The cost of essentials has been increasing dramatically. That is putting considerable financial pressure on couples. So many are now struggling to pay their mortgage, rent, electricity and gas bills, food, other essential household goods, etc. It is very difficult time financially for so many. But as well you want to have a baby. What do you do?
Find savings elsewhere
It is very tempting to quit your health fund membership or scale it back if money is tight. Sadly, you need top level of hospital cover with your fund to have pregnancy cover, and so if you scale it back you may be covered for a heart attack but not for pregnancy care. If you quit or scale your health fund cover back you will have to wait 12 months when you re-join or increase your cover before the health fund will cover you for pregnancy care. I recommend you continue your health fund subscription including for pregnancy care and find savings elsewhere.
If you are not covered by your health fund for pregnancy care or are not in a health fund there are three options…
Private pregnancy care.
- Paying for private care. I have quite a number of women who do this. With our practice, you can pay the management fee in instalments each visit as long as it is paid in full by 28 weeks gestation.
- Ask your parents to pay for your pregnancy care. Consider asking your parents for a loan or even giving you the money for your pregnancy care.
- Compare obstetrician fees. Don’t assume all obstetricians charge the same. There are some very expensive obstetricians in Sydney. I am confident an obstetrician having greater fees does not indicate that the obstetrician is better trained, has more clinical experience, or provides better quality pregnancy care.
- Hospital packages. Norwest Private Hospital has all-inclusive (except SCBU cost if relevant) packages for women who are uninsured for confinement. 2 nights stay is $4,000. 4 nights stay is $5,670. On top of this there are doctors’ fees and pathology fees. Medicare will reimburse part of these bills. You can make enquiries about how much extra you will be out of pocket for doctors. You can phone my secretary to have chat about this.
The San Hospital is also looking at introducing a all-inclusive package for women who are uninsured for confinement.
- Antenatal care as private patient. I have patients who are not insured who see me for their antenatal care and who are confined in a public hospital as a public patient. The only out of pocket expenses for most are for the initial consultation, the pregnancy management fee, the NIPT (if done), the foetal morphology ultrasound scan (if done at a specialist pregnancy ultrasound unit). There may be extra bills (not from me) if you have extra pregnancy considerations. This option means you will have good quality pregnancy care, my availability for pregnancy concerns or queries and minimal or no waiting for antenatal visits. Give my secretary a call to chat about this option.
Public hospital pregnancy care.
The other option if you want to have a baby now and are not covered by a health fund is to book with a public hospital. This is what a lot of women are doing currently.
The public system was already stretched before this influx of new bookings. It is now over stretched and I am repeatedly told public hospitals have far more patients that they can cope with this. What does this mean if you decide to go public.
The implications of going public are…
- Limited choice of public hospitals. You most likely need to book at the public hospital of the area you live even though this may not be your preference.
- Long waits for antenatal visits at the antenatal clinic.
- Junior staff management. Your care will be provided by nursing staff (often trainee midwives) and if needed by junior medical staff (often trainee obstetricians). It is unlikely any specialist obstetrician will be directly involved in your care unless there is a problem that the junior doctors cannot manage.
You will have no choice as to which specialist obstetrician is called if you or your baby have a severe complication. It will be the obstetrician who is rostered on at the time. This obstetrician doctor may not have a good ‘bedside manner’, may not be good clinically, may have minimal clinical experience, and most likely will have any genuine interest in you as you are a public patient.
- Less continuity of care. There will usually be less continuity of staff care, no one really being interested in you and your baby’s wellbeing.
- Greater risk of complications for you and your baby which can be life threatening and which could be avoided if you had an experienced well trained obstetrician was looking after you.
If there is an avoidable adverse outcome or serious complication for you and/or your baby that most likely would not have happened if you were being managed privately by a very experienced well trained obstetrician then this can have devastating implications for your mental health as you have to live with decision you decided to go public.
- No childbirth choices. The staff of the hospital can decide to choose a mode or timing of delivery that you disagree with, but their say is final. Often these staff decisions are governed by NSW Health financial pressures on the hospital and often by a midwife bias. You may want to be induced, want to be induced early, want an elective Caesarean section but this request may fall on ‘deaf ears’ of unsympathetic staff.
- Shorter stay than desired. Because of the pressure on beds, you may be advised you will be discharged before you are ready to go home.
- No privacy. Usually you will be in 2 or 4 bed postnatal room.
Defer your pregnancy.
The other option is to wait. The current financial climate will end. Interest rates will come down, mortgages, rents, electricity and gas, food, other essential household goods, etc. will become more affordable. My wife and I remember having a mortgage when interest rates were 19%. We have lived through many times when there have been all sorts of adverse financial factors. These days will end so stay optimistic and maybe postpone your pregnancy until later when your finances are better.