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Public or Private Hospital for the birth: WDYT?

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#51 LegalSweetie

Posted 01 June 2010 - 01:07 AM

p.s. an example of cost for me was as follows:

initial visit with ob - $200
each subsequent visit - $100
ob management fee - $4000
assistant surgeon - $750
anaesthetist - $1200
theatre fee - $493
blood tests/pathology approx - $400 all up
padeatrician - $500 all up (4 visits)
health fund excess - $400
13 week scan/NTS testing approx - $300
20 week scan approx - $300
ie. nearly $10,000 altogether. i did get some of this back from medicare. not nearly enough

Narti was this with PHI? 

#52 km78

Posted 11 June 2010 - 11:08 AM

I think if you want a normal delivery and you can see where the ob money is better spent then go Public or even look at seeing an independent midwife if you want to allocate some money to pre/postnatal care.

I have private cover but from experience chose to go public homebirth as I can not justify the money spent on someone (ob) who rushes you in and out at appointments that are clinical and all about scans then steps in at the end of the birth and you hand over thousands of dollars.

Use them if you need to be under their care but if not they are a specialist not very good at holisitc care. (how many sit there after the birth and help get bubs latched on correctly, haha hard to picture hey or bring you an ice pack to help the swelling or an arm around you shoulder when your milk comes in and you are teary) Good old midwives original.gif

#53 Obesa cantavit

Posted 11 June 2010 - 11:33 AM

Firstly, you didnt do your homework on health insurance very well. I joned for the same reason (plus reaching the age threshold for co payment) and I have paid nothing, not even my excess, for my 3 private hospital births.

I personally do not think it is a public private thing as to what is the best, it is your primary care provider that will ultimately control the outcome.

I chose private as I had no fai\mily aorubnd me and was the first of my peers to have a child. I wanted to stay in hospital as long as I wanted after the birth and wanted continuality of care. I have had on (medically indicated) elective c/s and two VBACS, one of them totally intervention and drug free, one needed intervention largly due to her position. Yes it is possible in a good private hospital to have the exact birth you want.

For each of my births I was out of pocket, all up; u/s, OB visits, tests etc, less then $1700 (not including my health insurance premiums) In my case it was money well spent.

each subsequent visit - $100
ob management fee - $4000

WOW! My first OB bulkbilled consultations and the second charged as much as my GP ($65) I had, arguably, one of the top OB's in Melbourne for my first two births and my management fee was under $1500 (4 and 6 yrs ago) My lastest OB was $700, again, one of the top in the state i now live.

Edited by Obesa cantavit, 11 June 2010 - 11:38 AM.

#54 Obesa cantavit

Posted 11 June 2010 - 11:42 AM

Someone has already mentioned NICU - private hospitals don't have them. A set of triplets died in my city recently because their mother was labouring in the private hospital, things weren't going well and the private hospital didn't transfer them quickly enough.

Very sad sad.gif But was that really a lack of NICU or the breakdown in protocol in transferring? I know all the private hospitals I have birthed at had level 3 special care nurseries with enough expertise to keep a baby alive to trnasfer 500m down the road to the nearset NICU for the first 2 hospitals, and down the hall for the last.

#55 Chaton

Posted 14 June 2010 - 12:07 PM

I went public through a birth centre.  I was very happy with the experience - I had the natural drug free birth I hoped for (although if I had of arrived at hospital any earlier I think I would have begged for drugs).  The only thing that was a bit of a shame is that while I had my own room/birth suite I was only allowed to stay the one night.  But the midwife who delivered my bub phoned me every day for about 4 weeks to check on me and bub.  When I was readmitted with mastitis and a breast abcess, the midwife who delivered my boy visited me in the maternity ward every day after her shift.

We didn't pay a cent for anything including our antenatal classes, blood tests and ultrasounds (except the 13 week NT scan).  If you go private you can request your OB refer you to a bulk billing ultrasound or pathology place - medicare will allow you to bulk bill one scan per trimester (except NT scan) and all bloods should be free.

#56 Georgie01

Posted 14 June 2010 - 12:46 PM

Someone has already mentioned NICU - private hospitals don't have them.

Most public hospitals don't either though, I think there are four NICUs in Melb (maybe three?), there are many more hospitals with high level SCNs (some private) but not every hospital (public or private) has these either. Of course, if your pregnancy is high risk or there are complications that warrant it then you should be delivering in a hospital with appropriate facilities. There are private hospitals that are co-located with tertiary public hospitals too, with equal access to NICU (at least here in Melb). When I delivered my twins I was in a private hospital but because of complications there was a team from the co-located public NICU in the room ready to treat her and whisk her down the corridor if needed (thankfully they weren't needed). My OB would only deliver multiples and high risk pregnancies at this particular private hospital because of the level of facilities available.

Private vs Public - as a PP said, I think it really comes down to comparing the hospitals that you are considering and considering the care models that go along with them.

For me personally the antenatal care from an OB that I trusted was non-negotiable, a handful of poor experiences have left me generally distrustful of all medical staff so it was important for me to find someone that I could trust and have continuity of care. Where I ended up delivered the baby was secondary - I'd booked in with my OB weeks before I decided to deliver in a private hospital. Other people are happier in midwife programs. I think everyone needs to find what suits them, there's no one-size-fits-all answer.

#57 chrisl

Posted 03 September 2010 - 10:21 AM

I think this is a hard one to answer not knowing where you live, so what options are available to you in terms of the local hospitals? My experience is that I went public with my first one and private with the second. The only reason why I went private with the second is so that i could have a private room after the birth and to basically have a bit more luxury before I went home with new baby in tow (with a toddler at home). In terms of the birth, both experiences I had excellent midwives. Midwives delivered both my babies in the end. I actually had a private obstetrician for my second child who I had seen all through the pregnancy. My baby came so quickly the second time round that she walked in the room 20 minutes after the midwife had delivered him  huh.gif . So, there you go - thanks for the $4000 out of pocket for the obstetrician to NOT deliver my baby in the end. if a natural birth is what you want - Private hospitals are a lot more interventionist. I had so much more intervention with my second baby. I was induced in the end even though my waters had broken only 16 hours earlier. NOw, I won't get into detail about that because it was fine and I consented to it but if I had been in the public hospital, the policy is that they wouldn't even have called me in until 24 hours had passed after my waters breaking and then they would have been talking induction. I was put on an IV and all sorts of things in the private hosptial whereas first time round I didn't have any of that. I remember asking my husband, "why are they doing all of this?" (he's a doctor by the way) and his response was, "to justify being here." Also, my husband works in the public system and he says that there is no difference to the level of medical care, it's just that the outside looks a lot nicer. I personally don't think an ob needs to deliver babies unless there are complications in which case, of course you need an ob, but if you are in the public hospital, they will still call an obstetrician in.  The only difference is that the rooms aren't as nice and the food isn't as nice - but it depends whether or not that matters to you and it's fine if it does - I think go for it if you want that bit of comfort but don't necessarily kid yourself that you are going to get better medical support because you are in a private hospital. I think that is a huge fallacy. In Melbourne, where i live, the women's hospital is one of the best maternity facilities in the country and complicated cases are referred there. Some of the best physicians including Obs also choose to work in public hospitals because the work is often more interesting. But, you will be sent home earlier from a public hospital so that may be something to consider. And I have friends from regional areas who found their local hospitals almost as pleasant as private hospitals because they were small and they were allowed to stay longer. So I think it really depends on where you live, how long you hope to stay in hospital after the birth and whether or not you want continuity of care with an ob during the pregnancy and delivery or whether or not you are happy to be treated by midwives during the pregnancy. Oh last point - I had a hell of a lot more tests during my second pregnancy (third scan, extra blood tests) than I did with the first when I was only seeing a GP and most of them were completely unnecessary.

#58 White-Lily

Posted 03 September 2010 - 03:12 PM

I went public and would happily do the same again.
I had a drug free vaginal birth after a complication free pregnancy. I did shared care with my GP and the public hospitals OB and midwive and it was all bulk billed, all i paid for were my ultasounds. I saw the same OB right thru the pg the only thing was he didnt deliver the baby BUT she was born on a long weekend and quickly with no trouble so he wasnt needed, nor would he have made it!

The only negative thing i had heard about the hospital i went thru was that if you have no problems with the birth they like to get you home quickly. I didnt have that problem as DD was sick and we had to stay in until she was well enough. So we were in for 4 days.

DH and I looked into private cover and couldnt justify the cost when i could get the care i wanted thru the public system. The childrens hospital is public and so is the Womens hospital in Perth. We thought about what would happen if anything went wrong and we would have been transferred to the public hospital, so why bother going private.

As it turned out DD had health issues and was under a paed for 4 months and is still an outpatient for the Childrens hospital (and will continue to be for at least another 12-18months) and all her tests and treatment (aside from 2 ultrasounds) have been bulk billed.

For my situation, if we had have gone private we could have afforded the pregnancy but if DD had of been put through the system as a private patient it would have probably financially ruined us.
**She was seeing the Paed every week and he was running numerous blood/urine/stool tests And she was seeing the Ortho Surgeons and Occupational Therapist and having ultrasounds at the Childrens Hospital every 6 weeks as well as the occasional physio session

This is just our experience. I feel i got the same level of care my girl friend got even tho she was private and i was public, yet she paid for it. *Her OB was not there for the birth of her DS

Edited by White-Lily, 03 September 2010 - 03:18 PM.

#59 loniemac

Posted 29 February 2012 - 12:31 PM

Maybe public or private isn't the best question you could ask?

I think it's better to shop around a bit and find the best carer for you and the place of birth where you will feel safe, cared for and as comfortable as you can. If one place offers a deep bath for labour and another doesn't then that might be important for you (water is great for aiding a natural birth) so there are things like facilities and policies to consider.

BUT you can't control everything in labour so I believe it is more important to find the place you feel safe and the people you like and trust with your care, your labour and your baby's birth. If that happens to be the private hospital and a private obstetrician then do that and if it happens to be the public hospital or birth centre then do that.

Also remember if you have a great ob or GP but they are only there for the last 5 minutes and you don't know any other people looking after you during labour, you might not feel as safe and relaxed as you needed to, and similarly if you have a lovely midwife in the public antenatal clinic but she doesn't work on the labour ward you might have the same experience.

If I had my first birth again I would base my decision on looking for the place where I felt safest, and least vulnerable, the health professionals I liked best and trusted and who would be there for me during my labour.

But I didn't have private cover, it was too late for the birth centre and I didn't know that feeling safe, relaxed and cared for during pregnancy and labour was something that mattered. Now I believe it does original.gif

Wishing you all the best with your choices - it is never easy to decide what is best for something that is so unknown and new. original.gif

#60 kam_kamz

Posted 29 February 2012 - 12:44 PM

When reading previous comments there are many that I agree with and ALOT that I dont.  I went private with a very highly regarded Ob and to what I classify as one of the best private hospitals on the Northshore.  The costs were obviously more than going public, but not as outrageous as what some other people have stated.  Going by narti bear's breakup, my costs were as follows:

initial visit with ob - $175
each subsequent visit - Free
ob management fee - $3500
assistant surgeon - Included in hospital cover
anaesthetist - $800 - but I got about $400 back from MC
theatre fee - Included in hospital cover
blood tests/pathology approx - Covered by MC
padeatrician - $275
health fund excess  - no excess
13 week scan/NTS testing approx - $200
20 week scan approx - $250 + $10 for DVD

So I think the important thing to consider if money is an issue is each fund and hospital are different.  The money I paid above was more than worth it as I suffered quite serious complications which resulted in my son arriving at 36 weeks after an emergency cesarean.  He had to spend a night in SCU (which was also covered under the hospital cover), but both him and I recovered well and were home within the week.  

I am now pregant with number two and after the wonderful experience I had last time, there was no question that mine and baby's health is worth the money.  I have the same Ob and am booked in at the same hospital again.

Ultimately I guess you need to do your research and find out which hospital (and Ob) in your area have the best reputation.  There are plenty out there that have miracle/horror stories attached to them, and I don't think that anyone can tell you what is best for you except you.

To Emma and all EB members who read this thread I would like to say good luck with your decision making process and even more importantly good luck with the birth!!  Parenthood is the most amazing experience any person can ever experience.....congrats!

#61 HolyDaffodil

Posted 29 February 2012 - 01:19 PM

I went Private for a number of reasons, many of them were reasonably superficial i.e. the hospital maternity level felt more like a hotel than a hospital and that WAS something that mattered to me, it made the whole process a lot less scary for me. I was also keen to stay for a little longer than the time frame my sister had stayed in her Public Hospital (with complications) birth and I wanted the guarantee of my own room.

An even bigger deciding factor for me was the need to have an OB. I had a condition prior to conception that meant I had to have a cardiologist consulting throughout the pregnancy and it was much simpler to have the OB consult directly with him so I didn't need to do a million extra specialist appointments (it also worked out perfectly that they ended up having gone to University together). Over the duration of the pregnancy I came to adore our OB, I trusted him completely with both mine and my unborn child's life. He was just amazing. There were a few complications that occurred and the level of above and beyond care I received was unparallel. If my DH was unable to make any appointment he would often give him a call to chat about any concerns or questions he had to keep him in the loop, obviously with my permision and I love it as it meant that I didn't have to remember all the little questions DH had. He spent over 30 minutes with me at each appointment going over anything and everything, getting to know my views on everything and opening up discussions on all possibilities and easing my mind as much as he could. When the time came to deliver I was so calm and at ease due to the level of trust I had for our OB, DH could focus completly on me as we were both confident that OB had everything under control with my best interests at heart.

Despite not really requiring the additional length of stay the second time around I would definitly still go private, although I think I will have a breakdown if the time comes and my OB has retired... DH even joked that we need to have as many as possible in the next couple of years to make sure he is still practising.

As for cost, it really wasn't much more than the Management Fee and various scans that we were out of pocket for, but we also pay quite a bit more than $100 a month and that's with a substantial corporate discount, so not sure if perhaps there are various levels of maternity cover?

#62 Gumbette

Posted 29 February 2012 - 02:19 PM

I'm again going through the SAN and my costs were much the same as kam_kamz's except for the management fee and subsequent visits:

initial visit with ob - $175
each subsequent visit - Free $75.00
ob management fee - $3500 $2,200
assistant surgeon - Included in hospital cover
anaesthetist - $800 - but I got about $400 back from MC
theatre fee - Included in hospital cover
blood tests/pathology approx - Covered by MC
padeatrician - $275
health fund excess  - no excess
13 week scan/NTS testing approx - $200
20 week scan approx - $250 + $10 for DVD

I would not consider going public as I loved the continuity of care, the special treatment and my OB is fabulous.  In saying that a close friend had her baby at NSP, her OB refused to come in and see her even though she had been in labour for 13 hours (he was at a family BBQ), and was basically delivered by midwives who constantly tried to call her OB.  Her birth was very traumatic and she had excessive bleeding for 3 months post birth.  For this she paid around $6K all up.  Another friend had her baby in public, the birth was okay but lay on the bed afterwards bleeding for 45 minutes whilst the staff argued over whose job it was to do the stitches. She left after 24 hours, with a promised follow up from the hospital which never eventuated. Needless to say she went private the 2nd time around.

It sometimes can be luck of the draw regardless of whether you chose public or private, especially if you don't know your OB or have no recommendations to go by.

#63 vlbally

Posted 01 March 2012 - 01:49 PM

I think it is totally about where you feel comfortable, what you think will be best for you during labour and after the birth, and what suits your financial situation the best.

I had #1 through the public system and it was fine. We had been paying the private health leading up to the pregnancy, but decided to give public a go for two reasons - financially better, and the midwife service offered seemed fantastic. Overall, the care throughout my pregnancy was great, and after the birth of my daughter everything was fantastic. The only thing I didn't really enjoy was that during the labour I had a number of different doctors all examining me and needing 2nd/3rd/4th opinions, which lead to a lot of uncomfortableness for me and was a little bit stressful!

For #2 we decided to go through a private OB purely for the continuity of care - I didn't want 6 or so doctors doing internal exams during labour again!! We also chose to use private hospital as well as the stay after birth is generally longer which is what I wanted.

Overall, both were great and I would probably do either again, however these days with public hospitals discharging after anything from 24hrs, I will definitely be going private again - use the help from the midwives as much as possible and enjoy the fact you don't have to cook and clean for a few days - gives you some more time to get to know bubs and get your head around everything without having to worry about the house etc!! Also, I loved my OB so much I wouldn't want to go to anyone else! He was fantastic!!

#64 *lil*chil*

Posted 02 March 2012 - 09:24 AM

I had my 1st in private and wasn't overly convinced it would be any different to treatment in a public hospital except I had my own room. What really sold me on the private system was the post hospital care bubs required and the cover allowed us to continue to see a private paed after the birth - def cost effective as private paed's can be upwards of $200 per visit.
I am in my 2nd preg. at the moment and following a miscarriage a few months ago I am glad to have the extra medical attention in the private system... If it where a regular pregnancy I would def. consider public as the idea of having a midwife with me through the pregnancy is just about as good as an ob. provided there are no complications!

#65 ubermum

Posted 02 March 2012 - 09:45 AM

Private for my first births, public this time. I have noticed no difference in the level of care so far. If I have another v/b, my hospital stay will be much shorter, but as I have done this a couple of times before, I don't think I need the extra time in hospital. Deciding factor for us was the cost. Since the change to the Medicare rebates, the out of pocket expenses for my ob was going to be around $5K. Also, when you factor in obstetric cover on your health insurance, you can add quite a bit more over the year. I didn't think it was necessary.

I will be giving birth in a birth centre, co-located in a tertiary hospital. If necessary, NICU and SCN are available and I can also be transferred to normal labour wards, theatre and postnatal recovery wards if need be. I am confident that given any circumstance, I am in the best of hands. We also have private health insurance that will cover myself and the baby should we require the services of any private professional. We have just chosen not to use it for the birth.

#66 nataliej_cat

Posted 02 March 2012 - 09:54 AM

Hi I had 2 public deliveries and could not fault the hospital or follow up or anything it was fabulous Ds1 was a long labour with an epi  and Ds2 was completely natural. Midwife delivery for both babies and was part of the team midwife service which i loved. was visited at home for 3 weeks afterward for the 1st and 2 visits for 2nd. Would not have changed anything about either delivery.

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