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  5. Antenatal Care.. How do you choose???

Antenatal Care.. How do you choose??? Rss

Hi ladies!

I'm pregnant with my first and was hoping some of you could shed some light on the pros & cons of the different Antenatal Care available e.g. Private Obs, local bulk billing medical centre, Antenatal Clinic etc.

I don't have private health cover, can I still get a private obs?

I know there is a section on this website about the choices, I would really love some personal feedback on what you think is the best way to go (and why).

Thanks in advance for any feedback you can give. xx

Hi,

Unfortunately I am in New Zealand so can't comment on the specific options that are around in Australia but I will give a general answer that I think is universal.

I think the kind of antenatal care you decide on depends largely on the kind of birth you would like to have. Here we have the option of an OB, GP, or midwife in terms of the person/people who will be attending your birth. If there is no MEDICAL reason for it and you want an OB you have to pay for them. I knew right from the start that I wanted midwife based care as I had in mind the type of birth I wanted (home water birth)and I knew that a midwife would support me in MY choices.

I think with OB's you run the risk of all sorts of interventions you probably won't need or want as at the end of the day they are specialists in their field. I feel they should only be used in complicated and at risk pregnancies, not the normal everyday run of the mill ones like both of mine were. Think of it like wanting to get the oil changed in your car, you are not going to take it to a car dealership that specializes in selling cars when your neighborhood mechanic would do. Now if you had serious issues with your car, and a recall was made y the vehicle manufacturer, then you would take it to the dealership you bought it from as they would, more than likely, be the best person for the job.

So that is my 2 cents worth, not sure if it is helpful or not. So maybe the best place to start would be to decide what kind of birth you want and then research the best options to facilitate that and work from there. Of course if in the course of my pregnancies I had developed complications that needed the expertise of an OB, I would have had to examine my options again, but why start at the "top" if you don't need to iykwim.

Christina


Hi,

Congrats on your pregnancy. There are really heaps of options to choose from and will depend to some extent on which hospital you choose and your GP as well. I know that our GP offers shared ante natal care with the hospital, so most of your ante natal visits are done by the GP at their clinic.

The hopsital where I had my first 2 offered private a well as public in a standard labour ward but also had a family birthing centre. This was midwife care in a home like room and your stay is quite short and focused on a natural home like caring environment. My friend had both hers there and loved it. This style is of course dependent on no complications - I ended up with 2 emerg CS's so not an option for me.

You can still opt to go private without private health cover but it is very expensive. The hopsital I am going to this time around requires about $3000 up front if you don't have private health cover and then there could be additional expenses if you have complications or require the special care nursery. This also does not include the cost for your OB.

Personally I have chosen private and it has suited me well. I have had 2 emerg CS's with a MC in between and am going to have an elective CS for my 3rd on the 2/6/08. With the added complications that I have had and the MC I was really pleased that I was able to go back to the same OB who knew my history and I trusted, especially when I had to make the call to say I was having a miscarriage.

Having said that however, I have had friends that have gone public and had great experiences and it really suited them. The best advice I can give is to do tours of the hospitals in your area (they all run them regularly) and ask any questions you can think of. Then make your decision based on which option feels most comfortable for you. If you do choose to go private without private cover, don't forget that babies are an amazing user of cash!!! You always need something that you didn't think of, so you may need any spare cash down the track.

Good Luck.

Megan - DS1 17/7/04, DS2 1/11/06, DS3 2/6/08

Thank you very much for your feedback Jamesmum2003 and Megan, I really appreciate it.

I am only 7 weeks at the moment so its a bit difficult to tell if I'll have any complications or if everything will be smooth sailing and also being my first I have nothing to compare to. That sounds like the basis on why you would opt for a private OB over a midwife - whether or not your labour will be high risk or not.

Megan, your suggestion of touring the hospitals is a great idea so at least I'll be making a more informed decision on what 'feels' right for me.

If anybody else has an opinion on this please feel free to share : ) x

Dolce,

Not a problem. There is no reason to think that you will not have a healthy, uneventful, complication free pregnancy and birth. I got denied a home birth (in the UK) for my first baby because I got fed this "but you've not been pregnant/laboured before so we have nothing to compare it to" malarky. I have had an under active thyroid for years, been closely monitored but it didn't cause any complications with either pregnancy and my midwife was very supportive when I said I wanted a home birth, and I think that would have still been the case if it had been my first. My midwife co-op does home births for 1st babies all the time.

There seems to be this fear surrounding birth that I can't quite wrap my head round, everyone seems to work on the premise that something IS going to go wrong instead of the premise that it is very unlikely that anything will go wrong. Don't get me wrong, sometimes things happen like gestational diabetes or high blood pressure/pre-eclampsia, ect that need careful monitoring but these are by no means things that WILL happen in every pregnancy.

I agree with touring hospitals, we toured our local one as it was part of our antenatal group. I hated it (but hate hospitals in general), and everyone in our class thought we were nuts for wanting a home birth, but it was right for us and DS1 loved being involved and being able to meet HIS baby right away. I guess I am just one of those "hippy" people who trusts in her body's ability to know what it is doing and never feared birth the way it seems alot of women do today.

So I hope the pregnancy and birth goes well and just do what works for you; at the end of the day I support a woman's right to CHOOSE how and where she gives birth, even if it isn't something I would do myself. smile]

Christina


hi! i know a fair bit about all of this because i work in a maternity ward.

With public patients (under medicare) you can still go to an Ob if you choose to give birth in a public hospital. You don't need to pay for the birth, anaesthesia, or for your Ob to be there.

You can choose to go with the Antenatal clinic, which is a free outpatient clinic run from the hospital. The midwives you see in the clinic aren't necessarily the ones that will deliver your baby though. You will get whoever is working that day. If all is going well, the midwife will deliver and the Ob on call, will check you out afterwards but if you need a ventouse (vacuum suction cap) or forcep delivery, the Ob on Call will deliver.

But if you choose to go under a particular Ob, and you go into labour 'after hours' they probably won't call your Ob, and will just call the 'On call doctor' unless your Ob has requested for them to ring him/her when you arrive at the hospital smile

I hope i've helped!! It's all a little confusing
Hi Denae,

Thank you for your information. You're not wrong! It can be a little confusing, there seems to be quite a lot of different options available. Which is great, I just need to get my head around all of them!

Being in my 1st trimester I still haven't told anyone about my pregnancy so I haven't been able to get advice from friends. Our little bubs will also be the 1st grandchild on both sides so I haven't had a close family member go through this (recently) to talk with so I'm trying by best to educate myself as much as possible to make an informed decision.

I've started reading 'What to expect when you're expecting' which touches on this topic. I was suprised to learn that over 80% of women have an obstetrician. I beginning to get the impression that having an Obs was an unnecessary luxury unless the needs for one are medical based and critical. I'm glad to hear you don't need to pay for an Ob if thats the level of care you want.

When I went to my first appointment with a GP to confirm my pregnancy I know I walked out feeling like I didn't get enough information (admittedly the GP isn't trained in antenatal care) so I know I definitely want a level of care where I feel I am being informed and 'looked after' in way that I don't feel worried/concerned about things when I don't need to be.

I read a little bit about Birthing Rooms/Centres. They sound like a good medium. Having 'hospital' care on hand but a 'homely' environment. I also like the idea of being in one room/bed for labour, delivery, recovery & postpartum. Are birthing rooms in a hospital? How would I go about looking at one?
[Edited on 27/05/2008]

Hi Dolce, it would depend on where you go. Not all hospitals provide the birthing centres. Birthing Centres are for low-risk patients who choose to go more natural (i.e no epidural, birthing pools etc) and i think you have to pay for them.

At our hospital, we only have labouring suites. There's still a bed, couch, bathroom etc but no birthing pool and you have the option to have all pain relief.

I've found with the patients that go under Obs, is that these women would rather know who they are having to deliver their babies. I have one, but only had one for the last 2 appointments in my pregnancy with my son and felt really confused. I had been seeing the midwives at the antenatal clinic when they decided i was too high-risk to continue with them and sent me off to an Ob at 38.5 weeks! So this time i've decided to see one from the start smile

But it is total preference of what you would feel more comfortable with.

Hi,
I'm having my baby at a birth centre which is public and is on the same floor as the delivery suite. At this particular birth centre you can choose to have your own midwife who takes care of you all through-out your pregnancy and delivers your baby, or you can see a team of about 6 midwives and you'll get any one of them at the birth of your baby. There is a giant bath to give birth in if you wish to have a water birth, an ensuite and a larger than normal bed so you can snuggle with your baby and hubby after the birth, and all medical equipment is kept out of sight so it almost looks like a hotel room! It is all covered by medicare.
You do have to have no complications and you can't have an epidural but you may be able to have pethidine or gas.
If you want an epidural you have to be transferred to the delivery suite, same if any complications arise during the birth or pregnancy.
All hospitals have different services and policies so i guess it just all depends on where you live.
Nicole.

Hi Dolce
Sounds like we are in the same boat! I am 6weeks 3days and really want to talk to mum and my sisters in law about their experiences with private/public but not wanting to let the cat out the bag. Having said that, the public care seems to be of a high standard and we think we will go that way, as our health cover doesn't extend to private care. I have read that when you go private you end up paying for tests that are free under the public system. I too left the GP very underwhelmed when I went for my first appt. It was bascially a case of: Planned pregancy? Date of your last period? Do you want to go private or public? Don't know yet? Okay, let me know when you decide and off you go to get some blood work done. Nothing about diet, exercise or anything let alone a discussion on antenatal care options (apart from being told private was very expensive without cover). However, I got some accupuncture done on the same day and my naturopath was great - gave really good advice. I am also going to look into the birthing room thing - I believe the some operate on a lottery system because they are quite popular.
I went public with my 1st and will be doing the same this time.

At the hospital i am going to they run a programme called group practice midwifes. I did this with ds and have already put my name down for it this time too.

What the group practice is, There are 4 or 5 midwifes. You see a different one at each appointment so you get to know them all. Then when you go into labour you have a mobile number to ring. It rings Thur to the on call mid wife out of your team. She then meets you at the hospital and stays with you until baby is delivered. ( unless you have a very long labour and then they swap with the next member.)

I can't wait to do it all again.

i''''m baking a baby

I have gone to the antenatal clinic for all of my pregnancies and have found them to be fantastic. The hospital I attended give you the choice of full midwife care, full Dr. care or a bit of both. At the moment I am under a family care midwife who looks after all my appointments, gets the Dr. to see me if needed and comes for home visits for up to 6 weeks after the baby is born.

I have also had both DS and DD in the delivery suite and have found although I have had several different midwifes (due to shift changes) they are all fantastic and know exactly what they are doing, they also treat every patient as a individual. And when the OB was need they were called. It is definately a personal choice but no matter how many pregnancies I have I will always put my trust in the antenatal clinic and delivery suite midwifes.

Good Luck!!!!!
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