for the delivery.

[Mozzie1]

I gave birth as a public patient at RPA recently. During the pre natal classes, we were told about the availability of all pain relief options. I ended up having an epidural, and had no issues in getting one.

I agree with the PP who talked about understaffing though - it was shocking in that regard. Most of the staff were wonderful though.

[ceeshell]

I delivered both my girls at RHW as a public patient, firstly through the midwife program in delivery suite, secondly with the midwives in the birth centre.

I used gas with my first labour and I am confident that had I asked for an epidural I would have received one, but my labour was only 4 hours and progressed well so I didn't need one.

Second time around was an emergency induction so my plan of giving birth in the birth centre went out the window and I was taken down the hall to the delivery suites. The gas made me vomit so I ended up having DD2 drug free. My labour with her was only 2 and a bit hours, so again, I managed without an epidural. I am positive that had I asked for an epidural they would have given me one (as long as there was time, of course).

In terms of the episiotomy, they tried to give me one during my first labour and I asked them not to as I preferred to tear naturally if possible. They respected my wishes, but again, they weren't anti-episiotomy.

I was very happy with both experiences. I was not offered an epidural because there was no need, and my midwives were aware of my desire to do without one - but they are not 'anti' pain relief by any means.

My best friend had her son there last year and she wanted to labour without pain relief. In the end her labour went on and on and she was very fatigued and it was her midwife who gently convinced her to try the epi. She did and was happy with her decision.

I should add that I became ill just before the birth of my second daughter and ended up in acute care after her birth. The care I received there was absolutely second to none. RHW is absolutely the place to be should anything go awry.

I recommend the hospital 100%

This post has been edited by ceeshell: 20/02/2013, 03:13 PM

[blue4me]

I had both kids as a private patient at RHW. I saw my OB up in the Professorial Suites upstairs.

Both were c-sections so I can't help with any info about pain relief etc going natural. I also had a private room both times and everyone I saw there were all very nice and made my stay enjoyable (as far as a 5 day hospital stay can be!)

I have PHI so my entire stay was covered by them, it would be a lot of money to pay if you go private without using PHI. OB fees were a lot too and only got a few hundred back from both Medicare and PHI. With DS1 my OB fees were $6000 and DS2 they had gone up to $6500. I would guess it has probably gone up another $500 since but I'm not sure. I was out of pocket over $5500 & $6000 respectively after Medicare rebate and the very small amount my top hospital and extras PHI gave back.

[lisles]

Hi Shells,

We had our first daughter in RHW, back when it was in Paddington. Of course a lot of what happened then is no longer relevant, but reading other women's comments about busy staff and overcrowding did bring back some memories! One thing I wanted to add that you may not have considered is to look in to the early discharge programme (if it is still available). We went home less than 24hrs after the birth, and had a lovely midwife come to the house every day for the first week. She spent a lot of time with us making sure we got the breastfeeding established and that everything was going well. From memory, she was there over an hour most visits and taught me lots of things I hadn't thought to ask about but was later grateful for. I got way more help from her than I did from the hospital midwives, and was more comfortable at home than in hospital. No yucky hospital food, and no being disturbed by roommates (or their visitors!) It was a completely free service, and one I highly recommend.