Obstetricians charge so much!
, Apr 10 2013 06:11 PM
64 replies to this topic
Posted 11 April 2013 - 12:46 AM
Many women do bring their partners to every visit though and I honestly think the chances of a women answering anything about DV whilst their partner is waiting outside the door is remote.
DH wasn't outside the door with mine. I was called, then gave medical history, was it planned, happy/unhappy all that, how far along we thought we were, all the "what happens now info". Then the MW walked us both back to the waiting room. We sat down and then she said "you come with me, DH can just wait here - we just need to do BP/urine etc - we'll be back in 5min". We went quite a way from where he was. There was no overhearing.
So I'd assume they'd make sure the DH wasn't right outside the door.
Our toilets were also strictly patient only. When you went in, to do the urine sample - there were sticker dots in each cubicle. if you were experiencing domestic violence or were frightened of your partner, you just stuck a dot on your urine sample, and handed it over without a word.
It was a good system I thought. Sadly, I was told by the MW that a lot of domestic violence starts when the woman becomes pregnant.
Posted 11 April 2013 - 02:46 AM
Here's a link to info on the statewide DV screening program in NSW for those interested in finding out more about it. All NSW health workers in the public system should be aware of it & implement procedures in their workplace if required. Private obstetricians are not required to follow this policy. http://www.health.nsw.gov.au/publications/...e_Screening.pdf
DH was not excluded from an appointments but was asked to wait in the waiting room for a part of one appointment so that personal questions could be asked. These included screening questions related to DV, past abuse, sexual partners etc. It's best practice not to ask these questions with anyone else present as people can answer more honestly. As a PP said, it may be the first time a person has been asked these questions directly and they may disclose things they have previouslu never told anyone about.
OP - I had a baby 2 weeks ago in the public system, in another area if Sydney. I went through a birth centre & was very happy with the standard of care provided for the birth. I have PHI but not obstetrics cover so if I'd gone private it would have been very expensive. I had always planned to go public though. Also at our local hospital you are able to use regular PHI to have a single room on the postnatal ward. There were no gaps to pay, the hospital covered it as they benefit from patients using PHI. The single room meant DH could sleep in the room on the fold out bed. It was the perfect arrangement for us.
Hope you work out a good match for you in your area. Good luck!
EFS - Yes, I accidentally wrote pubic system instead of public! Well, there definitely was a pubis involved!!Be kind to me, it's 2:49am & my baby has finally gone to sleep and I'm typing this on an iPhone!
Edited by WhimsicalDragonfly, 11 April 2013 - 02:50 AM.
Posted 11 April 2013 - 05:02 AM
Interesting that the presumption seems to be that if you are private then you are not at risk......how wrong is that.
I went private in QLD and was asked a range of questions regarding DV, drugs, finances, mental health, family support by the midwife at my booking in appointment for the hospital. This is done by phone and it requests that you organise somewhere private to be when they phone you. I agree that it should be standard across both systems.
Posted 11 April 2013 - 05:13 AM
I've gone public for both pgs and do remember being asked about safety at home, and support as well. It was kind of a pre emptive strike for PND as well as looking for signs of DV. I know DH was with me for my first ever appt, but I can't remember him being asked to leave the room at any point, but it was a couple of years ago. I attended this first appt without him so no issues there.
I'd be surprised if there was facilities for DH to stay in birth suite, as in a bed etc etc, rather a few chairs and maybe a couch. Certainly the birth suite i was in wasn't set up for him to get comfy!
Partners weren't allowed to stay over night either, altho they did offer as I was in a single room post section, and sans baby as he was in SCN.
Posted 11 April 2013 - 08:50 AM
Many women do bring their partners to every visit though and I honestly think the chances of a women answering anything about DV whilst their partner is waiting outside the door is remote. I'd support the mother being given a phone number which would allow her to call at a time that was comfortable to her to reveal any personal issues rather than being expected to do so on request.
It seems that as it is only policy at some places and only asked at the discretion of the obstetrician it can't be mandatory?
I am aware of MCHN's asking this question though.
I agree with you. When I told my mother about it, who was in a dv for many years, she said there was no way she would have told them. I mentioned it to a social worker friend and he said it works on the theory that there may need to be multiple opportunities to tell before the telling takes place. It's about planting a seed in minds.
It was a public hospital booking in appointment, the midwife told me it was a nsw health standard question. They also ask how you feel about mess because apparently that be a precursor for pnd.
Posted 11 April 2013 - 08:59 AM
OP congrats on your pregnancy. I'd just like to echo the cost of going private isnt just the ob its the other out of pockets as well including scans, pathology, and if you have a c-section its the out of pockets for the assisting ob, paed and anethitist. All up for this and my last pregnacy I am about $6000 - $7000 out of pocket
Posted 08 May 2013 - 02:39 PM
OP, congrats on your pregnancy. I would add to the chorus here - definitely go public not private for all the reasons stated above.
It sounds like you had a horrid first encounter with the midwives clinic there. Bear in mind that the hospital clinics can be a little hit-and-miss although they are generally perfectly fine. For my first pregnancy, I basically saw a different midwife each time - some were wonderful, some I was uncomfortable with.
This time around, I found a fantastic one early on and booked all my appointments with her and that has worked really well. I would try that - if you find a good midwife, book as many appts in advance as possible with them (explain how uncomfortable the other midwife made you feel). If you don't 'click' then book your next appointment on a different day/time and try someone else.
Some more advice - my husband also has a disability and this changed a couple of things for us. Firstly, the midwifes are always hypervigilant about whether I was/am going to get peri-or-post-natal depression. (Stereotypes! You have to laugh or else you'd cry.)
Also we had our first at RPA. I know a lot of people have recommended Birth Centres as somewhere your husband would definitely be able to stay over with you. My husband and I were booked into RPA Birth Centre but eventually went with the labour ward as we both thought that the physical requirements on him as the support person in the birth centre may be too taxing. Don't know whether that is relevant to your situation. (In the end it was moot as I had meconium in the fluids and had to be induced, etc etc, ended up quite a medical-intervention type of birth). Also, the Birth Centres are generally only for 1 night if at all, then you get shuttled over to the antenatal ward with everyone else.
We had PHI that we didn't use, so I did book into RPA as a 'private patient in a public hospital'. This gave us a better chance of getting a private room so DH could stay overnight and was no out-of-pocket expense for us. As it turned out, the labour ward was PACKED and extremely busy - I got a shared room. Oh well. It was hard for DH to say goodbye at night and go home, but we were both sooooo exhausted that actually I was happy for him to get a good nights sleep in our bed at home, not on a dodgy foldout. So it worked out OK.
Hope this helps! PM me if you have any other questions.
Posted 10 May 2013 - 08:20 AM
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!
Yeah that's interesting, never was asked this questions too.. probably just an assumption by private OB that if your partner can take time off and share the cost less likely you are a DV victim...
with the extra cost going private will really stretch your money, OB fees etc and you need to make sure the OB and anesthesiologist have no gap fee...
on saying that I love going to my OB, she takes time to have a chat and absolutely great, I contacted her once around 2am because of a bad pain and she respond to my voice mail after few minutes, that's when I thought it's worth paying...
Good luck on your pregnancy!
Posted 10 May 2013 - 08:28 AM
Hi just wanted to add that my partner was excluded from the first visit at Liverpool hospital.
They asked me about DV, if I was at risk of depression etc.
Posted 10 May 2013 - 08:35 AM
The first pregnancy appointment takes a long time and is mostly about your history with a lot of personal questions about your relationship with your partner. Your partner won't miss much because the appointment isn't really about the pregnancy.
If you want your partner to sleep in the maternity ward with you overnight after the baby is born, then Private Hospital is the way to go. My DH stayed with me for most of the five nights after our first child was born because we had our own room at the Private Hospital.
I had my second child at the public hospital at Liverpool and I didn't bother having DH at any of my appointments and I only stayed for one night after DS2 was born so DH didn't stay over. DH was able to be with me for the entire labour though. I wasn't very happy about the whole situation at Liverpool. I much preferred the Public Hospital because the level of care was better and people seemed to know what they were doing during the labour. I had a trainee nurse looking after me at Liverpool and she kept telling me that it wasn't time to have the baby for another couple of hours when I was very ready and needed to push. Caused me a lot of pain.
I agree that the midwives are a bit pushy during appointments, because they have so many people to get through. There was always a least a two hour wait every time I had to go to an appointment at the hospital during my pregnancy.
Posted 13 May 2013 - 12:43 PM
I found ob fees vary considerably. I have been told more does not mean better! I suggest you phone around as I did. You should be able to get good care with ob out of pocket less than $2000
Posted 13 May 2013 - 12:54 PM
I had 2 in private and 1 public. My worst birth was my first private.
The public system is not that bad. DH was with me for all my births. He didn't need anything supplied for him. He held the shower rose for me, talked to me, etc. I was in labour all night for 2 of them and he didn't sleep in that time.
I didn't have DH at most of my appointments due to work. He was more welcomed by the midwives than the OB I had though.
My best birth was by a GP who specialised in obstetrics. He was happy for midwives to do everything and only step in if needed.
Babies are expensive. Don't put yourself in financial difficulties for a private birth. It's not worth it. Btw it cost us $1000 more than budgeted for #1 due to medical issues that we couldn't control. Same service, same professional in public would have been free.
Posted 13 May 2013 - 01:05 PM
Keep in mind that if you go private, but dont have private cover and are paying it out of your own pocket, and your baby requires special care nursery, it can cost $900+ PER DAY. Op ur best off going public.
Posted 13 May 2013 - 01:10 PM
If you are at all concerned about costs then go public.
At the first appointment they do ask about domestic violence, previous pregnancies and lots of personal things that a) they don't want your partner to be present for or b) things you may not feel comfortable answering in front of him.
The midwife may have been a bit harsh with you but I wouldn't expect them (or any other medical professional) to answer a list of questions that I could easily google. You do need to be proactive about educating yourself about pregnancy and birth.
When I went public they made it clear that your partner can't stay overnight (in private my DH could), the midwife said it so many times I asked if it was an issue and she said that it was.
There was very little difference between my private experience and my public one so I would happily go public again.
Posted 13 May 2013 - 01:57 PM
Last week I had my first appointment with the midwife at the public hospital I am booked in to for my labour. It was long and strait forward with medical history stuff. When they told my husband they had to ask me some questions privately (relating to DV) I told him he could just head back to work rather than waiting around - it was seriously not a "you need to be here for this" experience for me. That said he would never miss a scan or if I had an appointment I was nervous about.
I did a hospital tour prior to choosing to go public or private. Both hospitals DH can sleep on the recliner in the room with me after the birth but I didn't bother asking about sleeping through the labour as he will be there to support me, not to sleep. I was told that you only go in to the hospital once you had gone through most of the prelabour (though I'm sure that is only when there have been no complications) so no sleeping will be happening. I could be wrong though.
I also know of others who have booked into a public hospital outside their area because they wanted to avoid their local hospital. Is this something you could look in to? That way you could end up somewhere you are comfortable without having to spend a fortune on private fees, you may just have to travel a little further. Mmy friend was meant to go to Blacktown and went to Hornsby instead.
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