Planning for a Child - Private or Public Hospital?

Hey all,

The wife and I are planning on trying to have a baby next year. We do not have private health but are debating whether or not it is worth getting it primarily for her pregnancy and it's related appointments etc.

So basically we are wondering whether it is better to go private or public and what the pros/cons are for each.

From what I have heard from friends/family, private allows for more consistency and continuity of care with specialists etc. which imo is enough to justify going private.

Any tips or recommendations are much appreciated!

We are in Adelaide

Comments

  • +5 votes

    Have had 3 kids, all public. Their mum got her own room all 3 times.
    First baby came early at 26 weeks and passed away after 22 days. The hospital NICU did everything possible (I believe) for our daughter.

    No experience with private so can't compare but we were perfectly happy with the public system

    • +3 votes

      I'm sorry you had to go through that :(

      Thanks for the reply! I have heard that in the case of an emergency the public system will be utilised anyway.

      Thanks again

    •  

      That's very sad, sorry to hear.
      How do you ever manage to come back from that?

      • +2 votes

        You manage, you have to

        Though we separated for a bit a few months later, got back together, then separated for good about 6yrs later

  •  

    Hi,

    My wife is currently pregnant and although we have private medical - we will still be out of pocket between like $3000-$5000.
    We could go full public, but as my wife doesn't want cesarean and the intervention rates at hospitals are like almost 50-50 … we are doing a shared care option. Basically we are in public system, seeing midwife up until 35 weeks. then she will deliver the baby in private hospital, having OBS there and private covers the stay there. After birth we will be back and cared for by midwife. Basically trying to get best of both sides.

    •  

      Ok that's another option too, thanks! Good luck with it all :)

    •  

      Cranzy, can I ask how much it would cost you in total if you didn't have private health insurance?

    • +1 vote

      Remember that cesarians are sometimes medically necessary. My daughter would have died without one.

    •  

      I didn't even know this was an option.

    • +1 vote

      Bear in mind that cesarean rates in private hospitals are about twice the rate of that in public. Especially if it's late on a Friday. Those Private OBGYNs don't wanna miss their golfing tournament!
      https://theconversation.com/private-hospitals-health-insuran...
      http://bmjopen.bmj.com/content/2/5/e001723.full

      •  

        Yeah I wonder where did crazy pull that 50-50 from. From economics perspective the public system will do their best to keep caesarian at the lowest possible so there's no way they're gonna do it unless absolutely necessary. A caesarean would mean they need a bunch of specialist, double length of stay and many other.

  • +5 votes

    We do not have private health

    There is a 12 month waiting period for maternity cover. Have you factored this in?

    •  

      Ah ok no I wasn't aware, thanks!

      • +2 votes

        Plenty of 'practice' time.

        •  

          haha ;)

        •  

          @Heracles26:
          FYI, it's 12 months until you can give birth to be covered, so you buy insurance and wait 3 months before trying. As long as the baby's due date is after the 12 month waiting period, the birth is covered.

        •  

          @joqob:

          Thanks!

      •  

        And only one of you needs it, no point adding it to a couples policy.

  •  

    We are 18 weeks ATM and have opted for pubic hospital.

    I am in the New England region and the local health service offers options for care to be shared between OB and midwifery unit as you see fit as well as other birthing options for indigenous people.

    We looked at Private, but in reality it is a waste of money for where we live, seeing as you will receive virtually the same care.

    •  

      Thank you for the reply and hope it all goes well :)

  •  

    See ihbh comment above. Ive seen couples get private cover and not be covered for pregnancy.

    But check with provider how they work, eg you may be able to get cover 3 months before falling pregnNt and with the 9 months pregnancy meet the requirements.

    The main benefit is continuity of care, as you'll see the same OBS for the whole time and they will have a complete history which is better than having scattered coverage. Especially important if there are any issues that need a complete history to pick up more easily. Essentially its extra insurance

  • +2 votes

    Pro's of private
    You can choose your specialist and ensure that they will be the ones who deliver your child
    You can guarantee you will have a doctor deliver your baby, not a midwife (Not a knock against midwives, but some people prefer doctors, the reverse is also true)
    No training midwives or training doctors will be doing the delivery (it is possible that the doctor in the public system who is delivering your child will be doing it for the first time).
    You will have the option of having a elective cesarean delivery, it dosnt have to be medically indicated.

    Con's
    It will cost more (can be quite expensive)
    The nursing and aftercare arnt necessarily better - its not a matter of paying more = better treatment
    You dont have a choice of natural delivery vs cesarean, cesarean only happen publicly when medically indicated.
    Cesarean rates are higher in the private system (provided you want to go natural)
    Continuity of care regarding specialists/midwives (if you have a long natural delivery publicly you will change midwives a couple times, if you have a long natural delivery in Private your obstetrician will be on call for the entirety of it and will be present when the delivery takes place)

    • +5 votes

      There are no guarantees that an obstetrician will a) get there on time or b) not be on holidays.
      A close friend had her obstetrician not be in the country for birth #1 (baby was 3 weeks early) and then for birth #2 the obstetrician didn't make it to the hospital in time, and the midwives safely delivered her little girl.

      If there are no complications, either system will be fine - you're just paying extra in the private system for a few more nights in hospital. Book yourself a hotel room if that's a priority (and, several maternity units in Melbourne now offer that as an option with private care…)
      If there are serious complications, you will just be returned to the public system. It just depends how much you want to pay for the experience - intervention rates are much higher with an OB (who may want to speed things up so they can get home) than with a midwife/OBs on call if needed.

      And 'training midwives' and 'training doctors'??? Seriously? The hospital system doesn't just let anyone in and say go for it…! If a doctor was attending their first delivery they would be supervised by a highly trained doctor.

      •  

        Thanks for the response!

      •  

        More like less experienced staff in public compared to private.

    •  

      Thanks for the reply! I am leaning towards public now I think

  •  

    I didn t have medicare or private health when i got my daughter so have to pay everything from our pocket. Basically, private and public offered the same service and you will definetely have the same level of care no matter what you choose. When we start asking for price, it was actually similar for me. So what make up my mind was actually the neonatal services offer by both etablishment. When the private hospital told me that if something goes wrong with my baby, she or he will be tranfer to the public hospital without me. I know that i wouldn t like it and choose public from start to end. Never did i regret it. My daughter ended up coming way too early and i have the most amazing care i could hope for. I was a first time mum and the support i ve got along my pregnancy to the birth has been quite helpfull. Esp, when midwives are taking time to listen and reassure you. So, my advice is go with the team and hospital that you feel the most comfortable as i guess it depends on the area you are. Good luck!

  •  

    We did private for two kids. You tend to be looked upon as a cash cow for the hospital so there will still be a gap of stuff you have to pay afterwards. There is no guarantee you will get a private room - or even be in the private wing of the hospital - due to demand. The dr you chose might be away, sick, asleep etc.

    If the baby (heaven forbid) needs any intensive care DO NOT give them your private health insurance details as that can be a huge gap payment too. You don't care who the dr is in intensive care and there are no special treatment for private (apart from the extra bills). They gave us a sob story about how I shouldn't put a burden on the hospital system by not going private.

    •  

      Thanks for the reply and the tips!

  • +1 vote

    We have private health insurance and chose to go public.
    Had my daughter at RPA in Sydney (we live walking distance)

    Everything that could go wrong went wrong, and the midwives, anesthetist and NICU were fantastic.

    Cesarean section is not a "choice" it's a life saving tool.

    "choosing" to go "natural" is great, but if they say you're having a C-section, guess what? You're having a C-section.

    It's not a bad word mate, and as someone said, private Obs is a lot of money spent for nothing.

    The midwives are awesome.

    •  

      Never even thought about natural vs C-section, it's not something we are factoring into the decision.

      Whatever happens, happens. If it's all natural that's great but if a C-section is warranted then so be it

  • +5 votes

    What has your wife decided to do?
    As that is probably what you are doing :)

    • +2 votes

      Smart man ;)

  •  

    We've had 2 public births at 2 different hospitals:

    1st child: Different midwife and obstetrician every visit (which would good, coz a random one caught out he was breech).
    2nd child: Same midwife whole way through and usually same obstetrician (harder to make appointments as you had to choose a time that your midwife had available).

    All midwives were amazing and I can't think paying for the hospital would have got any lovelier help.
    Both private rooms with about 3 nights' stay after caesarean section.

    •  

      Thanks for the reply, sounds like it all went smoothly in both instances!

  •  

    I think you'll find that in an event of any emergencies, in most cases you'll be sent to a public hospital anyway who are prepared to deal with them.

    One major advantage of private care are the check ups. You can expect to wait hours at a public hospital.

    •  

      Really? I didn't even think about wait times. That in itself is almost enough to make me choose private! haha

  •  

    If comfort after giving birth is the utmost importance for both of you, you might have to go to private.
    Depending on the busyness and your wife’s condition after birth, it is a possibility to have a room with 4 patients in it.

    My wife has just given birth in public about 5 weeks ago, we can’t really complain. The care that the midwife was outstanding. The midwife did a home visit twice, one of which was on Sunday.
    And we didn’t have to pay at all, apart from the parking tickets which could be expensive depending on where the hospital is, but that’s a different matter altogether.

    •  

      Thanks for the response and congrats! :)

      So even in a private hospital a private room isn't guaranteed?

      •  

        Sorry, what I meant was, in public you could get in a room with 4 patients in it.

        In private, i assume you would get a private room, and thus i mentioned that if comfort is very important for you, you should consider going to private, not public

  •  

    As long as you don't get this lady, you'll be fine…

    https://honey.nine.com.au/2018/06/06/11/49/vaishnavy-vilvana...

    But seriously, wife was adamant she was going private for our 1st, but after some research into the nearby public hospital facilities and staff on forums, she completely backflipped (I was so happy being the tightass I am).

    Midwives are the unsung heroes. The doc we had was a young female with zero bedside manner. Wife did not like her at all.

    Recommend doing the 2 day calmbirth course if you can afford that though (we did get some of that back through PHI actually), very informative for you and partner. I found it a bit "hippie", but wife really believed in it (and she was reassured that I knew stuff too), a lot of it is about trusting the female body and visualisation/meditation/breathing techniques etc

    See my previous rant: https://www.ozbargain.com.au/comment/4507143/redir

    •  

      Oh wow how traumatic! :(

      Thanks for the tips!

  •  

    People getting private room in public is rare and not guaranteed.
    Private rooms are all single to my knowledge and some private hospitals have larger double sized beds and better places for partner to stay over night with bub.
    Midwife/Doc care should all be similar across both. But I've heard in public they are possibly moving to quicker discharge from hospital eg 1 day or less for natural birth with a followup at home instead.

    There is a lot of out of pocket expenses in private that are free for public.

    You should do some research on what public hospital catchment you are in and see what people say about those hospitals to help you decide as some public hospital may not be as good as others.

  •  

    Everyone is different.
    Some prefer private, others public.
    As OP is the husband he should ask the wife what she wants
    Furthermore every health insurnace policy is different.
    As OP is having kids it would be very wise to have family health insurnace from day 1 anyway.
    And health insurance costs increase as one gets older too.
    Therein lies the answer.

    •  

      Good points thanks!

  •  

    We've done both. Private for our 1st 2 then public for the 3rd. I remember private costing a lot more out of pocket.

    Look and ask around about the public hospitals that you're likely to go to and see what people say. In our area the public hospital had mostly positive feedback and in our experience both public and private were comparable.

    •  

      Will ask around and do a bit of research thanks!

  • +1 vote

    We went private for our 3 kids. We had the same Ob in the same hospital each time. The hospital ran prenatal classes which were very helpful. They also had post birth physio classes for Mums who needed it.
    We had large, private rooms with double beds so the husbands could stay as well if they wanted to. The meals were lovely and so not like ‘hospital food’.
    The midwives were excellent and they taught us how to look after a new born. Lactation consultants were readily available if required. We were able to stay 5 nights after each birth so we went home rested and comfortable with coping with a new born.

    Overall, yes, it was expensive. The out of pocket for each birth ran in to the several thousands. Money well spent in my opinion.

    One final thing, if an epidural is offered, consider taking it. Our first 2 kids, I didn’t have an epidural. Third child, I did. Much more pleasant. Natural childbirth hurts. With an epidural it doesn’t.

    •  

      Thank you for all the advice!

  •  

    Private and we didn't regret it, we heard too many public horror stories from friends that convinced us otherwise.
    That is not to say you can't have a good public hospital experience.

  •  

    Just to add my 2c, I went private for all my pregnancies. The 1st one unfortunately was an early miscarriage which required surgery, my private obstetrician booked me in immediately to get taken care of. I had friends go through the same thing on the public system who were left for hours in A&E (because it wasn't a life-threatening emergency for the mother) and were then just told to go home to let nature take it's course which was a far more distressing experience imho.

    Anyway, onto happier times, I used the same obstetrician for my 2 successful pregnancies and I would 100% do the same thing again. My first child had to be induced as he was 'over-cooked', I was able to have him at 40 weeks and 5 days (public system would have made me wait for spontaneous labour or until 42 weeks). The birth was fairly traumatic but the doctor did a fantastic job of patching me up afterwards.
    The second birth was also induced, this time at 38 weeks because he was BIG. Again, I would have had to wait in the public system and risk birth complications due to his size - as it was, even at 38 weeks he got stuck and had to be delivered by caesarean. He ended up in the special care nursery for 48 hours, but our private health insurance covered all that.
    All in all, we were out between $3k and $5k for each birth (on top of the year of insurance premiums) but for where we live, it was completely worth it. FYI, of the 10 mothers in my parents group, 6 out of 10 went private for their first, but 9 out of 10 went private for their second.

    •  

      OP, there is so much misinformation out there, please do your research before trusting everything on OzBargain…

      Inducing labour before the body and baby is ready can lead to a more traumatic birth, and these births have a higher rate of medical intervention - forceps, vacuum delivery, caesars, etc. If there was a medical reason your baby should have been induced any hospital would induce you. If it was just because you were uncomfortable/sick of being pregnant, a public hospital would not have risked your/baby's health by inducing you - sadly, the user pays system in private hospitals means that procedures that are not necessary are completed because the 'customer' wants them.

      If a baby was identified as being large in regular check ups, private OR public, an appropriate plan would be devised - the public system would certainly not have just let you wait and see what happens and risk issues! You would have been induced or a caesar would have been scheduled; the medical professionals would have decided on this based on the risk to you and the child.

      •  

        Obviously OzBargain isn't the appropriate medium to discuss in-depth medical topics whilst keeping posts informative and easily read, however in my above examples, induction was indicated by low amniotic fluid levels (detected during weekly ultrasound) and the favorable birth outcomes for an induction between 40 and 41 weeks vs expectant management for neonatal morbidity in uncomplicated pregnancies (despite this research now being peer reviewed and publicly available, many doctors still stick to the 42 week deadline). I am not aware (but nor am I am 100% certain) that the issues leading to my inductions would have been detected in the public system as they were a direct result of my private obstetrician performing weekly ultrasounds in the later stages of my pregnancies.
        In any case, it's impossible to say 100% either way what would or wouldn't have happened if the situation was different but you're right, OP should do research (or his wife should) until they're happy with the decisions they make based on the complete knowledge of their particular situation.

  •  

    Just remembered, one of the most important thing for me about going private was that my obstetrician had an ultrasound machine in her room. So every time I went in for a check up, we were able to see the baby, check the growth and heart rate etc. After previously miscarrying, being able to see the baby was healthy every visit was a great comfort.

  •  

    We've gone public twice now even though we have private health insurance. In WA, you can get public midwifery care through the Community Midwifery Program or the Family Birth Centre, which is next to the maternity hospital here.
    Community Midwifery Program gives you one midwife for appointments and if your midwife is not available, there's only 3 others in each designated group that would be at your appointments/birth. Family Birth Centre care has groups of midwives too. So you end up meeting most of them before the birth.
    We use the Community Midwifery Program but with birth at the birth centre, as CMP does a few home visits as appointments. Especially afterwards - the extra home appointments when you're sore…
    It turned out so well for quite a few reasons that we definitely went with them the second time:
    - Only out of pocket costs were the typical pathology and ultrasound gaps.
    - Extra home visits before birth picked up sudden pre-eclampsia that happened between 2 days. Meant I got to the maternity hospital sooner so had more options. (If anything goes wrong, you go straight into the maternity hospital next door to the birth centre).
    - Everything that could have gone wrong did, but because of the early pick up and because the maternity hospital often deals with cases much worse than mine, I was able to give birth naturally as they were able to keep the complications to the point before the risks meant a caesarean was required. A close friend who works in maternity at a top private hospital here said their rule was after 24 hours, automatic caesarean is required, whereas the maternity hospital bases it on a case-by-case risk analysis.
    - Massive large birth rooms in both birth centre and maternity hospital.
    - No complaints about the obs that were allocated to me in the situation I was in; as they see much worse, they were relaxed and always explaining things. Plus it helped having the mifwife I knew there.
    - Private rooms after birth.
    - I can't sleep on hospitals for the life of me, so with both the noises and baby keeping me awake, because I had the at-home visits through the midwife group, I could go home and actually could sleep between feeds.
    - Had issues breastfeeding and the midwife at home spent time sorting it out, so didn't have to travel to lactation consultants.
    - Also had an amazing student midwife the whole time who was great support too.

    So yeah, no way I'm paying $$ out of pocket when the care I had was that great!

    Also, both my own mother and 2 friends paid for all those obs appointments out of pocket, but had complications where they had to go to the maternity hospital, so still ended up in public. So you may not get a choice!

  •  

    There is no private health cover for all the consulations prior to delivery and the costs will add up.

    We just had our second baby in a private hospital this week. Others have already pretty well covered the pros and cons so I wont go over what has already been said.

    In private you pay for everything seperately. You will be getting little bills in the mail for pharmacy, physio, pedeotrician, anasthetist etc.

    In WA in a public hospital you only stay in for 1 night after the delivery, in private its 3 night and this can be more if you ask,most private hospitals allow for a partner to stay overnight and you get a double bed or a second bed.

  • +1 vote

    I'd say go private, but my reasons are a little… unorthodox. I like Australia's public health system. But I also think the public health system is just not designed to, and not enough, to provide 100% of medical care for 100% of Australians, especially considering the amount of elective medical treatments that people will (perfectly reasonably and justifiably) also want. So I feel the public health system should be there as the safety net to cover emergencies, for those who absolutely cannot afford it, or for bare necessities, and anyone who can afford their own medical treatment should at least try to cover some of those themselves, whether though just paying (not recommended) or private health insurance.

  •  

    I went private and I’m so pleased I did notwithstanding the cost.

    My second child was complicated and my insurer ended up paying about $40k. The condition we had was extremely rare and but for the private treatment it probably wouldn’t have been picked up which would have resulted in the death of my daughter within seconds of my waters breaking.

    Also, it’s fairly routine for a public hospital to just let you keep going until you go into labour (up to about two weeks overdue) whereas with private they’ll induce you if your baby is getting too big which avoids all kinds of trouble. Downside is that often you’ll be induced on your doctor’s delivery day which kind of spoils the romance of going into labour naturally. That said, you’ll get your actual doctor.

    First bub, Private will keep you in hospital for about a week - in a room of your own - which is great for learning what you need to and having someone there to look after YOU.

    Also, planning to have a baby and actually having one are two very different matters. If you end up needing IVF then private is a no brainer.

  • +2 votes

    When it comes to obstetrics, there is always the reassurance that your doctor's are experienced to a point where they're called a "consultant". In the rare case when there is shoulder dystocia and your bub ends up with an Erb's palsy, or when your ask for an epidural and you get a post dural puncture headache, or if there is an emergency caesarean and the baby's head gets stuck resulting in delayed extraction and subsequently bub gets HIE, you will love with the regret of wondering whether having a more experienced personnel looking after bub may (or may not) have changed outcome.

  •  

    Wasn't too impressed with the private hospital when I visited my friend. She had a single room, her obs went straight to c-section and didn't even try to induce when she was a bit over. They refused to move her to a bigger single room so her husband was sleeping on the pullout couch not the double bed. Very slow in giving pain meds despite paging nurse and having the schedule written out for meds on the wall. She got to go to a hotel for a few days but really… I didn't see how it was all worth the obs fee of over $5k out of pocket not including all the other gap fees she had to pay.