LondonNurse

Epidurals and C-sections are available in Oz although I have to say in my opinion the are not always a good idea and carry their own risks.

Bear in mind that childbirth is a normal physiological process and midwives are trained in both the normal and abnormal labour. If there is any problem the midwife will refer to the on call obstetrician who will take over your care. Personally i'd go with a midwife. They generally offer better continutity of care and you're less likely to have to have an episeotomy etc... which im sure youd like to avoid.

In the UK you're likely to have a 5 day stay after a C-section as it's major abdominal surgery so i'm assuming its the same in Oz.

Also, instead of an epidural you may be offered a spinal block which works faster than an epidural and this will be administered by an anaesthesist and then you will be able to labour pain free.

Feel free to ask me any questions, as you can probably guess i'm pro-midwives but i will try and help out where i can.

lynnj

i am 31 weeks pregnant with our 3rd, i've been in WA for 3 weeks now and eventually got round to seeing the doc this week, he has referred me to the local hospital where i have an appointment for next tuesday where i will be under the care of the midwives, i still have to go to the doc every 2 weeks for an ante natal check, so far as he told me medicare pay for everything but i will be attended by whoever is on duty when i go in, just as in the uk.

He also sent me to the path lab for blood tests and a diabetes test which had never been mentioned in the uk, unfortunately this showed me to have a low red blood cell count and also that i require further tests on the diabetes, neither of these were even mentioned to me in the uk before we left, so far i am happy with the level of care here, but i will be interested to see what the hospital set up is re how long you have to stay in etc.

Give me another 8 weeks or so and i should be able to give you a first hand update.

Lynn

Kelpiegirl

Hi LondonNurse,

thanks for the information. It's very silly that I worry so much because I'm not even pregnant yet. My hubbie and I would like to have a baby soon, though, so we will start trying to get pregnant once we've moved to Brisbane and have settled in a bit.

But I think about these things regularly and since I will be in a foreign country, I have a lot of questions.

I realise there's always a risk involved with any anaesthetic, but I've heard from several women who had an epidural who were very happy with it. They said they could 'relax' a bit more and could concentrate better on what was happening and on what needed to be done.

I guess I would just like to have someone around (both during pregnancy and labour) who knows what they are doing and who can answer all my (often silly) questions. I really wouldn't want to be in labour for hours on end without any sort of anaesthetic, I would really want it to be as pain free as possible.

So, if you have a midwife helping you, does she call the anaesthesist to give you an epidural/spinal block or can you only get an anaesthetic if you have an obstetrician there?

Also, do they give you the anaesthetic fairly soon after arriving in the hospital or only at the end?

Someone mentioned on another thread you can't get a private room on public healthcare in Oz. Does that mean you don't have any privacy at all when you're in labour and you have to give birth in a room together with someone else?

How many people are usually in the room with you when you give birth?

I'm actually very scared of hospitals and doctors and all things medical...can you tell? LOL. I know it's silly, but I guess I'll have to get used to it if I want to have a baby.

I would appreciate it if you could answer some of my questions.

Thanks for your help!

Kelpiegirl

Kelpiegirl

Hi Lynn,

thanks for your reply. Hope everything goes well for you. Keep us informed of what's happening.

Kelpiegirl

NickyC

Dont worry - Australia is not a third world country! All the hospital facilities available in every western European country are available there. If you want an epidural and you're are not too close to giving birth (no point having an epidural if you're in the second stage of labour or close to it) of course you can have it. Even if you're a public patient.

The only people that would be having babies on a public place are those who didn't make it to the hospital in time. The comment about private rooms applies to after the birth (not during). Labour 'wards' consist of multlple individual rooms and you would normally have one midwife who pops in an out during the first stage of labour, getting things ready and giving you regular checks etc. Once you get to the active second stage there would be at least two of them, plus an obstetrician/anaesthetist whenever necessary. Plus who-ever you want to be present too. Some people take - apart from their partners - families/video cameras/music to help jolly the occasion along.

Most hospitals even have a more home-like 'birthing room' if you don't want to give birth in a clinical looking labour ward. They have bean-bags/baths and normal looking furniture. Bit more touchy-feely if you want that sort of thing. Only low-risk women can usually use it, because they are normally further away from emergency intervention and high-tech pain relief probably wouldn't be available there.

Once you've had the baby, public patients - and even some private patients - would normally be in a shared ward. These are not necessarily huge rooms, but usually 4-bed wards. The main advantage of being a private patient is that you can choose your obstetrician. Whether you get a private room depends on your level of insurance cover.

Really you have nothing to worry about. All Australian hospitals cater for all types of women (even scared ones!) and all types of births.

evila

Hi nickyc...

thanks for such a comprehensive explanation.

I´m now more confident that my wife will be good cared during her pregnacy/labour (altought we will wait at least until we are in Melbourne to start looking for it).

happy hollidays...

Enrique.-

LondonNurse

Hiya Kelpie,

Got a few answers to your questions here.
EPIDURALS
You usually get your epidural in 2nd stage labour which is the middle bit, they won't give you one once you're over 8cm dilated but if its your first baby labour is generally slow and your cervix dilates at approximately 1cm per hour of established labour so you'd have 8 hours to get to the hospital and request an epidural - plenty of time! This is an estimate b.t.w... In the first stages of labour you can use a TENS machine which pulses little electrical currents into your back which makes the labour pains much more bearable. You can also opt for a shot of pethedine in the third stage of labour which takes the edge off the pain and makes you feel nice and relaxed.

You can also opt to sit in the waterbirth pool in the first stages of labour to relax yourself and you don't have to deliver in there, you are free to get out whenever you want. But if you have an epidural you will only be able to give birth lying on your back in the bed as the epidural also numbs your legs so u wont be able to walk or mobilize.

If you have a midwife to deliver your baby she will call the anaesthetist. Obstetricians cannot adminsister epidurals/spinal taps so whichever one you have they will have to ring the anaesthetist to put it in as its a specialist procedure that normal doctors arnt trained to do. Midwives can administer any other pain relief and are highly competent in Australia and have degrees and are very up to date with pain management.

You never give birth on a ward, even if you are in a public hospital. All women are taken to a delivery suite where they are the only labouring woman in the room. You are only with other labouring women in the first stage of labour and after you have given birth. There are usually 4 women in each little side bay.

Hope this helps and if you're at all worried visit a few birth centres / hospitals and meet some midwives who you like and trust so that you can familiarize yourself and not get scared.

susmac

Hi
I haven't posted here for a long time and only occasionally have a peep to see what's going on, however as a midwife I feel have to set the record straight here. The second stage of labour is the time from full dilatation ie 10cm until delivery it's not the middle bit!!It is very unlikely that you would require or be given an epidural during this time as it when you should be pushing. A spinal tap is not an anaesthetic procedure so disregard that!
I work at Sunnybank Private hospital in Brisbane and am very, very impressed with the care given to patients. I have friends who work in the public system and I believe the standards there to be comparable to the UK. The only thing I think is missing is a follow up at home service ie the community midwife and health visitor. If I were you kelpiegirl I would take out private health insurance ( which is much more affordable here) when you arrive and cover yourself for future pregnancies
Cheers
Susan

kevwalt

Hi,

My family and I are landing in Brisbane on 17 Jan 04 at which time I will be 32 1/2 weeks pregnant.

Thanks to this thread a lot of my queries have been answered. I'd guessed that I would have to see a GP first who would then refer me on for ante-natal treatment and booking in etc.

Do you have a choice of public hospitals or do you have to go to where you are referred? and are there any recommendations. I will be in Wellington Point.

Thanks for any info.

Kate

ABCDiamond

Hi Kate
My answer here is only related to general care at the "Redland Public Hospital". A lot has been said about the poor quality of this hospital, but when I went there with my daughter I was very impressed with the service. It was ony on one occasion, so I cannot be consired an expert on the place, but I do fel hat they give care to those that need it, in priority to some that dont .

Kelpiegirl

Hi Susan,

thanks for your reply. I don't think I'll take private health insurance in Oz, it's actually very expensive compared to Belgium.

Here my hubbie and I would pay $800 per year for the two of us, which I think is very reasonable. We don't have it though, because public healthcare here is very good and covers a lot already.

From what I've checked on private health insurance websites, we would pay $2500+ for the two of us in Oz.

I've got nothing against public healthcare at all, I'd be happy to get attended to by any doctor or nurse/midwife. It's just that everybody says different things, which kept me wondering what public healtcare in Oz is like. I have to say from what I've read on this forum, people are very happy with it, so that's good enough for me.

As far as the follow up service goes, I suppose you could always go back to the hospital if there are any problems with you or the baby.

Greetz,

Kelpiegirl

NickyC

I'd be surprised if Basic Hospital Cover is as much as $2500 for a couple. Medibank Private quotes $1438 for their Basic Hospital Premium for a couple. That includes the 30% rebate from the Government and assumes you're both under 31. If you're over 31 the premium is about $1700. Medibank Private is one of the more expensive funds so you should be able to get cheaper than that.

Don't forget that if you earn more than about $80,000 you get charged an extra 1% Medicare levy if you DONT have private health insurance so take that into consideration when doing your sums.

Public healthcare is pretty good on the whole but can be dependent on where you live. City suburbs are generally very well served by long-established hospitals and plenty of consultants/specialists - but some of the new outer suburbs can be a long way from the nearest hospital. Country areas, away from the coast, often have problems attracting and retaining doctors.

LondonNurse

Oops apoligies!!!

Meant 2nd stage about the pethidine not the 3rd stage! Was rushing to type that last reply was off to work.

Although i wasn't talking about a spinal tap, was talking about a spinal anaesthetic. Not sure if they have them in Oz yet but i'm sure they'll be winging there way over soon if they havnt got them.

I work in obs theatre and the procedure room as a theatre nurse and assist the anaesthetist in siting epidurals and spinals. At the moment i'd say we're doing about 90% spinal blocks for c-sections and about 60% normal epidurals and 40% spinal blocks for labouring women not in for a c-section. the only difference between a spinal is that it it goes deeper than an epidural and it offers almost instant in pain relief. the team of anaesthetists i work with seem to prefer it to siting epidurals.

I'm really shocked they don't have community midwives or health visitors in Oz... Do they have any sort of baby clinic where the babies can be weighed and their progress checked?

NickyC

In NSW we have free Baby Health Clinics where you see a paediatric Nurse and get the weighing and measuring done, ask advice, can get immunisations done there etc. Not compulsory to use them though. No such thing as Health Visitors. If you have a problem with the baby you take it to a paediatrician or your GP or the nearest hospital (in an emergency).

There's less hand-holding here - most Aussies would faint with shock at the thought of someone knocking at the door wanting to check out their baby!