Author Topic: Aussies: private or public health cover for giving birth?  (Read 6345 times)

HappierAtHome

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Aussies: private or public health cover for giving birth?
« on: February 18, 2015, 01:05:28 AM »
What have you chosen? Or what would you choose?

I'm not planning to get pregnant just yet, but I'm at the point where I would probably want to get maternity added to my cover next time I pay for my health insurance (an annual event) if I'm going to use a private hospital for pregnancy and birth.

But I'm in the catchment zone for the specialist maternity public hospital in my city (theoretically the best public hospital to give birth at), and I'm wondering whether I really *need* to give birth in a private hospital. My spendy family and friends have all gone the private route, I'm still waiting on my non-spendy relative to share info about why they chose public and how it worked out for them.

What have other Aussies done / what would you do? Are there any good reasons for choosing private?

agent_clone

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Re: Aussies: private or public health cover for giving birth?
« Reply #1 on: February 18, 2015, 01:44:53 AM »
Disclaimer: I've never been pregnant and don't expect to be.
From what I've read on the net or wherever I obtained the information (admittedly some of the net isn't so reliable and who knows I may be self selecting) public is the way to go.  If there are complications in delivery often you get sent to the public hospitals rather than private anyway as the public system has more capabilities in dealing with those issues.  Public doesn't cost a lot (if anything).  For private and obstetricians you will be paying money anyway even with health cover, and you aren't guaranteed that you will have your obstetrician at the delivery either.

nora

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Re: Aussies: private or public health cover for giving birth?
« Reply #2 on: February 18, 2015, 01:59:27 AM »
Public is my vote and what I went for. You live near the best public hospital for giving birth at, go there. There is an obstetric and anaesthetic doctor on site at all times to help if there are any issues. Or if you have an uneventful labour and birth, a midwife who works as part of a team of midwives will attend to your every need and help you all the way through. And it costs no extra to you!

Advantage of private, probably get your own room. Although I got my own room throughout in the big public hospital, depends on the layout and your needs at the time.

marty998

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Re: Aussies: private or public health cover for giving birth?
« Reply #3 on: February 18, 2015, 02:08:36 AM »
Disclaimer: I've never been pregnant and don't expect to be.

I don't expect to ever be pregnant either!

You're choosing between good and more good when it comes to hospitals in Australia. We are so lucky to live in a country with good, accessible healthcare, be it public or private.

If you have a favourite Ob/Gyn doc then your private cover could make a difference, but that's for you to decide.

Wildflame

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Re: Aussies: private or public health cover for giving birth?
« Reply #4 on: February 18, 2015, 02:18:13 AM »
My experience with the private system in WA (for physical trauma though) is that you get a bit more 'waited on', a bit better 'looked after', but ultimately the health outcomes don't differ by much, if any. The private room was nice, but not necessary. Maybe hedge your bets and go public, but set aside money for extra care above and beyond what the doctor is willing to provide, and if you feel they're falling short you can supplement the public sector care yourself.

agent_clone

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Re: Aussies: private or public health cover for giving birth?
« Reply #5 on: February 18, 2015, 02:20:22 AM »
Disclaimer: I've never been pregnant and don't expect to be.

I don't expect to ever be pregnant either!
The difference being that I'm female thus I am able to be in that state :P But hey, you could also have a girlfriend/wife that gets pregnant and thus you would be interested (and judging by some tv shows/movies 'pregnant' as in you and your partner).

Anatidae V

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Re: Aussies: private or public health cover for giving birth?
« Reply #6 on: February 18, 2015, 02:34:08 AM »
I'm glad you asked this one :) I haven't been game to ask my family yet, because it's easier to talk about this on a forum that with them... But I have a friend or two who gave birth last year that I'm seeing in a week's time, so I'll let you know their thoughts. I am also asking my GP his thoughts sometime in the next fortnight, which will be informative.

marty998

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Re: Aussies: private or public health cover for giving birth?
« Reply #7 on: February 18, 2015, 02:43:07 AM »
Disclaimer: I've never been pregnant and don't expect to be.

I don't expect to ever be pregnant either!
The difference being that I'm female thus I am able to be in that state :P But hey, you could also have a girlfriend/wife that gets pregnant and thus you would be interested (and judging by some tv shows/movies 'pregnant' as in you and your partner).

:P

"We're pregnant" is such a silly phrase. Yes I know you (the guy) had your 30 seconds of fun. Now stop pretending pregnancy is an equal imposition on you LOL.

happy

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Re: Aussies: private or public health cover for giving birth?
« Reply #8 on: February 18, 2015, 03:06:29 AM »
Its 2 decades ago and things have changed a bit, but I went private because it was already included in my cover at no extra cost, I was in my late thirties and had 2 high risk pregnancies, I wanted my FEMALE obstetrician, and I had access to a large exceptionally well equipped private hospital.

The decision is a very personal one, and  your choice may vary depending on the facilities in your area as well as your personal preferences. Things to consider/find out about:
- are you likely to be a high or low risk case
- what does your local public and private facility provide and how big are they ( best to go to a  big comprehensive service)
- do you want your baby delivered by a midwife or an obstetrician?
- what are your views on natural childbirth and what can you access and how
- if there is a problem for you or your baby what facilities/specialists are on site that can be accessed quickly. ( obstetrics/anaesthetics/paediatrics)
- if you went private in a public hospital what benefit would that provide you ( it might not be much)


HappierAtHome

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Re: Aussies: private or public health cover for giving birth?
« Reply #9 on: February 18, 2015, 03:07:34 AM »
Disclaimer: I've never been pregnant and don't expect to be.

I don't expect to ever be pregnant either!
The difference being that I'm female thus I am able to be in that state :P But hey, you could also have a girlfriend/wife that gets pregnant and thus you would be interested (and judging by some tv shows/movies 'pregnant' as in you and your partner).

:P

"We're pregnant" is such a silly phrase. Yes I know you (the guy) had your 30 seconds of fun. Now stop pretending pregnancy is an equal imposition on you LOL.

30 seconds?!

HappierAtHome

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Re: Aussies: private or public health cover for giving birth?
« Reply #10 on: February 18, 2015, 03:23:11 AM »
Thanks for all the interesting replies! And Marty's worrying one :-P

My decision is definitely being shaped by knowing that I would be at the dedicated maternity hospital (anatidaev, you can look up online the postcodes for the different hospital catchments).

I don't have any (known) issues with the plumbing, so I don't have an OB/GYN already and have no objections to midwives delivering my hypothetical babies.

orangestreet

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Re: Aussies: private or public health cover for giving birth?
« Reply #11 on: February 18, 2015, 03:47:46 AM »
We went with a public hospital and could not have been happier. Cost $20 (from memory ) and we got a hug and kiss from the fantastic midwife team on our way out. We also had a private room but that might have been the case because the delivery turned out to be more complicated and turned out to be a cesarian. 


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pancakes

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Re: Aussies: private or public health cover for giving birth?
« Reply #12 on: February 18, 2015, 03:49:58 AM »
Thanks also from me for starting this topic.

My private health insurance is paid for by a family member who insists that I have it and my cover includes giving birth in a private hospital, though I imagine I'd still be out of pocket some but I don't really know what to expect.

Interestingly when I last called my health insurer they tried very hard to get me to downgrade my level of insurance to remove maternity cover. They insisted that if I do have a baby that the public system is just as good. It was really a strange conversation but I suppose I'm probably in a high risk bracket for pregnancy and they'd prefer not to pay out.

Anatidae V

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Re: Aussies: private or public health cover for giving birth?
« Reply #13 on: February 18, 2015, 06:47:55 AM »
What about antenatal and post natal care? Has anyone had experiences with those that were different in the public or private, whether that was the facilities available or it being covered or not by insurance?

Disclaimer: I've never been pregnant and don't expect to be.

I don't expect to ever be pregnant either!
The difference being that I'm female thus I am able to be in that state :P But hey, you could also have a girlfriend/wife that gets pregnant and thus you would be interested (and judging by some tv shows/movies 'pregnant' as in you and your partner).

:P

"We're pregnant" is such a silly phrase. Yes I know you (the guy) had your 30 seconds of fun. Now stop pretending pregnancy is an equal imposition on you LOL.

30 seconds?!
I am also concerned by this terribly small amount of time. If we're including warm up time the fun should be measured in hours...
« Last Edit: February 18, 2015, 06:49:48 AM by anatidaev »

happy

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Re: Aussies: private or public health cover for giving birth?
« Reply #14 on: February 18, 2015, 12:31:38 PM »
My obstetrician charged a flat fee per confinement.  All antenatal and post natal care was included, and it was the same fee whether a vaginal delivery or a C-section. The antenatal visits were frustrating since there was always a long waiting time for a short visit. If someone was delivering you just had to sit and wait til she got back. Since I expected her at my delivery I thought this was reasonable enough. The point I'm making is that the wait time was not short, and probably the same as attending a public antenatal clinic.

MsRichLife

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Re: Aussies: private or public health cover for giving birth?
« Reply #15 on: February 20, 2015, 12:38:42 AM »
In my ideal world I wanted to go public with a midwife service. I had an idealised notion that I would have a low risk pregnancy and do the whole thing as natural as possible. The statistics on private were a little alarming in terms of the number of pregnancies that end in intervention and c-sections etc. However that may be a function of the women choosing to go private (i.e. more financially well off aka 'older')

When it came down to it, I had little choice to go private. Work paid the bills and I had no choice but to go private. In the end that turned out to be a good thing for me. As an 'older' mother I ended up being one of those statistics whose pregnancy ended in c-section. I had one glorious week post-partum in a private double room overlooking mountains with balloons floating through the sky with the most awesome midwives. I truly felt well looked after.

However, I wouldn't have wanted to pay the bills myself. Even with private health cover, the bills are huge! Also, if I'd had low risk pregnancy I wouldn't have got my money's worth, so to speak. Even in Private if you have a vaginal birth you are out of the hosptial pretty quickly. In addition, the private hospital was not set up to deal with all neo-natal needs, so if my son needed assistance, he may have been transferred. That would be awful not being in the same hospital.

If I were young and healthy, and my pregnancy was low risk I'd certainly go public. Having said that, my friend was exceptionally high risk and she also went public because the specialist (best in the region) only worked through that specialist maternity hospital.

Nudelkopf

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Re: Aussies: private or public health cover for giving birth?
« Reply #16 on: February 20, 2015, 02:04:20 AM »
Well, there's no public hospital in my city... So, if I was pregnant in my current city (town?) then I wouldn't bother with private health.

And I think the only private midwife service in town is for Aboriginal or Torres Strait Islander babies anyway, and I assume that my baby will be not... Is that racist? I just assume I'm going to marry a white person. I kinda want kids with blue eyes. Wow, is that really racist? I've got blue eyes... I want my kids to have blue eyes...

travelbug

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Re: Aussies: private or public health cover for giving birth?
« Reply #17 on: February 20, 2015, 03:07:23 AM »
I have had two children, the first one I went public, the second private.

For me it would depend on where I lived. In a capital city or large city with large hospitals I would go public. If you are in a small town I would either go private or have the baby in a larger city.

I am a bit biased though as my first child was a horrible birth that had her in intensive care for 5 weeks and me there for 5 days, separated in two cities as where i birthed her could not keep her alive. The public system was ok, but saved her life once she was choppered out to a major children's hospital at 6 hours old. I could not fault them. The midwives at my birth, however, were average. But that could happen anywhere, depending on the shift.

The second baby was an elective caesar as I was not risking anything. I wanted to choose my own surgeon for that so we went private.

I hate hospitals and wanted out asap both times.

We are blessed in Australia that we have great hospitals and wonderful amazing medical teams available to us for free. The private system cost a bomb out of pocket, but was worth it for peace of mind for us the second time.

Again, for me it comes down to location.




agent_clone

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Re: Aussies: private or public health cover for giving birth?
« Reply #18 on: February 20, 2015, 05:58:12 AM »
And I think the only private midwife service in town is for Aboriginal or Torres Strait Islander babies anyway, and I assume that my baby will be not... Is that racist?
I don't think it's racist.  I think everyone has their own preferences for looks and personality.  Race just happens to be a factor in the looks part.  I think where racism plays a part is for example if you had a problem with a caucasian person being with an Aboriginal/Torres Strait Islander.
« Last Edit: February 20, 2015, 06:00:54 AM by agent_clone »

Sunnymo

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Re: Aussies: private or public health cover for giving birth?
« Reply #19 on: February 20, 2015, 06:32:39 AM »
Private, no question.

My husband and I have had fertility issues and have gone through six rounds of IVF (thank you Medicare). My fertility specialist is also an OB/GYN and we would like the continuity of care. Also, the hospital he delivers at is the closest one to home.

Having said that the last IVF cycle ended in a miscarriage at nine weeks and an overnight stay in public hospital after presenting at the emergency department. There was little to fault about the care I received and the nurses were very kind, spending extra time with me and arranging a social worker visit.

This is the hospital that, if there were any complications the baby would be transferred to. Having had that experience I am more comfortable with how the baby would be cared for than if I had not gone through that experience.

On the other hand my friend is currently expecting no 2 and is going public. She did with her first and was happy with the management of the pregnancy and the care they received during delivery and the hospital stay.

EngineerMum

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Re: Aussies: private or public health cover for giving birth?
« Reply #20 on: February 22, 2015, 09:51:14 PM »
PUBLIC! PUBLIC! PUBLIC!

I actually did have private insurance that covered maternity, and chose to go public anyway. I have a pre-existing condition and my (illness) specialist wanted me to have access to a particular obs, who works both private and public. However, the private hosp he works at would have been about 45 mins away in no traffic, the public was about 5, and we didn't want me going into labour on the freeway in rush hour. Also, even with top insurance (which we had) the out of pocket is upwards of $5k, in my mothers group most paid between $5k and $10k for their private hospital. That would pay for a LOT of nice food to be brought - and the food was literally the only thing I could see that they (and other friends / family who have gone private) had any better than me. Oh, and my husband couldn't stay in my (single) room with me.
I did have complications and it was managed expertly, and without a C-section, which I was very strongly against if I didn't have to, as they can be problematic with my medical condition. Whereas just about every woman I know who went private had a C-section, the public system has a MUCH lower rate, which is still quite high by world standard.

Ante- and Post-natal - I paid $5 total for the following: early pregnancy info session, 7 ante-natal evening sessions with partner covering breastfeeding, bathing, normal births, possible complications, anaesthesia, exercises, contraception and sex post birth, mastitis, introducing solids, bottle feeding, and so on, ante-natal physiotherapy, post-natal physio, baby massage (that's what cost $5), info sessions on various baby things post natal, 1 on 1 breastfeeding assistance, treatment of mastitis, flu vaccination, fitting of an implanon after birth, home visits from midwife for 5 days post birth... I think that's it. I could have also done a new mum pilates class but didn't get myself organised to do it. Yes, you can tell it's public by the rubbish tea and biscuits at the info sessions, but the staff have identical training and are universally excellent. I paid for one ultrasound before my hospital referral was sorted, that cost more than everything else put together, at about $250.

Some things I learnt about after the event - such as I could have requested a trainee midwife to go through the process with me, as they need to do this with a certain number of women there are plenty to go around, and they appreciate you letting them be there, and it's a familiar face through the whole thing. I just saw whoever was there at the time, for antenatal check-ups and during the event. I think that's a gamble regardless, as even private they don't guarantee you will actually get the person you've been seeing or your nominated obs.
In a perfect world I would have gone to the family birth centre at KEMH, but it's for low risk people so I wasn't eligible, but what I like about it is that it's just a few hundred metres from the hospital so if anything goes wrong, you are in the best place you could be within seconds.
If I do want to have another baby in the future, I will get top private health again, but purely in case we need assisted reproductive services, I'd go public hospital for the birth again.

JetsettingWelfareMom

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Re: Aussies: private or public health cover for giving birth?
« Reply #21 on: February 22, 2015, 11:21:07 PM »
Depends on all kinds of factors--your age, pregnancy risk, rapport with a doctor/midwife and most of all what you feel. I don't think I needed a C-section on my second baby but I felt pressured into it after a short labor mostly because it was convenient for the doctor and I'd already had one and had been reminded 30 times how I'd been allowed by them to progress in labor even though it was dangerous. Even my first baby C-section was probably caused in part by the labor induction, which had been pressured on me because I was 42 weeks along and no baby. If I had it all to do over again, I'd go midwife. Hard to say sometimes if all these medical interventions solve problems or create them! :-P

HappierAtHome

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Re: Aussies: private or public health cover for giving birth?
« Reply #22 on: March 16, 2015, 12:02:17 AM »
So in case anyone was interested in where I ended up on this issue (probably not?):

I had an opportunity to chat with an OB who specialises in treating women with auto-immune diseases (a sort of extended family member - who I didn't know specialised in my condition until this conversation!).

She said that if I didn't have an auto-immune disease, she would encourage me to go public as that's a perfectly sound option with a high standard of care. But that because of my specific illness, continuity of care (i.e. one OB overseeing my entire pregnancy) will be important, so she would recommend going private through an OB, but delivering privately at my local -awesome- public hospital as that's got a high standard of care and combined with having my own OB, will be the best of all possible worlds.

So there you go. I'll be upping my private health cover to include maternity stuff, and paying more out of pocket, but I feel confident about it being the right choice for my specific medical issues.

Other girls with medical complications who are thinking of getting pregnant at some point - OBs can do 'pre conception consultations' where you learn how best to proceed for your own health issues.

happy

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Re: Aussies: private or public health cover for giving birth?
« Reply #23 on: March 16, 2015, 02:36:49 AM »
Thanks for updating, always of interest.

JLR

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Re: Aussies: private or public health cover for giving birth?
« Reply #24 on: March 16, 2015, 05:39:55 AM »
I'm glad to hear you've figured out what you want to do. It can be difficult to decide, and often you don't know the best option until it has already all happened!

We went public with all three of our kids. For the first we were living in a regional city which has a major referral hospital. They have a separate 'birth centre' in the hospital for if you are hoping for a 'low-intervention' birth. We chose to go there. No out-of-pocket for any of my antenatal visits, birthing and baby classes, when I visited the hospital for monitoring on my due date for a pregnancy-related condition, a private room following the birth (where my husband was able to stay the night), and 5 days of nurses visiting me at home following the birth.

With our second we were living in a small, country town. Went to the nearest hospital with a maternity department. Public again, so no charges. I like to head home quickly after the birth, so no overnight stay with this one. Had him in the morning, then asked to head home at lunch time after we'd had a nap. My husband and our toddler stayed with me the whole time I was in the hospital. They set up a second bed in my private room for them. Actually, I was the only patient in the whole ward. They re-opened the ward just so I could come in and give birth and would have loved for me to stay for 5-7 days. They made me promise to not let word get out that I had gone home so quickly, as more women might get the same idea and then they would have fewer babies to play with and spoil! :)

Third child we went to a different public hospital in a rural area. Got the room that private patients usually get - no cost. It had it's own lounge room with a sofa bed, so after our son was born that night my husband and our two young children stayed at the hospital with me and our new baby. It was too late for all of us to drive home once our mandatory 4 hours at the hospital post-birth was up, so we went home the following morning.

Overall, public was a good experience for our births. There were two 'nasty' midwives out of about 12 midwives that took care of us for the three labours. I think that could have also happened if we had gone private. :)