Please advise: having baby public route

[Gunner]

Hi everyone

Wow, it’s been a while since we’ve posted here. Hubby and I arrived in Melbourne just over 5 months ago – we will definitely post our thoughts soon on our experiences thus far (all good don’t worry).

My question today is more baby related, hoping someone can advise.

Since we held off our baby plans while we were in SA (we first wanted to move here), hubby and I are now both ready to start expanding the family.

We will be going the public health route (we are on Medicare), and I wanted to know how the process works here. I know that when you get that positive pregnancy test, your first port of call is to visit your GP. What happens hereafter?

1. Who do you go to for all your follow up appointments? (I know in SA you go see your gynae). Do you see your GP here for these appointments? What about scans?

2. How does hospitalisation work? Do you choose any public hospital? Do you need to book in, in advance? (i.e. tell them your due date)

3. Where do you go for prenatal classes?

Any other info/ advice is most welcome.

Thanks guys

[Riekie]

You go to your GP and unless there is something of concern, you will be seen by your GP throughout the pregnancy. Anything that's not covered under Medicare is extra. If your GP does not bulk bill, there will be a gap payment. You basically go to your local public hospital for the birth and your baby comes into the world assisted by a midwife - the doctor only gets involved if there are complications. You go to the hospital before the time - most of them have "tours" for expecting mothers and they're very helpful - they also give you heaps of information and will be able to assist with information on pre-natal classes etc. After the baby is born, you get quite a few home visits to check on you and the baby etc. and they have regular "mommy training" where you meet other moms and they discuss topics like breast feeding etc. The support is really great. Although the public system is great, I would consider private health for the baby. Your baby is looked after by a GP - not a peadiatrician. You can get a referral to a peadiatrician only if the GP agrees that the baby need to be seen by one and then you have to wait (sometimes months) to see a peadiatrician and it is not always the same one each time.

[JackieO]

You actually have a choice if you are low risk you can choose:

GP shared care (Gp does almost everything)

Midwife care at local hospital (with birthing centre if they have that or normal delivery suites otherwise)

Midwife care combined with OB/GYNAE care at local hospital

If you have complications you will be immediately changed over to OB/REGISTRAR care.

Your GP will know which hospital you are zoned for and will arrange your fist appointment with a referral letter.

At that appointment they will answer all your questions and ask you loads more.

Usually you have a dating scan early in the pregnancy and then a morphology scan at 20 weeks.

If everything is going well you wont have any other scans (but can choose to pay privately for more)

[Nev]

We had a private OBGYN (Obstetrician gynecologist) in a public hospital, and for sure we will go full public next time,

Heidelberg (public) hospital is absolutely fantastic and has the biggest or one of the biggest infant ICU centers in Victoria, our little guy had major problems when he was born and honestly i don't know how private could have been better, we have also spent a lot of time in both public and private hospitals over the last 4 years here, for adults, private is more efficient, for childbirth, we will be using public going forwards.

I do suggest that you go to a big hospital though, as they have the facilities if there are problems, if you are close enough i highly recommend the Heidelberg (Mercy) Hospital, and if you want to go public but with a private OBGYN the lady who helped us is highly qualified & regarded and based out of the Heidelberg Hospital, it is really pricey though and most of it out of pocket

[LisaActually]

I just came across this not sure if it's of interest to you

http://www.bellybelly.com.au/pregnancy/maternity-care-options-australia/

[duppies]

I just had my baby in April and all through the public system as we don't have private health. I will try and post as much detail but mine will be a mix of this and that as it was an IVF pregnancy and then from mid second trimester I was high risk. It will be a long post so sorry about that and I hope it all make sense. I am in Cairns, Queensland so I don't know if it will be different in other places...Probably yes.

Your first call will be your GP that will order your blood test. My first trimester was monitored by my ivf clinic but I think it will be very similar, so if I get it wrong could somebody please correct me.

Once confirmed, the GP will give you a referral for a dating scan .If it is early enough it will be around 7/8 weeks. He will also give you a referral for your 12 week scan and bloods. He should also refer you to your local public hospital ( just remind him).

I don't know if the 12 week scan is covered by Medicare unless you are classified as high risk. I think this is an optional scan. My out of pocket was very small(if any) but I was 35 and it was an ivf pregnancy. Maybe some one else can shed some light on this. Ask that all results are also to be send to the hospital

My hospital appointment was at 14 weeks and it was done by a midwife. You will fill out a lot of forms and they will have this questionnaire on how stressed you are.

You will be assessed as low, medium or high risk. You will also get a referral for your 20 week scan and bloods (mine was bulk billed).

If low risk, you can choose to see your GP (sharecare) or midwifes. Find out if there is a midwifery group practice in your community. You get one specific midwife that will always be at your appointments ( there will be a back up and they might work in a group of 3 or 4). If you don't have this you will most probably see a different midwife every time ( if you choose to be seen by the midwifes). My choice was the group practice and I loved my midwife. I was so scared that I wont like mine and then I'm stuck but you can ask for another one and they wont hold it against you.

If you are medium risk you will have a combination of Obstetric care and GP/midwife

If high risk you will have Obstetric care with the hospital and your appointments will be more and you will have more scans.

You will have the following appointments with your chosen care provider

20 weeks - to discuss the 20 scan (if medium and high risk this will be at the hospital)

24 weeks - referral for bloods one of which will be a glucose tolerance test

28 weeks - to discuss the bloods ( if anything is wrong you will be contacted sooner)

30-32 weeks - standard appointment

34 weeks - standard appointment

36 weeks - at hospital will get referral for bloods

38 weeks - standard appointment

40 weeks - standard appointment

41 weeks - at hospital

If you are classified as high risk don't think you will not receive the proper care due to the fact that you will go public. I had excellent care. I was hospitalised at 32 weeks and at my delivery I had 2 specialist looking after my well being, a midwife that was holding my hand and talking me through everything, a paediatric specialist looking after my sons well being, all their support staff and all the other dr's necessary to perform a c section. It was a very busy delivery room. If we were low risk my allocated midwife would have been there for the delivery.

My little one was in SCBU(special care baby unit) and afterwards were seen by the paediatricians for about 3 months after birth. He made enough progress and we all felt we can move over the our GP.

A midwife will also do home visits. I don't know for how long as we had 3 weeks in SCBU and then 3 weeks of home visits. But I think it is less if you are low risk.

We went to the hospital for our prenatal classes. It was booked at our 14 week appointment at the hospital for later in the pregnancy. We had 2 choices. 6 weekly classes or 1 full Saturday. I enjoyed the weekly classes as you get to know the other parents.

Oh my this turned out to be longer than I thought. Hope it helps.

[Mara]

Nev, surely that is Mercy Hospital at the Austin and not Heidelberg Hospital?

[rozellem]

We will be going the public health route (we are on Medicare), and I wanted to know how the process works here. I know that when you get that positive pregnancy test, your first port of call is to visit your GP. What happens hereafter?

1. Who do you go to for all your follow up appointments? (I know in SA you go see your gynae). Do you see your GP here for these appointments? What about scans?

2. How does hospitalisation work? Do you choose any public hospital? Do you need to book in, in advance? (i.e. tell them your due date)

3. Where do you go for prenatal classes?

Ok, my info 5 and 6 years old, but I think it still applies. Yes, see your GP and tell them its your first time and to explain it all to you, take notes if possible. I remember they gave me a timeline sheet, that I put on the fridge, with the when, who and what. Dont be shy to tell your GP that you are "concerned about costs". It made my GP send me to bulk billed/Medicare paid scans. You might not get it, if you dont ask for it. Dont compare your pregnancy care too closely with friends in RSA, as the Medical Aid machine in RSA steer their care in a very different way (heavy handed). If you have a healthy, normal pregnancy in Aus, you will have a scan twice and get amazing, world class care. And if the chips are down and you or your baby need anything more than that, the Medicare system will call in the cavalry and help you. I joined a group called bubhub.com.au and they had lots of helpful info. It told me to phone my local hospital and gave them my due date and they put me on their files. I went to see the midwives there for regular check ups. They will tell you about tours of the hospital and pre natal classes. We had the most fantastic care (before, during and after) and it only cost us the parking fee at the hospital (about $60). Remember not to stress too much, trust the process and the professionals. I did not go to the prenatal classes or the hospital tour. Instead I did a hypno birthing class and was going to zen the kid out with acupuncture etc. in one of the hospitals amazing birthing pools. The fun and games started on the Saturday morning, kid A was delivered via C section on the Tuesday afternoon. Moral of the story is, roll with the punches and dont try to be a hero, everybody is there to help you and the baby make it to the other side safely. I am so happy we went the Medicare route, even with all the money in the world, I would do it again.

[RedPanda]

While people are discussing this topic, does anyone know if it possible to have an elective C-section through Medicare? (If you don't ask, you'll never know.)

[rozellem]

While people are discussing this topic, does anyone know if it possible to have an elective C-section through Medicare? (If you don't ask, you'll never know.)

Personal opinion: I really wanted a natural birth first time, tried my hardest, but it didnt happen. When the professionals saw it wasnt happening, they immediately suggested a C section. They are not unrealistic and noting is set in stone. I was the one who didnt want to and they ammused me for a long time after (because the baby was being monitored and doing great). They do not force you to, but they want you to try, if its possible. Because its so much less hastle to do it the natural way and recovery wise, scarring, etc. With my second they had me choose and said I could try again if I wanted. I had child care arriving by plane and needed a definite date.

When you realise how RSA medical aid dictates medical care over there, to the point where it becomes the norm, its a revelation. My best friend was told by the most popular baby doc in the Cape, that delivering a baby over 3kg naturally is "impossible". She arrived at the hopital in the early hours, he was called out (angry, interupted his sleep), told her the birth wasn't progressing and wipped baby out via C section. They just like an ordered diary and a full night of sleep. An old school friend in the UK (very pro natural birth in the NHS over there) had a 4,5kg baby naturally, nobody blinked.

Short answer. You will be encourage if its in both your interests. If anything changes, the baby will be wipped out asap. Ps. State hospitals are allways staffed, where private hospitals might have to ring the anaesthetist to come in from home, wasting critical time.

[duppies]

It is possible. Mine was due to medical reasons but I would have asked for one any way. I think they will try to talk you out of it but you just need to stand firm.

Edited November 4, 2015 by duppies

[Nev]

Yep Mara, spot on, the Austin (Mercy) hospital

[RedPanda]

It is possible. Mine was due to medical reasons but I would have asked for one any way. I think they will try to talk you out of it but you just need to stand firm.

Ok, so they will allow an elective C-section, even if the reason is choice and not complications? Good to know, thanks.

It's still some way off in the future for me, but I do like to be informed of things. It makes me feel better about the choices that I make. (I think if you really get down to it, most of life is an illusion, but that is long talk for another time. Suffice it to say that I'm happier about a choice/planning if I believe I had considered all the available information.)

[RYLC]

It is possible. Mine was due to medical reasons but I would have asked for one any way. I think they will try to talk you out of it but you just need to stand firm.

Sorry I just had to laugh at this. Since your C section was for medical reasons you will never know whether they would have said yes. I don't know anybody who has had an elective c section (in the public system) and I've asked on a forum I'm on with thousands of mums. Maybe private will do it but I do have my doubts. I asked about it and there was no "standing firm" to insist LOL.

I ended up having epidurals tweaked just right so you can't feel but can push. Best of both worlds. Oh and I went private both times. The Ob told us that the difference between private and public is the visible stuff such as private rooms, tv in rooms, free food for guests and Dads etc but also the "invisible" things such as the equipment they use. Private use a lot more one use and throw away stuff whereas public didn't. He didn't go into detail about what and I didn't want to know. He also said there was a higher staffing ratio in private. Not that public has no staff but private has extra staff. Private also let you stay for a few days whereas public sometimes send you home within six hours of delivery. Also visiting physiotherapist and lactation consultants in hospital with private. So lots of extra services which were a god send as a first time mum.

@Gunner: Do go along to the prenatal classes (usually held at the hospital you have chosen) as you will meet other couples there and it can be the basis of great friendships.

Edited November 5, 2015 by RYLC

[Gunner]

Wow, thanks so much for all of this information and for sharing your experiences, I definitely have a clearer idea now of how it all works. Think the closest public hospital to me is Royal Women's Hospital, so hope they are good.

And yes, will definitely go to the prenatal classes when we get there - I'm sure it will be great meeting other couples in our same situation.

[rozellem]

I cant rember if my two private rooms in the, state of the art, public hospital in Sydney (Medi Clinic eat your heart out) had a tv. Didnt have time/energy to care. I stayed for 4 days each time, husband slept in the room too. Had really great food, nappies provided and exellent care. I am still friends with my whole mothers group the nurses hooked me up with. We are having a 6th birthday party for the 10 kids in a park next weekend. My hospital also had weekly, free pre natal yoga and I still catch up with some of the ladies I met there. The Medicare resources are mind blowing. They are there to help you.

[Aneldari]

The midwife leading our prenatal classes informed our group that if we want a c-section (by choice not medical reasons) we must do it through the private hospital and pay for it all.

The prenatal classes were great and so informative for both hubby and I as our little girl is our first. Good place to meet parents whose child will be more or less the same age. I still attend playdates with 3 other mums and their bubs and they are now 18 months old already.

[RedPanda]

..and a few comments later it seems that I will have to do some research (specifically for Victoria) before we plan the first one.

[duppies]

LOL, I knew when I posted the short answer that it will bite me in the bum. I do stand by my statement that it is possible but I will add that it is not easy. I can not comment on the experiences of others but I can share mine.

There is something that they will take serious and that is anxiety. If you truly fear a natural delivery they will give you an elective c section. For me the risk of the unknown was huge.

When I saw the midwife at my 14 week appointment (random midwife) I did not get far with my request but not long after I met with my allocated midwife and she started to advocate for me once I shared my fears with her. We actually made good progress and she was talking to the doctors about an elective c section no sooner than 38 weeks but most likely at 39 weeks. I was not classified as high risk at this stage as my conditions were only picked up at around 23 and 27 weeks.

I am on various support groups for the two main conditions that I had. Many women join after they were diagnosed early in the pregnancy but during the pregnancy things stretch and move and they get cleared for natural birth. A few do not feel comfortable with this and still request a c section and not one of them was denied. Just today one complained about the note in her file that read... requested due to anxiety.

It wont be the same as in South Africa were you just walk into the office and request a c section. In my experience, if you really fear giving birth naturally and you do have a valid reason for it, they will not force you to do it. You are just in for a fight. My pregnancy journey took another direction so I never fully explored that avenue but it might be that they classify anxiety as a medical reason. I will never know if that is indeed the case. All I know is that I was well on my way of getting an elective c section.

[JackieO]

I know of more than a couple of people who have had completely elective c-sections for their first child in Australia through the public system

[Aneldari]

The midwife leading our prenatal classes informed our group that if we want a c-section (by choice not medical reasons) we must do it through the private hospital and pay for it all.

The prenatal classes were great and so informative for both hubby and I as our little girl is our first. Good place to meet parents whose child will be more or less the same age. I still attend playdates with 3 other mums and their bubs and they are now 18 months old already.

Hi, just to clarify my comment above. This is what we have been told and it was probably said to deter us from wanting to go down that path. Hubby and I didn't pursue it any further as we wanted a natural birth (which we did). I am sure if we would've taken it further eventually they would've agreed.

So, it seems it is not the norm but can be achieved.

Good luck! We are blessed with a beautiful little girl who is now 18 months old already.

[Sibella]

I can recommend Box Hill Hospital as myself and quite a few of my friends went there. I also have a midwife friend who works there and they've recently redone the maternity unit.

I had the best birth there and it did not cost me a cent. It was a c/section but it was my third and after two c/sections they insisted I have another.

Had skin to skin contact with my baby as soon as she was born which I missed out on with the other two. After I went home (after 2 nights) a midwife came to my wife to see me every day for a few days.

The only thing which disturbed me was meeting the obstetrician for the first time a few minutes before I went to theatre! But she was excellent, the nurses held my hand and the anaesthetist took photos for us (even took a photo of the clock!).

Oh and they don't have a 'nursery' so the baby stays with you 24/7 which is exhausting!

If you go private you will end up paying at least $2000. But then you might be able to stay in a hotel after the birth! Which is what one of my mothers group mums got to do - apparently the latest thing.

[RYLC]

Maybe one of the differences with private then is that they DO have a nursery. I found it such a help with my second child because I was so exhausted from the delivery.

[rozellem]

Different strokes........the idea of a nursery for babies gives me the heebie jeebies. Maybe I have seen to many movies. My kids slept a fair bit after they were born, in the cot next to my bed. If I needed a hand the nurses/midwives/lactation consultants/husband was on hand to hold the baby. Worked for me.

[RYLC]

Maybe I have seen to many movies.

Probably ^^^

It is such a difficult thing to know what you will need / want when you give birth. Many a birthing plan was torn up once the live event started...

And one never knows how it will be until it is over. I don't really want to share all the gory details but it's enough to know that I needed a few hours of uninterrupted sleep after birthing my second child and the staff popped him into the (very nice) nursery for a few hours.

For Saffas coming over: using the public health system over here would be nothing like using public health in RSA so you can rest assured that whatever you choose based on your particular circumstances, you will be comfortable and well cared for.

Private health isn't necessary but does provide some differences for (particularly) elective things / additional comforts / wait times. A bit like the difference between economy seats and business seats in an aeroplane. Both seats get you to your destination and in an emergency we would all get the same life-jacket and oxygen mask. It's just the little things about business class that you may choose to have and pay for. Same with private health.