Private, Public or Birth Centre?

[siofra]

Hi,have recently moved to Brisbane from Ireland and have found out I'm pregnant.Have medicare sorted out but no private health insurance (imagine it would be fairly expensive to go private so) Beginning to get stressed at this stage about hospitals ect.Can anyone fill me in about going public? Do I have a choice of Hospital? Living north Brisbane.

[BellyBelly]

Welcome to BellyBelly! I will move this to recommend a hospital and you might get more help there.

Are you anywhere near Selangor? They have a great reputation for birth there. Private vs public - well the main thing is what birth do you want? Much higher levels of intervention in private.

With no health insurance - a private hospital will cost you thousands of dollars.

Usually with public, you go to one of the public hospitals closest to your home.

[Berry]

Aus has a great public health system.

Generally you can choose which hospital, but better to book in to the one you want ASAP.

[Shanti]

Siofra, welcome to BB Congrats on your pregnancy AND welcome to Oz!!!
I used to live north Brisbane too (grew up there) & the Royal Womens Hospital (public) is not far... (in the city) about 20mins from most suburbs, well it depends, which suburb do you live in? most people in brisbane go to the mater hospital public or private also...
the health care system is much better here than in lots of other countries... and if you have medicare then thats all you need to go public system.
talk to your local gp/doctor perhaps? all the very best....

[~kaos~]

Welcome to Brisbane

I would say go public. Not only would private cost you many thousands of dollars, I don't necessarily think that paying for maternity care gets you a better standard of care (unless you are paying for an independent midwife, then it is the best care avail IMO ). And like Kelly said, private hospitals have higher levels of intervention than public hospitals.

If you are northside of Bris, and still in your first trimester, you might be able to get yourself on the ballot for the Birth Centre at the RBWH. There is a great standard of care there with continuity of care from a known midwife. Otherwise, Cabooluture Hosp has a midwife program, I think it is called Holding Hands. Check that out too.

All the best for a happy and healthy pregnancy, labour and birth

[Snacks]

Hi Siofra, and welcome!
Its such a tough and stressful decision to make, isn't it? I really struggled, mostly because you have to choose almost as soon as you find out you're pregnant - everything 'books out' so quickly. I chose public - I had no reason to believe that I'd have anything other than a normal, natural pregnancy and birth, and midwives specialise in that sort of birth, so it just made sense to me. I was very happy with the care I was given!
All the best for your decision-making, and your pregnancy.

[Shanti]

thats so interesting, i didnt know that there is less intervention in a public system.... i reckon that's great.... cos i am going public !!!!
i wonder why there is less intervention?!? Kelly? anyone?

good luck choosing your hospital

[Ginger]

can someone please explain to me what it means that there is more intervention? sorry, i feel like i am always asking dumb questions on here, but i don't understand what that means and am interested..

[visitor1]

Interventions: Things like c-sections, inductions, drugs, not so natural labour. Ie...u do it their way not yours,

[Karina]

I went public and it was really good actually. I still had easy access to an obststrician, paediatrician, physio during my stay in hospital, even though the ward seemed really busy. In hindsight there was only one thing that annoyed me about my antenatal care and that was how I had to see a different midwife for all of my appointments, but at the hospital I went to, they have changed it so you see the same midwife for all appointment and birt now.

[BellyBelly]

You can compare stats in Vic, they have perinatal data collection every few years, so another one is due soon, but see here: http://www.bellybelly.com.au/forums/...ad.php?t=16414

You can see the diff between public and private there.

[siofra]

Thanks for all the advise!Leaning towards the public route at this stage but on the subject of intervention could you be refused a c-section if you requested one? I will be 41 having first child and just know what to expect.I don't think just because go you public you should have no control regarding how you give birth!Will need to check that one out

Thats the unfortunate thing about going public... you can't choose to have a c-section. They will perform one if it is medically required - which you may find out prior to going into labour (Breech?)... mine was emergency c/s as baby was posterier and stopped progressing in labour.

That is one of the reasons that ceasars are more popular in private hospitals (then public) - because women can choose to have one.

If you are in public, you can choose the type of pain relief you can have (time permitting of course)... but if you are in a birth centre, I don't think you can have an epidural or pethadeine... (not 100% sure of that though)

[barb]

Hi Everybody,
I also have a question about going private/public.
We live in Melbourne, and we have private health cover with a hospital excess of $200. Yesterday we went to see a private hospital for a maternity tour and they said that even though we have private cover the out of pocket costs can be as much as $5000. Now I am confused...where does this come from if we have cover? Should we just go to a public hospital? How does that work? Is there a huge waiting list? One of my girlfriend goes to a public hospital, and she says that the monthly check-ups don't cost here a thing, although I don't know how long she has to wait for a doctor???
We are new in Australia, I'd appreciate every information we can get...
Thanks, Barb

[seventh_heaven]

Barb, you would have to check the possible excess amounts with your private health fund. You may find that a normal birth (with no intervention) costs $200 but they may slog you with additonal costs for 'extras' such as pain relief, c-sections etc.

Regarding public hospitals - there are no waiting lists as every citizen is entitled to free public obstetric health. (Some hospitals have additional 'birth centres' as well as normal delivery suites - sometimes the birth suites have waiting lists.)

Appointment waiting time at the hospital is often very LONG! However Public hospitals generally offer 'shared care' which allows you to have your monthly check ups shared between your GP and the hospital antinatal clinic. Therefore, shared care would allow you to see your doctor for the majority of the check ups (and you would only have to see the hospital for several appointments).

To find out more about 'shared care' in the public system - simply call/visit your local GP.

Good luck. Let us know what you find out about those potential '$5000 out of pocket expenses'.

[~Debbie~]

Siofra - you will have to go public, as, if you sign up for private health insurance, they all generally have a 1 year waiting period before you can claim, so, unless you have a super duper long pregnancy.....

Personally, as a recent private patient, perhaps my obs, and private hospital are one of the rare ones, as, at no time was i encouraged to have a c/section, or pain relief. At my pre admission interview, i was asked about if i wanted an epidural, and i said, Yes, why not. The midwife doing the interview then advised me to wait until i am in labour, and see then if i really needed it. During labour, i was offered pain relief, and was only given a small shot of morphine. I asked for an epidural, but, was told that i was doing a very good job without it. I really felt that i was encourage alot to do it naturally as possible (i was induced by request - so that part wasnt natural.) From my experience of going private, i can only say good things....

Apart from the cost.

Barb is mostly right in the cost. I guess it vaires according to which hospital, and obs you are seeing. I dont know for sure, but, i estimate that our out of pocket expenses would be between $1500 to $2grand. The big killer is the pregnancy management fee, which is pretty much to cover the obs insurance (i think). For us, it was only $1000.00. But, i have heard that other obs charge ALOT more then that. The bonus is that is puts you straight over the medicare safety net thing, and the rest of your costs and then reduced quite a lot. You pay for every viist to you obs, your 12 & 19week scans, blood tests etc as required, all of which i imagine to be free if you go public. The obs should be fully covered by PHI. I also have physio fees, and i imagine, yet to come will be the paed fees.

DH wants us to go public next time, because of the cost factor. I am scared as i have heard some bad stories out of the public sector. And i know its only the small minority, but, still, as i had such a positive experince first time around, its scary to go somewhere different.

[Ginger]

hi barb- i was in a similar situation and was really frustrated when i found out that even though i'd been paying for private health insurance, i was still going to be out of pocket a lot of money. the fact is you do end up paying more, but you also get a lot back- so far, we have been out of pocket a bit less than $2000 by choosing to go private. all up i expect it will be about $3500. i have to say though, i have been really happy with the decision i have made so far. i guess it's just a decision you have to make. if you are really struggling to make ends meet financially, then public may be the way to go for you. we talked about it fora couple of weeks and spoke to lots of friends (particularly ones who have given birth at the particular hospital i am going to) and made a decision in the end and i haven't looked back. a friend of mine had one child at the local public and one child at the local private and she told me that if she was going to have another she would definitely prefer to go back to the private. this could just be the situation in my local area though, as i'm sure everywhere is different. like i said, you and your dh need to make your own decision about what is going to suit you the best, and take into consideration the financial differences...