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Really tough, urgent decision - OB or CATCH

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#1 gemgirl

Posted 08 December 2012 - 03:55 PM

I'm almost 25 weeks pregnant and on Friday, got a call from the CATCH (midwife) program at Canberra Hospital saying a spot was now available for me. Initially I'd got a spot at the birth centre, but they kicked me out when they discovered my high blood pressure. Because I wanted continuity of care, I decided to book in with an OB and go private (John James) after being kicked out. I didn't expect CATCH would offer me a spot so late in the game.

I've only met my OB once, though have another appointment this week and then monthly appointments  leading to fortnightly etc. A few reasons I opted for private:

* I have PHI
* I have high blood pressure and could require a csection
* I am overweight and 'over age' (ie. late 30s)
* It's an IVF baby and my FS strongly recommended I go private, even though he doesn't deliver anymore.

So I went private and haven't second guessed it. Part of me doesn't love that I have to spend money on giving birth, but I like the idea of the care the OB will give me etc.

So when CATCH rung me, I nearly said 'no', but instead  asked for the weekend to think it over. CATCH will offer continuity of care, just like the OB, but with a midwife. They can do csections/ epidurals (all the stuff the birth centre won't do, which was why I was kicked out). And the bonus? No cost, as it's all public.

Any perspectives on this?

Edited by gemgirl, 08 December 2012 - 04:10 PM.

#2 His Boy Elroy

Posted 08 December 2012 - 03:59 PM

And the bonus? No cost, as it's all private.

I'd be VERY surprised, shocked even, if this was the case......

I'd go private in any event......

#3 MrsShine

Posted 08 December 2012 - 04:04 PM

You're generally right about midwife program's being no cost - but in my experience, all the ones in Sydney I know of are run out of birth centres and heavily discourage epidurals and pain relief of any type.

I don't know any midwife program's that do do c-sections?

I could be wrong, but if its a high risk pregnancy personally I would stick with an OB, yes yours costs will be more but midwives will generally be more touchy feely and if it gets too tricky you'll be handled by the OB on duty at the time in the public hospital - which isn't really continuity of care.

If it was a straight forward birth without the IVF, late age & high blood pressure I'd say go for it but its your choice.

P.S I'm surprised you haven't had to pay the full pg management fee to your OB yet, I though it was usually due at 20 weeks.

#4 Harmonica

Posted 08 December 2012 - 04:06 PM

I'd go CATCH - I really liked having midwifery care with only an OB for key appointments.

#5 ~Sorceress~

Posted 08 December 2012 - 04:08 PM

If you originally intended to use the birth centre, I'm thinking a natural birth is your first preference? If so, your odds of having a natural delivery are higher in the public system.

Private obstetrician's fees are only worth it if you have a better chance of the outcome you want IMO original.gif. I really wanted a homebirth with our last two births but ended up feeling that the $5000 would be better spent on their education further down the track so used the birthcentre original.gif .

I don't know much about the CATCH program, but having a midwife through the birth centre was really great original.gif .

#6 gemgirl

Posted 08 December 2012 - 04:08 PM

QUOTE (MrsShine @ 08/12/2012, 05:04 PM) <{POST_SNAPBACK}>
You're generally right about midwife program's being no cost - but in my experience, all the ones in Sydney I know of are run out of birth centres and heavily discourage epidurals and pain relief of any type.

I don't know any midwife program's that do do c-sections?

P.S I'm surprised you haven't had to pay the full pg management fee to your OB yet, I though it was usually due at 20 weeks.

In Canberra, there are 2 midwife programs through the public hospital. The Birth Centre (no epidurals etc) and CATCH. CATCH is the same model, with one midwife looking after you, but has pain relief etc. Then there's just normal birthing in the public hospital, which means you get whoever is no duty.

I didn't meet with the OB til after 20 weeks for the first time (as I saw my fertility specialist up to that point, then he handed me over). But apparently the management fee is due at 32 weeks?

#7 gemgirl

Posted 08 December 2012 - 04:10 PM

QUOTE (His Boy Elroy @ 08/12/2012, 04:59 PM) <{POST_SNAPBACK}>
I'd be VERY surprised, shocked even, if this was the case......

I'd go private in any event......

Apologies - should read no cost as it's all public

#8 fooiesmum

Posted 08 December 2012 - 04:13 PM

Hi - I'm a high BMI mum, I'm not aware of the CATCH program in Canberra, but before dropping the OB/PHI option, I'd triple check that you are able to participate in the CATCH program.

AC, high BMI, high BP are all things that are classified as "high risk" which will often preclude you from a midwife led continuity of care program.

If they will accept you with the above mentioned conditions and you where initially looking to do midwife led care then I'd give it a go.  Good luck - HTH

#9 Oh My......

Posted 08 December 2012 - 04:15 PM

I am with the CATCH program and have a high risk twin pregnancy. My midwife is lovely and answer any question I have even if I don't have an appointment. I just txt her and she will call me back. Plus I see the OB every week and she comes to them as well.

If you want to know more happy to answer.

#10 gemgirl

Posted 08 December 2012 - 04:21 PM

Yes. On the phone, she said CATCH do "high risk" pregnancies. The birth centre doesn't.

#11 Cath42

Posted 08 December 2012 - 04:23 PM

I've had four high risk pregnancies and four caesarians. What it would come down to for me is continuity of care. From what I can gather, there's a difference between the CatCH program and the Canberra Midwifery Program (CMP). Both programs work with women to create an environment that fosters the natural process of childbirth, and one that is responsive to the needs of women and their babies. But the CMP is only available to low risk women who plan to birth in the Birth Centre, while the CatCH Program provides continuity of care for other women including those who may have an obstetric/medical complication. CatCH women birth in the Delivery Suite at Canberra Hopital, and their care by a ‘known’ midwife will includes antenatal visits, labour and birth care and postnatal care both in hospital and at home. If antenatal referral to an obstetrician is required, appointments will be scheduled with your obstetrician and midwife at the hospital antenatal clinic.

CatCH midwives will support women for 7 – 14 days after they are transferred home postnatally. After this period women are discharged from the care of CatCH midwives and referred to the ACT community Maternal and Child Health (MACH) Nurses for ongoing support.

Continuity of care from an obstetrician involves antenatal appointments, sometimes attendance at the birth (if there are complications, yes, otherwise it's left to the hospital midwives), daily 5-minute visits to your hospital room until you're discharged home, and then a 6-week check-up.

If I'd had the choice of a programme like CatCH, I'd have jumped at it. It's the best of both worlds: good antenatal care that involves bringing in obstetricians if necessary, and really good postnatal care that involves helping you to settle in at home and bringing in lactation consultants if necessary. And if you do have antenatal complications or complications during the birth, a large public hospital is the best place to be.

#12 Phascogale

Posted 08 December 2012 - 04:29 PM

I would not hesitate to use the CATCH program.

#13 Tenacious C

Posted 08 December 2012 - 04:30 PM

I have gone through the Birth Centre for both pregnancies so have no experience with the CATCH program. But I know I couple of people who have gone through the CATCH program, including a high risk pregnancy and they were really happy with it. If necessary I believe the midwife will also attend appointments you have at the FMU if necessary.

Just keep in mind, even though the new Women and Childrens Hospital has opened the maternity suite (except the birth centre) are in a temporary location until the other building is finished, meaning less beds and shorter stays after birth. If you wanted a longer stay in hospital after the birth you may need to go private. You are due around the same time I am and I don't think the other building will be finished in time.

#14 tenar

Posted 08 December 2012 - 04:32 PM

I don't know about the CATCH program specifically, but I've had two births: one with a private OB, the other with the COSMOS program at the RWH, Melbourne, which is a midwife-continuity of care.  

The first ended with an emergency C/S, the second was an induced VBAC.  The second birth was an incredibly better experience than the first.  I'd personally go with the midwives again any time given the choice.

#15 ThatsNotMyName

Posted 08 December 2012 - 04:33 PM

I've had two private deliveries (one c/s & one VBAC) in two different hospitals & I'd be going with CATCH if  was to go again.

#16 SplashingRainbows

Posted 08 December 2012 - 04:43 PM

I went private for my son - an loved it. Only thing I would change - would be to have had midwife care also - exactly like the CAtCH program you're considering.

I think if it were me I would go with the catch program.

Good luck with your decision.

#17 gadfly271

Posted 08 December 2012 - 04:55 PM

I have a friend who went through CatCH and found it a really positive experience.

If I was in your position I would confirm with my OB that I didn't have to pay the fees if you changed carer now. The fees might be due to be paid at 32 weeks, but they might have already been incurred because you're after 20 weeks, IYKWIM? It would be annoying to move to CatCH and then find out you still have to pay your OB.

#18 bright*future

Posted 09 December 2012 - 07:37 AM

I would say CATCH. I have a friend using that program at the moment and it sounds fantastic.  

I am with the birth centre and cannot fault the program or care, and I know they wouldn't hesitate to send me off to see one of the OBs if there was a sniff of a problem.

Having said that, I am giving birth public and having public management, but I still see an OB for checkups, just for extra peace of mind. You would have to talk to your OB to see if they would be happy to do that, but if so, that could be an option?  It means a lot of appointments and extra money, but it is perfect for me and my anxiety level!!

#19 Readee

Posted 12 December 2012 - 07:25 AM

You may have already made your decision, but in case you haven't - I would really recommend the Catch program. I went through Catch (I also had high BP) and I thought they were just wonderful!

I had pethidine and an epidural, got in the bath, used the gas etc. so there definitely aren't any problems with accessing pain relief. The other fantastic thing about Catch is your midwife can visit you at home everyday for up to two weeks after the birth. I had some trouble getting breastfeeding going and this help was just so valuable. You'll also have a phone number for your midwife so you can call her pretty much whenever you have a problem / need advice.

#20 Bluenomi

Posted 12 December 2012 - 09:15 AM

I'd stick with your OB. I found having the one OB for my birth so much more useful than having the same midwife. I didn't want an oncall OB overriding any decisions I'd made so having mine meant he knew my plans.

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