Hi to all you parents and soon to be parents of twins/multiples.

I have just found out today that I am expecting twins due early April 06 (if I make it that far).

I was (still am) undecided on whether to go public or private when I found out I was pregnant so booked in with both a private OB and the public hospital midwives clinic. I thought I would check them both out as to their recommendations re delivery/care and then make a decision - this was based on having a particularly nasty delivery of my DS. Now that I have found out I'm having twins, it takes the question of delivery away (I will definately have a CS) but poses a whole new problem in terms of pregnancy care.
If I go public, I have access to the Fetal Medicine Unit & NICU straight away but will have limited continuity of care. If I go private, I will get the continuity of care but have to rely on the OB recognising a problem if it arises, and then having to be referred to Fetal Medicine etc.

I would welcome hearing about other people's experiences with the public & private system with twins/multiples.

Thanks in advance

Michelle

Can I ask if you are in Sydney?

I'm having twins currently at RNSH hospital and I'm getting excellent care. I already had my daughter via midwives clinic, and had a very complicated and traumatic delivery... but I feel very safe in public hands. They have been right on top of everything so far, can't fault the hospital or the Obs I've been seeing.

I have had public twins lol - enquire if they have a 'high risk pg' group and if twins are included in that group. With the high risk pg group they are normally seen more often, and there is more continuity of care. I preferred the midwives clinic but wasnt allowed to stay there cos of twins. I had premmies (8 weeks early) and no problems at all. In fact i had a lot of continuity, i didnt like the registrar much but kept getting him anyway. When i went into prem labour was determined to get them out or keep them in and have it settled before he came on for the entire w/e. Ali

Hi,
We got private health insurance especially for having our baby. We had it all planned then we found out it was twins.
We had a few problems with one of our boys and were referred to the local hospital which has a Level 1 NICU.(Nepean Hospital, Sydney) We saw the same doctor every 2 weeks, and he told us that we would not be able to give birth in the private hospital as they were unable to deal with major problems.
I think you would find that having twins you would be seeing a doctor, rather than a midwife and the same one each visit.

Good luck with your pregnancy.

Mel

I'm having my babies privately. I don't know anyone who's had twins publically (now that sounds wrong doesn't it!!?) but from some work that I used to do (obstetric policy work for public hospitals) I have a good idea of how the public system works (here in SA anyway). With twins, they're considered high risk therefore you are more likely to get a senior Obstetrician who will likely see you a lot of the time. However, public hospitals are also known as "teaching hospitals" and therefore it means that you may well be seen by a Dr who's still learning (but of course would be overseen by a more senior Dr). Dr's in learning need to know how to deal with high risk patients as well as low risk patients. If you go public then, as you say, depending on the hospital you will have access to a higher (often highest) level of NICU care if needed. Not all public hospitals however will necessarily offer a high level of care for their NICU or their obstetric services - some are even lower than some private hospitals.

You will have to weigh up the private hospital you're considering vs the public hospital you're considering and compare the different levels of their NICUs and obstetric care (some public hospitals for example have very low numbers of births and therefore don't have Obstetricians around all the time).

If you go private you'll know exactly who your Ob is all the time. If your hospital doesn't cater for the needs of the babies if they're prem then you'll go to a public hospital but with your Obstetrician. The private hospital I'm going to can take babies from 32 weeks.

I, so far, have been happy with my care and feel better knowing that I have the same Ob no matter what happens. I also prefer the more personalised care of a private hospital and having a separate, descent sized room is appealing as well.

Hhhmmmm - I may have rambled a bit! I hope that all makes sense and is atleast vaguely helpful!!??

[center]ME 31 ~ DH 35
<a href="http://oneintheoven.net"><img src="http://oneintheoven.net/preg/ticker.24827.png" border=0></a>
www.users.tpg.com.au/stevesw

There are two things in life for which we are never truly prepared: Twins!
~J Billings~

Hi I had my girls in a public hospital( Sandringam Melb) and had no complaints or medical costs!! I had shared care with my local Gp and an OB at the hospital. They classified twins as high risk so care was fantastic. Found alot of the hospitals public or private wont take you before a certain no of weeks as the dont have good neonatal care. I wanted to start and finish my pregnancy with the same docs and hospital so the choice was pretty easy.

My sister recently had a baby (private) her out of pocket costs were still a few thousand and if she had of delivered early or bub had problems she would have had to go to the public anyhow.

Sandy hosp give you 5 days for a ceasar an extra day for twins. My girls stayed in for 7 days I was discharged as a patient(i.e no medical attention) but allowed to stay until the girls were ready to come home. Single room all meals etc.

good luck with your search and the pregnancy...

Rebecca 32
Nathan 28
Fraternal twin girls Amber & Olivia 08/05/03

Hi Michelle - congratulations on your pregnancy!

I am currently 24wks with twins, and have been getting Public care (at the Mater in Brissie).
I was immediately classified as 'high risk' and have been seeing doctors regularly throughout the pregnancy. I've never seen midwives or trainee doctors. Contrary to popular belief, you don't typically just see whatever doctor is available (when you're preg with multiples)... I see one of two OB's, one of whom is the hospitals head of Maternal Fetal Medicine. I only see the second OB if the first is called away for an emergency or something. I've had private treatment in the past for other things, and I don't think there's much difference at all with my current care (other than the fact that it's FREE this time!) Also, if you have any other health problems (like high bp or diabetes etc) you'll be treated by a specialist in that condition as well.
The hospital has the highest level NICU and specialises in high risk and multiple births. They don't usually 'book you in' in advance for a csection, they take a wait and see approach - which is fantastic if you are interested in natural birth - but csections are still pretty common for multiples. If you ever have questions you can phone the midwives directly, who will either answer your question or contact the OB for you.
The only things I haven't been thrilled with are mainly superficial, the hospital is looking a little shabby and old. The rooms are shared and basic. Sometimes the antenatal clinic is a little chaotic and wait times can be pretty long. You might not like being unable to phone your OB directly, which you could do in Private care. But overall I can't see the value in paying for Private....
(note: this is just describing the hospital I go to - not sure if others are different!)
HTH, and good luck!

Me 33, DH 37

Congratulations!

There's less of a difference between public + private care with multiple pregnancies than with singletons. As the other guys have said, you qualify as "high risk" (but that's just relative to the garden variety single baby (LOL)- it's not a guarantee anything will go wrong!)

Many public hospitals have "Multiples clinics" or "High risk clinics"- where you'll generally be seen by someone more senior (but not always by the same someone). They're usually the same doctors who see multiples privately anyway.

There are other considerations, like how long you can spend in hospital after the delivery (generally a bit longer if you go private), a single room etc.

The NICU issue isn't a problem if your private hospital is attached to a public one with a NICU (like Frances Perry + Royal Women's, or Jessie Mac and Monash in Melbourne)

[color=Teal]Hi there and congratulations!

I have had a couple of friends who have twins who delivered in a public hospital but had their own ob. I've also heard that if you're having a multiple pregnancy you're classed as "high risk" so you tend to have more continuity with docs.

Having said that, I went fully private and couldn't have been happier. I did a tour of the public hospital and was told (in no uncertain terms) by the midwife in charge that just because I was having twins I wasn't necessarily assured of having my own room! Well, that was it for me. I just couldn't cope with the thought of sharing a room while trying to cope with 2 new babies.

Best of luck with your decision making.

Vanessa

HI,

I had my twins in a public hospital - RPAH in Sydney.

I have to say it was fantastic - I went to the twins clinic and saw the same DR and the person doing the ultrasounds was extremely good. My twins were high risk and ended up delivering at 32 weeks due to placenta probs. We were in NICU for about 2 months.

Everyone was very professional and I felt I was in very good hands.

And no out of pocket costs too! Although parking cost us heaps during that time in NICU..LOl!

Ali

Hi There

I was considering going public but in the end decided to go private (in a public hospital with NICU )with the birth of my triplets & I am so glad I did.

Although it does cost a little more to go private I really think it was well worth it for me as I had everything you could possibly imagine go wrong in my pregnancy.

I was in hospital for 7 weeks in total when I had my 3 a month ago.

Being private meant that when I had a problem late at night which happened on more than one occasion, I was able to get the midwives to call my Dr (which they did) There were many times when I was able to call my Dr in if I was having a problem when I wasnt happy with the resident Dr's treatment or I was having troubles.

IE: At 28 weeks I developed collestasis (itchy rash) It was soooo itchy I asked the nurse to get someone to look at it. One of the hospital's resident Dr's looked at it & mis-diagnosed it & told me to use sorbelene cream to soothe it with ice packs. The rash only got worse & then I was able to get the nurse to call my Dr late at night & she was able to diagnose it quickly & prescribe the appropriate treatment........Things like this happened on more than one occasion......After my C section the midwives told me to be prepared to leave on the 4th day as this is what they normally do & they told me that they needed my bed for another patient.....I managed to stay to the 8th day, but only because I was a private patient & my Dr could see I didnt want to go yet (I just wasnt strong enough)...Had I have been public I would have been out on the 4th day like all the other public patients.

Cheers, Lilymurray

ME 28
DH 28

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This message was edited by lilymurray on Friday, 9 September 2005 @ 3:20 PM

Hi, I was a private patient at a hospital that offered both public and private rooms. This meant I had my own room (and my DH stayed in with me) and saw the same ob throughout my pregnancy and the week I spent in hospital after the birth. I am so pleased that I had my own room- it would have been hard if I was sharing to have had my crying babies wake up other bubs, and them wake me up when I was exhausted etc. Plus it allowed me to feel very relaxed whilst trying twin feeding. I visited a mum sharing a room with three other mums and bubs not long after my twins were born and I was very grateful that we had been lucky enough to have had a private room to ourselves. My health fund was great and funded a lot more because I was having twins.
Maycee

Maycee (35)
DH (33)
Twin boys (4/12/01)
DD (7/10/03)

Thankyou all so much for your replies.

I was thinking private today but after reading your replies I'm not so sure. My choices at this stage are Royal North Shore Hospital (Sydney) if I go public which is where my son was born or my OB delivers at the SAN. I visited him today for the first time and he was absolutely lovely although I'm now scared to bits about all the things that could potentially go wrong. I'm not really keen about sitting in the antenatal clinic at RNSH waiting for the doctor's clinic (midwives clinic was so much quicker!) with a two year old in tow but if that is what I have to do then so be it. My OB said that if things start to go wrong he will refer me to the Fetal Medicine Unit at RNSH anyway so then I start thinking why am I paying him if I am going to end up there anyway. On the other hand if things go okay then I will have a (hopefully) pleasant time at the private hospital when I deliver.

I'm thinking that I will go to my antenatal booking in appt next week at RNSH and get a feeling from that as to what to do.

Thankyou so much for your help. Yesterday has completely changed my life forever - just when I thought I was getting it under control.

Michelle

DS - Samuel (11/12/03)
Twins due 10/4/2006

Hey hon,

I'm having twins presently and go to RNSH Specialist or high risk Obs appointments on Tuesdays.... (which is when they are held) I don't take my daughter, and did once and we waited 3 hours, and she got very restless... so I leave her at home now with the Nanny (Yes lucky I can do that!) The thing I can recommend to you if you can't leave her in care of some kind is make your appointment at 10am (latest) and they usually see you by 11.30-12.00pm at latest... less time waiting.

My next appt is on 27th, so if you're going the same day, let me know

HI there

I ended up having my twins at 30 weeks. I went public & I was happy with the service I got.

I'm glad that I didn't have to pay any medical bills at the end as my girls had lots of blood tests & things like that.

I also got my own room for the whole time, except for 1 night. Due to the girls being born so early, our local hospital could not cater for them, so we had to travel to another hospital (only half an hour away). I was able to stay at the hospital for a few weeks! Then when they came to our hospital only 5 min's away, I was there for most of the day & they gave me lunch & snacks etc.

My sister recently had a baby at 35 weeks & was private. I thought I received better treatment then she did! Her OB was great, but as for HER care I didn't think much at all.

I got good treatment while I was PG. I saw an OB every 3 weeks, then every 2 weeks & then once a week. I also had lots of scans to make sure everything was well.

Hope that helps.

Belinda

P.S. I really think it depends on the hospital & the facilities they have. Both hospitals I was at had single rooms (& a couple of shared rooms). I know some big hospitals don't offer that.

Another public fan here.

I went to RHW in Sydney. Because my pregnancy was classed as High Risk (due to the combination of our previous loss and this being twins), I saw pretty much the same ob throughout (she was lovely).

I chose a hospital with a NICU because I could think of nothing worse than ending up in a different hospital to one or both of my babies.

I got a private room, because they try to give both twins and c-sections a private room, and I ended up fitting both criteria.

Not that I will be doing it again, but if I did, the very least I would do is go to a hospital with a NICU, even if that meant going to a public hospital as a private patient (only for my own room - don't think I would be good at sharing a room).

Jo2+2<BR>Rachel - born still 21/11/00 (23 weeks)<BR>Matthew & Erin 7/11/01<P><BR>

We have top Medical insurance but didnt need it here as there is only one hospital in Kalgoorlie. I was seeing the private ob but left to see the Ob/Gyno based at the hospital covered under the Medicare system. I got a private room as all multiple Mums do here in Kalgoorlie and the only difference in the hospital care using health insurance was the salt and pepper shakers LOL...I didnt need them either.
Our nearest NICU is an hour flight to Perth so If I had of needed that it too was covered under the Medicare system
Hope that helps - The service, quality of Dr's, Nurses, Lactation consultants, Midwives, anethesists was great I was thrilled with my stay

Haylie ~ Proud Mum of Hayden & Brooklen 21.3.05

I went completely public had the same OB who I was able to ring at home if I was having probs which I had to.
She was w/ me through the entire preganacy but was also a private OB as well. When my girls were born at 29wks another woman also had twin girls a few dys older then mine she had the same OB privately. our kids were in SCN/NICU together w/ the same neonatologist and they paid thousands. Our kids were side by side w/ hers were having all the same tests etc. Both of us were in hsopital in private rms for a few wks as we were both unwell. Absolutely no difference in any of it so for me it would always be public all the way. the care the staff were excellent. followup care was also really good.

Hi,

Another public fan here. I went through the antenatal clinic at Calvary Public in Canberra. The midwives were great and I saw an Ob when I needed to. At the birth there were three midwives, two Obs, a paediatrician and a trainee Dr observing the whole thing! So I didn't feel as though I suffered from lack of attention being a public patient! I had a private room and stayed for 6 nights then I was able to have the midwife home visit service for another week.

Beth

Sophie and Daisy 9/4/03

Hi i went private through Calvary private in Canberra. The main reason i went there is because i was in the RAAF so it was all covered - apart from a $2500 accommodation charge for twin 2 - but that is another vent so i will not go there!! All in all though the hospital was fabulous, i saw my Ob every 2 weeks and stayed for 7 days when i asked to go home, they were happy for me to stay longer.

Good luck - it is a tough decision.

Rach :-)