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Obstetricians charge so much!
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#1 RachaelMiller

Posted 10 April 2013 - 06:11 PM

Hello,

My name is Rachael, I'm currently 13 weeks pregnant with my first original.gif I recently have been looking into my options and trying to decide between going private or public. As Black town Hospital is the closest to me this is probably where I will end up. However, as a lower/middle class earner with basic health care cover I'm finding it hard to comprehend the double standard in care... At Black town I have been told that my husband is not allowed in with me for my first appointment with the midwives sad.gif (we are very close) there are no facilities provided for him if he chooses to stay with me through the entire labour.. birth (which he will) and when I went into the clinic I honestly felt like a piece of meat.. midwives are so bossy!! they were so busy and no time was given to me to explain anything.. I got told that "I should know all this" how? this is my first! I would really really like to go private.. I would feel more comfortable knowing that I'm my husband and I are going to be treated kindly and that I will have time given to me to explain the steps as we go along. but if I choose to go private the price is soo much! a few thousand dollars to me is my rent for a few months! as the sole income earner to a husband with a disability.. I think the system is incredibly unfair. I get obstetricians work hard but I just feel that there is no consideration given to the little people. truthfully I can probably afford maybe around $1500 if I could pay it off and my basic health insurance will cover the hospital with an excess but I cant find any obstetrician who will charge a smaller amount.. does anyone have any comments or advice? I would greatly appreciate it original.gif Sorry if this seemed a little negative..

#2 lucky 2

Posted 10 April 2013 - 06:44 PM

Hi there, Partners are not excluded from pregnancy visits in the public health system.
You might need to clarify this as this is not normal, I doubt this would fit within the values of the hospital and it certainly isn't best practice or evidence based.
There isn't a bed for a partner in a birth suite unless you are in a family birth type environment where you birth on a double bed. Perhaps they have this at the hospital?
My partner slept on a recliner when he could whilst I was in labour.

You could be proactive in your care by ringing up the Hospitals Clinical Governance unit (otherwise known as patient complaints dept) to talk about your experience/impressions and perhaps they can help you.
I do presume that as a provider of health care they would not want their patients feeling uncomfortable.
You can use the online complaint form or call to have a talk about your concerns, I suspect they will be very supportive.
http://www.wslhd.health.nsw.gov.au/Contact-Us
All the best.

#3 Soontobegran

Posted 10 April 2013 - 06:55 PM

As per lucky2.

I think you've been misinformed or you may have misunderstood because partners are not banned from any appointments with either midwives or obstetricians.
If you are talking about having your partner stay overnight after the birth of the baby this is ususally not an option in shared accommodation.

Hope you can clarify this....you do not have to go private to get excellent care.
Good luck.

#4 Box of Frogs

Posted 10 April 2013 - 06:56 PM

Hi OP, congrats on your pregnancy - just wanted to say that your DH is probably excluded from the first visit so they can assess you to see if you are at risk for domestic violence. I know that during my pregnancies, my DH was asked to leave the room and then they asked me. Chances are, they have had issues with this (dads getting aggressive etc) and decided that it was easier and less traumatic for Mum to come in on her own. He isn't excluded from any subsequent visit.

OB insurance costs are roughly equal to the average Australian salary - about $60k. That is why they are so expensive.

#5 Soontobegran

Posted 10 April 2013 - 07:30 PM

QUOTE (FrogInASock @ 10/04/2013, 06:56 PM) <{POST_SNAPBACK}>
Hi OP, congrats on your pregnancy - just wanted to say that your DH is probably excluded from the first visit so they can assess you to see if you are at risk for domestic violence. I know that during my pregnancies, my DH was asked to leave the room and then they asked me.

Have never ever done this? Can I ask where this was?

#6 Steggles

Posted 10 April 2013 - 07:34 PM

Yes the DV questions are also standard in QLD original.gif

#7 #YKG

Posted 10 April 2013 - 07:39 PM

QUOTE (FrogInASock @ 10/04/2013, 06:56 PM)
15459397[/url]']

OB insurance costs are roughly equal to the average Australian salary - about $60k. That is why they are so expensive.


Indemity insurance for a OB depending on state can be over $90k.
TBH the reason they charge so much isn't to do with Indemity costs it's what they have to do. Any birth comes with risk and cost, they are also on call 24/7. Their training coupled with what the actual job involves drives their cost, you are getting specialist care and it is expensive. OP you'll be hard pressed to find an OB that costs under $2k. But they are managing the pregnancy and more often then not OB's do rounds in public hospitals.



#8 Lucrezia Bauble

Posted 10 April 2013 - 07:44 PM

QUOTE (Steggles @ 10/04/2013, 08:34 PM) <{POST_SNAPBACK}>
Yes the DV questions are also standard in QLD original.gif

Wow...I can't recall this with my visit to my OB.....as it turned out DH wasn't with me...we went through my medical history and I mentioned a termination I had...the OB was very quick in with "does DH know about this" .....although I guess if had mentioned it in DH's presence the OB could have assumed all was ok!

Interesting with the DV..makes sense.


#9 Jobrielle

Posted 10 April 2013 - 07:48 PM

My partner was excluded from my first visit both pregnancies (different cities, different hospital) due to the domestic violence questions. It seems pretty standard? He wasn't excluded from any other visits. I'm not sure what you mean by 'facilities' for your dh. Do you mean they should provide him with a bed? Public hospitals just do not have the room.

#10 Nobody Cool

Posted 10 April 2013 - 07:49 PM

I went to Nepean Public and I was asked questions relating to DV in my first appointment interview. The midwife said it was standard line of questioning they asked all new patients.

#11 Jamelex

Posted 10 April 2013 - 07:52 PM

I went through Blacktown in 2011 and yes, they ask that you come alone to the booking in appointment so they can do domestic violence screening.
However, my DH was not excluded from any other appointment or checkup and stayed with me for the whole labour and birth. He went home around 11pm that night (I wasn't transferred to the postnatal ward until about 1am) and was able to stay from early morning until late evening on the postnatal ward.

Good luck with whatever you choose.

#12 Fourteenyears

Posted 10 April 2013 - 07:56 PM

QUOTE
just wanted to say that your DH is probably excluded from the first visit so they can assess you to see if you are at risk for domestic violence. I know that during my pregnancies, my DH was asked to leave the room and then they asked me.


Yup.  I went private but when I presented at the hospital during a threatened miscarriage, they asked him to leave the room and asked the questions about DV, previous pregnancies etc.  Some women have stuff in their case histories that won't be disclosed if their husband is around so at some hospitals it's the norm to create an environment where those things can be discussed if necessary in the first visit.  After that it's business as usual with partners welcome.

QUOTE
there are no facilities provided for him if he chooses to stay with me through the entire labour.. birth (which he will)


As your budget is limited, you'd probably be better off not seeking private care.  If your pregnancy has complications, the cost can blow out to almost ten thousand dollars.  Ask me how I know!  But something you could do is see if your hospital will admit you as a private patient after the birth.  I know that in some NSW hospitals you can have public antenatal care but use your PHI to pay for a private room (if one is available) after the birth.  

That would allow your husband to stay overnight - they can't in shared rooms for obvious reasons - and would probably fit your budget.

N.B.  Going private isn't just the OB's costs.  It's also the cost of however many ultrasounds you need, pathology costs, additional specialists like a dietitian and endocrinologist if you end up with gestational diabetes, an anaethasist if you need a C/S, and so on.

Edited by Eight.years, 10 April 2013 - 07:59 PM.


#13 glasnost

Posted 10 April 2013 - 07:59 PM

I had DS2 public in NSW.DH wasn't with me when they did the DV screening (I think it was at the booking appointment at 14 weeks) but I think it would be appropriate that your partner is asked to leave the room while they run through the questions.  There would be no point asking "do you feel afraid of your partner" if said partner was sitting right next to you.

The questions are pretty intense. I actually became quite emotional when I realised that they were asking me because DV is so common for pregnant women.

#14 busy_bee

Posted 10 April 2013 - 08:00 PM

Just to add - the obstetrician also has to pay for their rooms, facilities and the wages of their staff. They don't pocket every cent personally.

#15 Love_Evie

Posted 10 April 2013 - 08:04 PM

I had my first child in public and am also going public for our second.
I would say it would definately be for the DV and also there might be other things that they want to discuss that lots of women would prefer discussing without partners so to be on the safe side they prefer to talk to the mother alone first. I wouldn't take offence to this, there is a reason why original.gif
If you didn't like the general feel of the hospital is another public one an option? The hospitals that follow the Baby Friendly health iniative are a good place to start and possibly a reason for a little extra travel. Keep in mind that although the admin system in public hospitals are less than average that doesn't mean that you will not be well looked after during birth.
Regarding your husband during labour we had great birth suites with a couch and table and partners could stay in the birth suite as long as it was available to you. Problem in my case was giving birth finally at 11.38pm they said my partner could stay with me but I might be moved to the ward at anytime so it made sense for him to go home and sleep. I have also had family and friends in private and when moved to the wards(from tiny birth suites) they only got a single bed so partners staying were out for them too.
Good luck



#16 lynneyours

Posted 10 April 2013 - 08:05 PM

DH was made to wait outside at the first appointment of both my pregnancies (same hospital) whilst the midwifes asked about:
* domestic violence
* if DH was happy or angry about the pregnancy
* if I took any drugs (and did DH know if so)
* if I had had any other children or abortions that DH didn't know about

I saw it as protective behaviours for the women.  

Both of mine were born in London.

Go public OP.  Save the money to pay bills/rent/baby stuff.  Look into midwife-led birthing centres if you'd prefer something a little bit less clinical.

#17 lucky 2

Posted 10 April 2013 - 08:11 PM

QUOTE
Hi OP, congrats on your pregnancy - just wanted to say that your DH is probably excluded from the first visit so they can assess you to see if you are at risk for domestic violence. I know that during my pregnancies, my DH was asked to leave the room and then they asked me.

Thanks for pointing that out, it didn't cross my mind but it makes sense considering the how prevalent it is within the community.
Now I remember extra training was undertaken by MW's about 10+ yrs ago in how to discuss these issues with pregnant women.

eta, just curious, what does this mean? unsure.gif
QUOTE
Keep in mind that although the admin system in public hospitals are less than average


#18 ElysianLyric

Posted 10 April 2013 - 08:12 PM

I've had 2 babies at Blacktown Hospital, one just at the end of last year. As per PPs, they request that you don't bring partners or older children to your initial booking in appointment.  However after that, partners are more than welcome at appointments and of course during labour/birth.

My experience at Blacktown both times has been extremely positive and I would unhesitatingly go back there for any future births. It is a very busy hospital certainly - antenatal clinics and the postnatal ward are always packed. However the care I've experienced has been wonderful, with lovely midwives particularly. My second pregnancy was especially good as I was in the Midwifery Group Practice, meaning I was assigned my own midwife who visited me in my home for all my prenatal appointments and did 2 weeks of follow up postnatal care as well. If you do end up going to Blacktown, it might be worth enquiring about this program at your booking in appointment?

#19 Expelliarmus

Posted 10 April 2013 - 08:54 PM

I was never asked about DV ....

#20 Soontobegran

Posted 10 April 2013 - 09:00 PM

QUOTE (Steggles @ 10/04/2013, 07:34 PM) <{POST_SNAPBACK}>
Yes the DV questions are also standard in QLD original.gif


It makes sense but it must be hospital specific perhaps. Just did a whip around of DD's and none were asked.
TBH I don't know just how much it would achieve. I am fairly certain there'd be a large number of women who would not disclose this if their partner was waiting outside the door. sad.gif

#21 Alacritous~Andy

Posted 10 April 2013 - 09:04 PM

As well as Qs about DV, I also imagine you would get a more reliable/complete history re: previous pregnancies, terminations, sexual history/STIs, depression/mental health, etc without a partner present.  

I can see why they would request a visit alone.

#22 wannabe30

Posted 10 April 2013 - 09:06 PM

QUOTE (howdo @ 10/04/2013, 08:54 PM) <{POST_SNAPBACK}>
I was never asked about DV ....

Nor me.  I was a private patient, though.

I wonder if there's an assumption that if you show up for your extremely expensive appointment with hubby in a suit, etc, that you're not an "at risk" category.  Sounds like a massively big assumption to me!

#23 SplashingRainbows

Posted 10 April 2013 - 09:09 PM

I think it's fairly standard for NSW STBG. Everyone I know had the DV screen - a number of different hospitals.

I was also screened at my first visit from the MCHN.

Aren't health policies and health administration largely state based?

Makes sense that NSW and QLD have a different policy to VIC.


#24 Musk Sticks

Posted 10 April 2013 - 09:10 PM

I don't have personal experience with maternity at Blacktown (I am a Blacktown girl myself but now live in Melbourne).

However, I had my DS in a public hospital and found that the care was great. I had a very positive experience and would definitely go back when we have number 2.

They had a small waiting room with a recliner where DH rested while I was in labour. The midwives were all amazing and very accommodating to our needs.

Also, I was not asked questions about DV, but I have heard of partners being asked to leave so that sensitive questions can be asked.

#25 AliC05

Posted 10 April 2013 - 09:11 PM

Im currently a student in obstetrics and the DV questions are standard.

From what I was told by the midwives in booking in you are only allowed to have 2 people in the room when asking the DV questions. When I am sitting in on appointments sometimes the midwife leaves and I ask the questions or I leave and the midwife asks the questions.

The reason they ask partners not to come is it is awkward to ask someone to leave the room. Some women do still bring their partners - but we are required to ask them to leave.

There are a few other questions in regards to support that they routinely ask without the partner.  

Bear in mind that women rarely get asked about DV so directly. It may be the first time they are ever asked. It can be very effective.

In regards to going private - I think if you are going to be stretched you are better off going public. On top of the obstetricians fee, there is also the cost of the check ups, and any costs if you need a caesarean section (like the cost of an anaesthetist).






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