Anyone had a high(ish) risk pregnancy in the public health system in Australia?

[Ozziegirly]

I had my DS through the private system. It was a totally normal pregnancy until I got gestational diabetes. Before I got the GD I was pondering why I had bothered to go private as although it was nice to see my obstetrician, it kind of felt a waste when everything was so normal, and I was paying $1500 for the benefit!

However, when I got the GD it was handy to be able to book in appointments with the endocrinologist at my convenience, and the birth in the private hospital was great with my own room, bathroom and my obstetrician did my EMCS.

So, we're now thinking about number 2, and as it's fairly likely I will get GD again, and therefore probably have an ELCS, I wondered if anyone had been in that position in the public system?

Did you feel that you were able to choose an ELCS or were you pushed towards vbac? What was the room like after a CS? Did you have to share? How were appointments with specialists managed, and did you have an obstetrician, or did you have a selection of midwives?

Any info would be great.

I'm in Sydney but I suspect it would be similar anywhere.

Thanks in advance.

I have just had my daughter in the public system. All my appointments were more or less at my convenience - sometimes I was told a day but then could choose a time etc ...

I had a ELCS - as I have had 2 previous C/S there was no pushing towards VBAC although they did offer it if I wanted to try, I declined.

I had to share a 4 bedroomed ward - don't know if there were singles didn't ask. We closed curtains at night / during visiting. Otherwise it was quite nice to chat to the other mums.

During the pregnancy I saw 2 midwives (both Irish funnily enough!) So got to know them. In the last few weeks saw the consultant every time ...

Hope that helps.

I am on the Central Coast so not too far from Sydney.

Thank you Bonza, that's really helpful (I love the Central Coast, we were at Umina Beach this weekend).

The main thing for me is that I am totally happy with an ELCS and don't want to be pushed for a vbac (although I would give it a go if it happened naturally - but I would never be induced again, although I think you can't be if you've had a CS)

I did like having my own room as my DH would come up and take DS out for a long walk and I would have a sleep. TBH, I would happily pay for the room, but have "public" Drs, if that was an option.

Thanks again, really useful info.

Hi there Ozziegirly

I had dd2 in the Australian public system, which although wasn't a high risk pregnancy I was very very old so required a bit more monitoring than some elastic 20 yr old

I had a great experience, I had an obstetrician who looked after me throughout the pregnancy, I can't remember any problem with appointments. I had an elcs, although I was keen to try for a vbac it didn't work out that way. If anything I was encouraged to go for a cs (first baby emerg cs). I had a room all to myself in a lovely cottage hospital and I wanted to stay there FOREVER. In fact I'd go back now just for a lovely rest if I could. The midwives were all wonderful and it was a very happy experience. I really don't think I would have been given better care if I'd paid for a swanky private hospital.

Re getting your own room, check what the local hospitals policy is. In the UK I paid 50 quid a night to sleep in a private room but here it was provided.

Good luck, how old is ds now??

I had DS1 & DS2 using the public health system here in a public hospital and couldn't recommend it highly enough.

I am now expecting DC4 in 2 wks and am looking forward to going back to the hospital for a rest!!

The hospital has a midwife unit so most appointments are with midwives but several are with the obstetrician who leads the team. All of the cost of appointments is covered by medicare, I have only had to pay for 2 scans and they were part covered by Medicare, a total of about $150.

The hospital is great as it is about 10mins from home, DH is allowed to stay and during the past 2 births I have never had to share a room. The visiting times are pretty relaxed and they aren't bothered by my DC visiting.

I am in Melbourne but I am sure there must be other hospital which run similar units near you, maybe you should call around. I would imagine that there are plenty of high risk pregnancies which are managed just fine by the midwife teams. The only thing I would suggest is that you get in sooner rather than later, at my hospital if you haven't registered by about 8wks you may miss out on a place.

Good luck!!

The one thing I would never ever do in the private system is have a baby!

I am a high risk during pregnancy. DD1 I had an APH at 23 weeks.
Ds had hydrocephalus and was macrosomic, and was a cat 1 lscs on delivery
DD2 I had labile bp and she was breach.. ELSCS although I dearly wanted a vbac!

The private system lacks so many things in obstetrics and is greatky money driven. Most private hospiatls do not have a NICU or SCBU poor emeregency teams and agency midwives. The prouvate obs teams are dr lead and ensure that pregnancy is a mecial matter. Its none of my business why you had a lSCS or dont want a VBAC, however a system that doesnt encourage you to avoid major surgery is not doing its job! There is no policy that says you cannot have another lscs however they should encourage you not to.

With all my babies I recieved amazing cares! Scans as needed, bloods as needed, MRI's, obs involvement when needed and midwives when it wasnt!

My own room with the last one and a shared room with the first two. But after all its only a couple of days and its not like sleep is happening! and the support can be great!

Depending on your risk factors you may not get GD again.. and its a pretty soft one for high risk, generally. So it should need minimal obs involvement.

Im also amazed you needed an endocrinologist! There should be diabetes nurses to see who are specialst , normal nurse consultants who mange ladies with GD. Normally they are on the same clinic day as the midwife / obs that you see so its only one visit.

I had a crash section in the UK with dd1 & asked for a section here in SA. They were very obliging. More than happy to do it this way. I toyed with the idea of a VBAC & was told that I could change my mind up to a certain date, but I changed it within a week, tbh. I had PE with dd1 & they took great care of me here, I was consultant led, so all appointments had to be at the hosp.

I also had my own room, the hospital I had dd2 at have so many single rooms (bathroom, room for an extra single bed if dh wanted to stay), usually on a first come, first served basis. The rest were 2 beds to a cubicle.

Having a latex allergy, they made sure I had my own room from the off, and cleared out any latex products etc. And I was first in on the day of my section.

I agree with Chloe, re private not having the equipment in some cases.

When I went for my first appointment, they explained the difference between private & public. We were pre-empting problems due to my previous PE with dd1 & her induction led to her becoming v distressed! (She was 4lb when born & spent 72 hours in SCBU in the UK). They said if I decided on private, they had no SCBU, so baby would have to be transferred, but I would have to stay at the private hospital, esp if section.

I had DC2 in the Australian public system. It was almost miraculously good.

Obstetrician simply asked what sort of birth I wanted (DC1 had been c-section) and when I said ELCS, wrote it on my form and that was that. I am sure I could have asked for a VBAC or discussed the merits, but I was fine with my decision.

Appointments were pretty much at my convenience, and I had a week in a private room to recover. Even the food was good.

Midwives were great and VERY on-the-ball about everything, from breastfeeding to postpartum infection signs. Never got the sense that they were too busy to help - one came to take crying baby from me in the middle of the night to give me a chance to compose myself, and I found her sitting later at the midwives' station patting and rocking DC2 and listening to Coltrane. It was more like a celebrity rehab centre than a hospital!

Then I walked out the door with the midwives waving and the baby in my arms, without having paid a cent.

Honestly, the only way it could have been better would be if one of the nurses had brought me a glass of champagne at 7 o'clock every evening.

I watch One Born Every Minute, and to tell you the truth, it looks like a third-world hospital beside a big Australian hospital.

I say this as someone who gave birth to DC1 in the third world.

Ninedragons, I see your lovely nurse rocking dc2 and raise you a lovely midwife GIVING ME A POST BIRTH FOOT AND LEG MASSAGE in the Aus public hosp system FOR FREE! It was the single nicest thing anyone did for me and my apparently elephantine swollen (c)ankles .

Seriously Ozzie, having a baby in the public system here is (in my limited experience admitedly) a wonderful experience compared to the uk.