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Public vs private hospital debate
Just some interesting stats on public vs private


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113 replies to this topic

#101 lucky 2

Posted 09 July 2013 - 07:16 PM

I agree tigerdog.
It would depend on the model of care I'd say, ie MW care generally leads to less interventions/C/S's.

If you are booked into the birth facility that didn't have access to epidurals (ie no Anaesthetic cover) then you'd know what you were in for.
Otherwise you have those options available (narcotics, gas, epi).
I had my epidural in the public system, not exactly when I asked for it but it was delayed for sound, evidence based medical reasons rather than because of any so called agenda.


#102 savannah_8

Posted 09 July 2013 - 09:21 PM

Sunshine hospitals in victorias caseload care has home visits, I had one at 1 days, 3 days and 5 days post birth and a few more after that to help with breast-feeding and how we are coping. Again this is caseload are that needs to be requested through the public system and I found it fantastic

QUOTE (lucky 2 @ 09/07/2013, 11:29 AM) <{POST_SNAPBACK}>
.
Really curious stbg, where is this happening?
It's awesome but I didn't know it existed in Melb Metro Hosps, unfortunately, ime everything seems to be cut, cut, cut.





#103 epl0822

Posted 09 July 2013 - 09:32 PM

QUOTE (soontobegran @ 09/07/2013, 12:27 PM) <{POST_SNAPBACK}>
shrug.gif I am not so sure about this.
I do not think that the decision to be a private patient is made because a woman wants intervention.

She invariably wants choice of doctor, choice of private room and choice of staying longer than 24 hours.

I think it needs to be said that private obstetricians don't all give away interventions on request.

Depends on what you define as "intervention." If you mean elective c-sections, I'm sure not all OBs will jump on giving one whenever requested. Personally I want to have a choice in when to get an epidural; I also had some assistance with vaginal delivery and heard horror stories of women in the public system who were forced to go intervention free because it was supposedly good for them.

#104 TeaTimeTreat

Posted 09 July 2013 - 09:41 PM

My closest private hospital has caesarian rates of 55%, I am surprised it is not higher as everyone around here goes there and I only know of two women who have not had a c-section there, the most common reason seems to be failure to progress after being flat on their backs for 6 hours with the CTG strapped on and then with the subsequent babies vbac is discouraged. But it has lovely rooms and a luxury package! I would not be surprised if their rate rises to 60% soon.

And I am not convinced that is a good thing.

#105 PooksLikeChristmas

Posted 09 July 2013 - 10:13 PM

QUOTE (lucky 2 @ 09/07/2013, 06:50 PM) <{POST_SNAPBACK}>
This sounds familiar pooks, very Melbourne IME.
Except the bit about not having proper post natal observations.
In answer to your questions, the MCHN doesn't assess perineums/healing, you get that done at the GP 6 week check up.
Other than that it should (at least be offered or questions asked re comfort, discharge, colour) be the MW in the hosp and the Dom MW who does this.
You can also be advised on how to monitor healing and identify if there is a problem, there is often an emphasis on patient involvement with care, and you are out of the hospital so quick that I can see why this is important.
One dom visit, unfortunately too common for Melb, insufficient in some cases, perfect or even "too much" for some women.
MCHN should have enquired about feeding and offered assistance, that assistance may have been to discuss LC resources in your local area or hospital or practical assistance with bfing. I would depend on her workload, your needs and the MCHN's skills. Many MCHN's have gained the IBCLC qualification to improve their ability to provide bfing support. Also many local councils now run a Breastfeeding Clinic.
I've heard that the Hosp you went to has a good Bfing clinic, I hope that was true for you.


Yes, the only problem is that he was born on the Sunday afternoon, I was discharged on the Tuesday morning and saw the LC on the Friday morning. In that time I had confusing conflicting advice from brief interactions with numerous midwives in the hospital, including one who made me swear never to tell anyone that she told me with nipples like mine I should formula feed and relax, and then a Dom nurse who basically told me to feed formula until I saw the LC. I didn't, I expressed, and then used a bit of formula once the expressed stuff ran out- all using the bottle.

The LCs were lovely but ultimately unable to undo the damage that occurred in that time and no amount of their guidance was going to make the amount of expressing required to make it "work" in some way doable for me. I will always be grateful for the LC who gave me the support, advice (and the nipple shield!) so that I was able to have the brief breastfeeding relationship that I had with DS. But I will also never forget the look in her eyes when I told her what had happened in hospital and since. I am grateful for her resolve "ok, well we start from now!" but I know she was fighting a losing battle in that place... I know her guarded "well, no, that shouldn't have happened...", because I've worked in organizations where I've had to say similar things, where I've also felt like I was shoveling sh*t into the tide wink.gif

The MCHN referred me back to the hospital LCs whenever I said I really did want to BF. She was more concerned about DS's weightloss and listlessness than any ideological preference for BFing, and I think she recognised it was doomed long before I did. I originally was very offended by her lack of support but looking back, I understand she was being kind.

#106 lucky 2

Posted 09 July 2013 - 10:22 PM

Thanks for sharing that pooks.

I wish PN bfing advice was always consistent and optimal but I know it often isn't, I've heard similar stories to this time too many times to remember in both public and private hosps.

#107 PooksLikeChristmas

Posted 09 July 2013 - 10:30 PM

Yes it was really quite bizarre how inconsistent the advice was in hospital. I did complain to the hospital about it, and I was told that I was INTENTIONALLY given conflicting advice so that the baby would not become "used to" one method of feeding or another (I'm not sure how this explains midwives telling me that the other midwives were wrong). And that of course every midwife does things a wee bit differently, so what was the problem anyway. And that the hospital can't be held responsible for me formula feeding because they gave me information about the importance of breastfeeding and where to get support. And the woman who spoke to me had a formula fed son, and he is just fine.

Hand on the bible. Seriously.

#108 Claudemaude

Posted 10 July 2013 - 07:44 AM

I really resent the variation in what is available between public hospitals - whilst understanding what the historical reasons are. I also resent that in this area (Newcastle Nsw) if your a public patient it feels like your delivery options are polarized. Go thru the wonderful (by many many accounts) midwifery service and birth centre at Belmont - but you can't have drugs and if you have complications the transfer to JHH could take 20 - 30 mins in traffic. On the flip side birthing there has been described by one friend as 'having a baby with your Nanna'.
Or go to the John and take your chances with how busy the labour ward is, how chaotic the post delivery ward is etc etc
Is it too much to ask to have access to a caring service, with appopriate support - but with availability of operating theatres, SCN on site??

I'm another who had no concerns with the birth - a sudden PPH was dealt with swiftly but had awful, awful post birth care. I had lost 2 litres of blood but was sent straight to the ward. I had a cathader in with no instructions. My newborn started wheezing and did her enormous green poo (no concern in hindsight,but she was my first) and the buzzer was ignored. I walked out to the nursing station, pushing DD and prompted passed out.

#109 Taffyk

Posted 10 July 2013 - 09:48 AM

Oh Pooks, I know how you feel.  I had conflicting advice from the midwifes, the public hospital LC (who at least gave me nipple shields) and the 2 different MCHNs.

When I was referred for suspected PND, the doctor asked my husband what seemed to be a trigger.  His answer - she cries whenever anyone mentions breastfeeding.

I actually didn't mind the public hospital although I had to wait 4 hours for an epidural (after trying gas and pethidine).  30 hours of labour and failure to progress led to a CS.  I also then had epidural complications.

But it is the breastfeeding experience - or my failure to do so - that gets me thinking whether private would be a better option next time.

I live in Melbourne (east/south-east) so if anyone has recommendations for a hospital with great breast-feeding support please PM me.

#110 Soontobegran

Posted 10 July 2013 - 10:00 AM

QUOTE (epl0822 @ 09/07/2013, 09:32 PM) <{POST_SNAPBACK}>
Depends on what you define as "intervention." If you mean elective c-sections, I'm sure not all OBs will jump on giving one whenever requested. Personally I want to have a choice in when to get an epidural; I also had some assistance with vaginal delivery and heard horror stories of women in the public system who were forced to go intervention free because it was supposedly good for them.


Once again I need to point out that being in a private hospital does not guarantee the delivery of your choice, in fact I can not stress this enough.
Women deliver whilst waiting for epidurals in the private system too, women deliver without their obstetrician, women get crap post natal care and breast feeding support ....this I have very personal experience of for both myself and my daughters.

I have often lamented my decision to not deliver in the public hospital I worked in and also not trying to convince my kids that private didn't equate to quality.

By saying this I am not implying that the public system is better option everywhere but it is certainly no worse.
The level of care that one receives is hospital and area dependent whether it is metro or regional and this is the problem we need to address, not whether we should spend money and go private or not and go public.


The question of breastfeeding support is almost not applicable to a system which tosses it's women out within 24 hours of delivery. Most babies are not attached and sucking well, most women do not have their milk in, many babies are jaundiced and sleepy. The support is required at home afterwards.......having our discharge forms filled out saying you are breastfeeding does not mean you really are.

Edited by soontobegran, 10 July 2013 - 10:05 AM.


#111 WithSprinkles

Posted 10 July 2013 - 10:23 AM

The number one reason I chose to go privately was so that I could stay in a private room for 5 days and have 24 hour breastfeeding support on hand.

I had a drug-free intervention-free birth as I had wanted (however, I also told my ob that if intervention was medically warranted I was ok with that).
I did have problems breastfeeding to begin with but the time I left hospital I was confidently feeding myself (at the hospital I was in, they can also offer another 1-2 days extra stay if breastfeeding problems persist and there is room available).

I was lucky to have a straight forward birth and I'm sure it would have gone just as smoothly in the public system I'm zoned for. However, from what I have heard from others in my area, I'm not sure whether the post-birth care would have allowed me to continue breastfeeding my daughter, as I had needed support for almost every feed for the first 3-4 days (a visit my a midwife once a day would not have been adequate in my particular case).

#112 Soontobegran

Posted 10 July 2013 - 10:34 AM

QUOTE (WithSprinkles @ 10/07/2013, 10:23 AM) <{POST_SNAPBACK}>
I'm not sure whether the post-birth care would have allowed me to continue breastfeeding my daughter, as I had needed support for almost every feed for the first 3-4 days (a visit my a midwife once a day would not have been adequate in my particular case).


This^ is the problem.

A daily visit (if lucky enough to get it) after a brief stay in hospital may give you one supervised feed per day but it is the other 8-10 feeds that see a woman struggle and push women towards feeling that formula is a better option. sad.gif

#113 Fossy

Posted 10 July 2013 - 10:42 AM

QUOTE (soontobegran @ 10/07/2013, 10:00 AM) <{POST_SNAPBACK}>
Once again I need to point out that being in a private hospital does not guarantee the delivery of your choice, in
The question of breastfeeding support is almost not applicable to a system which tosses it's women out within 24 hours of delivery. Most babies are not attached and sucking well, most women do not have their milk in, many babies are jaundiced and sleepy. The support is required at home afterwards.......having our discharge forms filled out saying you are breastfeeding does not mean you really are.


A friend if mine who is doing her obstetrics training at a major Melbourne CBD public hospital says this is one of the hardest parts of her job, discharging patients who are not ready to be discharged but the doctors are told by the powers that be that they have to, they've had their allocated bed time.  It leads to so many issues down the track.  I have personally attended numerous women discharged from the same hospital suffering tremendously - infections, PPH, PND, mastitis, open wounds etc.  The entire health system needs an overhaul, it's scary how bad it is in some places. Overworked, under resourced, under funded = never going to end well.

#114 Gumbette

Posted 10 July 2013 - 10:52 AM

QUOTE (WithSprinkles @ 10/07/2013, 10:23 AM) <{POST_SNAPBACK}>
I'm not sure whether the post-birth care would have allowed me to continue breastfeeding my daughter, as I had needed support for almost every feed for the first 3-4 days (a visit my a midwife once a day would not have been adequate in my particular case).



QUOTE (soontobegran @ 10/07/2013, 10:34 AM) <{POST_SNAPBACK}>
This^ is the problem.

A daily visit (if lucky enough to get it) after a brief stay in hospital may give you one supervised feed per day but it is the other 8-10 feeds that see a woman struggle and push women towards feeling that formula is a better option. sad.gif

And this is where I'm eternally grateful to the wonderful midwives and LC at the private hospital where I had DD.  They came & sat with me during every feed. Due to DD not latching on properly I ended up with bloody nipples (I actually had more blood coming out of one than milk). They insisted I stay an extra 2 days (7 instead of 5), until breastfeeding well and truly under control.  They didn't charge my fund for accommodation costs for the extra nights, instead they 'snuck' me into one rooms usually set aside for parents who have babies in the special care nursery which was vacant at the time.  Without this support I almost certainly would have gone straight to formula.




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