What maternity cover to choose?? so confused!

Hello Lady!

Hi folks,

apologies in advance for long post - I'm just a bit discombobulated by all this!!! lol

at my last GP visit for bloods, my GP asked if I had made a decision on where I want to have the baby and what option (public, private, semi-private). I hadn't got a clue so he said think about it and let him know at my next visit. I have an appointment with my GP this evening and still haven't a clue what to choose.

We have VHI so would be covered to an extent, but I never realised that the consultant fees and scans (except the 20/22 week scan) are not covered under the standard package and have to be paid as an extra. I have looked at Holles St and the Rotunda and can see their prices, but they seem to vary from as little as €900 up to as much as €1800 for semi and €2,000 - €4,000 for full private. None of them could give me an idea of what it would actually cost - they all said it depends on what I need and how many visits! The max I can claim back from my VHI on consultants AND scans is €500. Now, bear in mind that I am preggers following IVF, and therefore a slightly higher risk of a MC and my RE is recommending scans at 6, 7, 8, 10, 12 & 14 weeks in addition to bloods every week until week 12. All of this is in addition to the normal 20/22 week scan. So €500 is not going to cover those, let alone consultant fees.

My preference is for semi - it would be much better to be able to turn up for an appointment for a scan and not have to wait hours as you have to do in the public system. The less time off I need to request from work the better for now (I know I am entitled to time off, I just don't want to draw too much attention to my time off until things are further along. With a private appointment I can pop in on my lunch, or leave a bit early without prompting too many questions).

I was hoping someone could shed some light on the whole thing? Is there any packages out there you can go for? Is it possible to go public for outpatient appointments and then just go private or semi for the actual delivery? And then I could just pay for the scans myself and claim back my €500?

I know we can claim from revenue on the med one form for any additional expenses, but as (please please god) baby is due Jan 2014, we would have to wait 12 months to get any of that back.

Your sage advice based on your own experiences would be most welcome!

thanks!
HL

January

Semi-private appointments can sometimes be as long as waiting for a public appointment in most of the Dublin hospitals.

Moonbeam

my longest wait as a semi private patient was 40 minutes and usually it was about 20/25.
You learn quick enough to book an appt 1st thing in the morning or last thing in the evening.
That was in Holles st,I have had 3 there and few complaints.

highly1111

I don't have time to write long reply but I attend (and have done with all my pregnancies - on my 3rd now) Holles st public on a Monday with Prof Foley and he runs an amazing clinic. Clinic starts at 8am and you'd be well out before 9 - except maybe for first visit where you have to do medical history. Could be there till 9.30.

Semi private seems to be a complete waste of time from stories of family and friends.

Private of course would be anybody's main choice if money was no object as you get a private room - but the cost to you after vhi is about €3k. So that's the actual cost to you.

I have many many friends and family who've given birth in recent years from private in mount Carmel to public in all the maternity hospitals and genuinely hand on heart medically - you will get the care you need. I have never never heard of a public patient not getting their required level of care. Required level of care is an important term as my level of care would be less than yours simply because of medical history if that makes sense. If the consultant (public or private) feels you need more scans - you'll get them.

Also, remember that you can choose say public care and pay for scans privately - but if you need those scans - you'll get them!

highly1111

Just re-read - you can't switch care from public to private for delivery and for the room.

January

highly1111 wrote: »

I don't have time to write long reply but I attend (and have done with all my pregnancies - on my 3rd now) Holles st public on a Monday with Prof Foley and he runs an amazing clinic. Clinic starts at 8am and you'd be well out before 9 - except maybe for first visit where you have to do medical history. Could be there till 9.30.

Semi private seems to be a complete waste of time from stories of family and friends.

Private of course would be anybody's main choice if money was no object as you get a private room - but the cost to you after vhi is about €3k. So that's the actual cost to you.

I have many many friends and family who've given birth in recent years from private in mount Carmel to public in all the maternity hospitals and genuinely hand on heart medically - you will get the care you need. I have never never heard of a public patient not getting their required level of care. Required level of care is an important term as my level of care would be less than yours simply because of medical history if that makes sense. If the consultant (public or private) feels you need more scans - you'll get them.

Also, remember that you can choose say public care and pay for scans privately - but if you need those scans - you'll get them!

You're not guaranteed a private/semi private room at all.

nikpmup

Semi private, IMO is a waste of time & money. You're still in the ward with the public patients - the big hospitals are so busy you'll have very little hope of a private room. As for private in Mt Carmel - a friend of mine had 2 there and was still in a ward. Also, I don't know about you, but I'd rather be in a big teaching hospital rather than a private one with no emergency facilities should anything go wrong.
I never even thought of semi private - I'm public in Holles Street, and my care is fine. Each to their own, but I'd rather spend the money on the baby and my little family afterwards

January

nikpmup wrote: »

Semi private, IMO is a waste of time & money. You're still in the ward with the public patients - the big hospitals are so busy you'll have very little hope of a private room. As for private in Mt Carmel - a friend of mine had 2 there and was still in a ward. Also, I don't know about you, but I'd rather be in a big teaching hospital rather than a private one with no emergency facilities should anything go wrong.
I never even thought of semi private - I'm public in Holles Street, and my care is fine. Each to their own, but I'd rather spend the money on the baby and my little family afterwards

Mount Carmel is well equipped to handle emergencies.

highly1111

January wrote: »

Mount Carmel is well equipped to handle emergencies.

unfortunately not always. My sister's care had to be transferrred from mount c to Holles st at 33 weeks due to complications which potentially could have arisen after the baby's birth. Thankfully the complications didn't end up being that severe but she could have needed complex blood transfusions which mount c admitted that holles st would be better equipped to handle.

Blueskye

I found out I was having identical twins at 12 weeks. It's a higher risk pregnancy so we decided to go private. I can honestly say its the best money I ever spent. I have had to have ultrasounds every 2 weeks til 32 weeks and then weekly. No delays waiting for appts. Can ring or text my OB day or night. I receive consistent care with someone familiar with me which was not going to be the case in this hospital. I have been admitted to hospital several times during the pregnancy and always get a private room. And having twins I wouldnt fancy sharing a ward for several nights. Any concern I have, I can check it out and am listened to.

If I had been having a single 'normal' pregnancy I would have gone public but so many issues can occur with ID twins, the reassurance and expertise has been fantastic.

It's a very personal decision and I sometimes feel its not pc to be in favour of private care but for me it was definitely worth it.

January

highly1111 wrote: »

unfortunately not always. My sister's care had to be transferrred from mount c to Holles st at 33 weeks due to complications which potentially could have arisen after the baby's birth. Thankfully the complications didn't end up being that severe but she could have needed complex blood transfusions which mount c admitted that holles st would be better equipped to handle.

That might have been the case a year or two ago but they've since up dated their SCBU and can care for babies born from 32 weeks now. Obviously if you go into premature labour before then you'll be transferred to a different hospital.

Hello Lady!

Thanks for all the replies folks.

I absolutely have no worries as far as the delivery goes and the quality of medical care you get. I fully appreciate that it is the same medical teams and consultants, as most of them work both publicly and privately, so it's not like your medical needs are better looked after being private!

To be honest, I would have no qualms about going public for the delivery. Its the pre-natal services that I am more interested in. Not having to wait hours for appointments is the main thing and being able to get them at shorter notice.

I know some of you are saying if you need scans you will get them, but so far that is not my experience. I had IVF in Turkey, and there, standard protocol is for your RE to look after your care up to week 12 (they are OBs as well as RE's so they literally take care of you from the minute you start fertility right up to 12 weeks if needed). The normal protocol for them is to treat an IVF pregnancy as a higher risk of miscarriage. It was explained to me that this is because literally, they medically forced your body through the various stages of conception and implantation, and as a result in a high percentage of women the pregnancy does not take. Even with a positive result, until week 12 they continue to treat you as risk of possible miscarriage, given the number of women who have IVF and loose the baby within those 12 weeks. They also give preogesterone protocol as standard and again, this is not the norm in Ireland unless you have past history of miscarriage. I also have an auto-immune disease which my Turkish doctor feels is important as my antibodies and inflammation levels are potentially also another risk factor.

So with all this in mind, my RE is recommending a set format of treatment. This is a recommendation from a fellow doctor (a very well noted one in the fertility field I might add) but so far I have experienced a 'pooh-pooh' attitude from the doctors here. My GP appreciates the advice my RE is giving but has said it is very unlikely that this level of care will be given in Ireland as they do not class IVF pregnancies in the same way. My GP has no way of requesting these treatments. I have contacted a few consultants so far, and none of them seem to think all these scans are necessary and will just be a waste of my money. They are all prepared to give me the scans, but with the attitude, it's your money, you can spend it how you like, rather than a 'right well a fellow medical professional advises that you need this level of treatment, so I will provide it for you'. None of them so far have also offered to formulate some sort of package for me, so it is very hard to actually calculate the final cost of all this.

My Turkish doctor is amazed at the attitude of the doctors here. I am his first Irish patient, but he has had patients from the UK, Germany, France, USA, Middle East etc and sent them off with the same follow up care report I got and has never actually had any of them not get the care needed. Even through the public system (which a lot of his UK clients end up using).

So if they are reluctant to agree to the scans as a private patient who will have to pay for each scan, I really don't have faith that as a public patient I will have access to this type of care.

I really don't know what to do!

My GP has advised to try at least semi private, and keep ringing aroudn and see if I can get a consultant who is amenable to my situation and is prepared to work with me. So far I have contacted half the consultants in Holles st and half in the Rotunda. I will contact the rest over the coming days.

To be honest, so far the attitude of some of the consultants has put me right off them - there is no way I would pay thousands for their services!

I am hoping that my continued search will result in me finding a consultant who is prepared to at least consider the advice of the RE and even meet half way in terms of frequency and number of scans/tests.

I will keep you all posted, and in the meantime if anyone has any other advice, or has experienced any similar situations I would most welcome your opinions/advice.

thanks,
HL

mrskd

I don't know which consultants in the Rotunda you have contacted but I'm attending the private clinic there - main reason was continuity of care and the high possibility of a private room after delivery (apparently there's not nearly the same issue with this now as there was in the boom). My consultant fees are €2,300 (due in stages) from which I can only claim approx €200 from my health insurance and the balance I will put a Med 1 claim in for. I have been seen by the consultant every 3 weeks since the 8th week of my pregnancy - it could have been more often had I needed it but I'm having an uncomplicated pregnancy. I am scanned by him at each appointment and my 20 week scan was also included as is my ante-natal class.

I understand it's still a lot of money - it'll end up costing me circa €1,500 net but if I wasn't pregnant this is money that I easily would have spent on nights out, weekends away, etc. For peace of mind it's well worth it, in my opinion

Hello Lady!

Thanks for that mrskd. Would you mind PM'ing me the name of the consultant you are using in the Rotunda?
thanks

LegacyUser

OP,

From the first hand experience of going trough Public clinic recently with my partner I can tell you that we have seen no problem and would recommend to anyone to go Public.

My partner has suffered with lot of different things throughout the pregnancy and was in the hospital at least twice a week at later stages. We went to Holles St.

Your problem is time spent at the hospital, well we found out that as long as you don't mind showing up early on the day of your appointment you won't be there long. We both worked at the time and yes it was easier not to spend much time off work but it worked out fine for us.

Regarding the care, I can honestly say there could not have been anything more the staff cold have done! She was cared for every step of the way.

One downside in this case was that you do not get to see same consultant every visit, however that worked out great as we were not happy with the "main" consultant that was there. He did not seems to read the file properly, was rushing to get done and general vibe off him was negative, however any of the other doctors that worked for him were an absolute pleasure to deal with.

Considering she was in the hospital so often she got to know the other doctors which worked out well as for her delivery the doctor that happened to look most after her was on duty and he was there is delivery.
From the prenatal to postnatal care we have only had positive experiences. The midwifes and all the doctors including the catering staff never once gave us any feeling we were getting any less than anyone who paid for semi private or fully private.

What ever you chose I hope it all goes well for you!

Annabananna

Hey,

I had my two children in mount carmel and was under a great doctor privately he is 3000eur and depending on your health cover you may end up topping up the hospital stay by 800e but it is well worth it as the care i got was second to none.

They deal the whole time with ivf moms so i am sure they would offer you the service you require. The night i had my baby i met an 48 yr old mam who had a scan every week of her pregenancy almost so they must have put a package together for her.

If you want their details check out mount carmel website and my consulant was DR Dockeray.

Chocoholic84

Hello Lady! wrote: »

My preference is for semi - it would be much better to be able to turn up for an appointment for a scan and not have to wait hours as you have to do in the public system.

I'm going public, and tbh I've found it fine. I've only had 2 scans so far and I wasn't waiting any longer than 40 mins to be seen for both of them.

I know another girl who is going semi and she says the only thing she notices that's different so far is that she'll be in a ward with 4 people rather than 8!

Hello Lady!

Annabananna wrote: »

Hey,

I had my two children in mount carmel and was under a great doctor privately he is 3000eur and depending on your health cover you may end up topping up the hospital stay by 800e but it is well worth it as the care i got was second to none.

They deal the whole time with ivf moms so i am sure they would offer you the service you require. The night i had my baby i met an 48 yr old mam who had a scan every week of her pregenancy almost so they must have put a package together for her.

If you want their details check out mount carmel website and my consulant was DR Dockeray.

Thanks for that, but having looked into prices mount carmel is working out just too expensive. A 2 night stay semi-private is €4000 plus between €2000-4000 consultant fees. The package only includes 3 scans and two bloods, and does not cover the nursery fees for the baby. Given that my insurance will only reimburse €3400 of the stay, zero of the consultant fees and €500 towards any extra scans/treatments outside of the above, there is no way we would fork out that kind of money. It would cost us about €4000 and we feel that, and that is with them discounting for the extra scans and bloods.

I am expecting call backs from 2 of the rotunda consultants tomorrow. If we choose semi private all scans ordered by the doctor are included as are bloods. We estimate it will cost us about €1000 after insurance reimbursement and med1. I just need to find a doc who is open to taking onboard at least some of the recommendations of my RE and we'll be laughing. I know €1000 is still a lot of money but as another poster said, we too think its worth it for peace of mind and we also saved money on the IVF costs by going abroad so now that I am pregnant I am happy to use those savings on maternity care. I also like that the rotunda private clinics are open late some evenings which is really convenient.

Annabananna

Hi Hello Lady

Just to ask did you ring Mount carmel the nursey fees are only not covered if you have a c section in which case your insurance covers the full cost of the five night stay.

I would say to call them if you havent as I would say they be willing to move a bit if medically needed as the consulant has the scanning machine in his rooms if he was willing to bring you in more often you get a scan each time included in his fees.

The bloods that are not included in the fees are 180e and i was able to claim these back from aviva.

Whatever your choice I hope you have a happy and carefree time.

RentDayBlues

I went to mount carmel too, had friends who had babies in holles street at the same time, public, private and semi private. All had good experiences but main difference was after care, in mount carmel it was excellent.

Double check with your health insurer, they covered all hospital costs for me, with exception of consultant and extra bloods. They way we looked at it : the cost was similar to a new couch, why not get the best care for something so precious.

Peanut2011

RentDayBlues wrote: »

I went to mount carmel too, had friends who had babies in holles street at the same time, public, private and semi private. All had good experiences but main difference was after care, in mount carmel it was excellent.

Just to understand you, what was so different in aftercare?? Holles St has very good aftercare. The staff there are very friendly and they could not do any more than they do!

RentDayBlues wrote: »

Double check with your health insurer, they covered all hospital costs for me, with exception of consultant and extra bloods. They way we looked at it : the cost was similar to a new couch, why not get the best care for something so precious.

Are you saying that the staff in Holles St are not good enough or will not give the very best care too??

OP, you have been given a lot of advice here and I can see a lot of people think that if you go private you will get the "best care" but I can assure you that is not true.

The only difference is that you will see same consultant each time and you will quite possibly have better meal options! The same consultant option may be what you want so you may have to pay for it but for the two days there are the meals all that important?

As last one mentioned the cost was similar to the new couch, well that is if you can afford the new couch! The money you will spend on private or semi private you can use to get all the stuff you will need for nursery.

You will still have additional cost when the baby is born so you must count that in. It might be 3-4k for the private and then on top of that you will need 2k to get the things for the baby.

If you have the cash to spare than go for it, if not I would suggest go public!

Hello Lady!

Annabananna wrote: »

Hi Hello Lady

Just to ask did you ring Mount carmel the nursey fees are only not covered if you have a c section in which case your insurance covers the full cost of the five night stay.

I would say to call them if you havent as I would say they be willing to move a bit if medically needed as the consulant has the scanning machine in his rooms if he was willing to bring you in more often you get a scan each time included in his fees.

The bloods that are not included in the fees are 180e and i was able to claim these back from aviva.

Whatever your choice I hope you have a happy and carefree time.

I have already spoken to both mount carmel and VHI and confirmed that nursery fees will not be included in the price quoted. They are not really that flexible or moving much on prices. The best they can offer is that instead of paying €25 each time for basic bloods (mainly hCG & progesterone I need tested regularly) that they will do 5 tests for €100. So they will give me €20 off. They will also give €20 off the more expensive bloods. Tehy said they will do scans for €95 instead of €125. But my insurance will not reimburse any more than €500 towards pre- & post-natalcosts, so the more all these scans and bloods cost, the greater my out of pocket expenses are. At least at the Rotunda, all scans/bloods requested by the doctor are included.

RentDayBlues wrote: »

Double check with your health insurer, they covered all hospital costs for me, with exception of consultant and extra bloods.

As mentioned, my insurer and mount carmel have confirmed the costs and the total price is coming in very high. To be honest, mount carmel isn't even that convenient for us as we are northsiders, so unless the costs stacked up, there is little point in attending there for us.

Peanut2011 wrote: »

OP, you have been given a lot of advice here and I can see a lot of people think that if you go private you will get the "best care" but I can assure you that is not true.

The only difference is that you will see same consultant each time and you will quite possibly have better meal options! The same consultant option may be what you want so you may have to pay for it but for the two days there are the meals all that important?

As last one mentioned the cost was similar to the new couch, well that is if you can afford the new couch! The money you will spend on private or semi private you can use to get all the stuff you will need for nursery.

You will still have additional cost when the baby is born so you must count that in. It might be 3-4k for the private and then on top of that you will need 2k to get the things for the baby.

If you have the cash to spare than go for it, if not I would suggest go public!

thanks Peanut, yeah I do know what you are saying. As I've mentioned before I have no illusions that the medical care is 'better' private. That is not really an issue. The main issue for me is that I get all the scans and bloods that I have been told I need and get a consultant who also takes into consideration the fact that as an IVF pregnancy there are higher risks. Not all consultants agree with that. Maybe I am just being overly anxious, but my RE, who I trust and who cared for me really well takes that view, and my instincts tell me to trust what he says. So I want to find a doctor that is on the same wavelength as my RE. I know that due to the strain on public health services, in reality the chances of me getting that level of antenatal care are slim unless I pay for it. We have saved long and hard to even get pregnant, we still have some money in the coffers from the IVF treatment, and I have no qualms about putting it to good use if it puts my mind at ease. Especially if it turns out to be twins!

Thankfully one thing in our favour is that this are very much longed for and waited for first (and probably only) grandchild(children) on my side of the family. I have already been told by my dad in no uncertain terms that pram, cot and car seats are grandad's responsibility. I know that there will be some very excited aunties who will shower baby with enough clothes to ensure I could probably not even wash the clothes as I will have a constant stream of new outfits! I know there are a hundred other things to be bought, but something tells me we won't even get to buy the child a rattle!

Moonbeam

I have been in a private room,semi private ward and public ward in Holles St.
The care in Private I felt was way better then the other 2 but it was also my 1st child.
If Mount Carmel was nearer to me I would have gone there for my 2nd and 3rd.

Hello Lady!

I do actually quite like the idea of a private room - I have this weird thing about sleeping in a room with strangers! (I'm a freak, I know!). I had an operation done semi-privately via the patient treatment purchase fund a few years ago, and when I was all drugged up on post-op meds, I didn't even register that there were other people in the room. But as soon as that wore off I just felt really uncomfortable sharing the room - I think its the embarassment of farting and talking in my sleep that has me so paranoid! lol

So the idea of a lovely quiet room all to myself seems wonderful - but not so wonderful that I could justify spending an additional €1500-€2000 on the consultant fees!

That is the thing that seems strange to me - my insurance will pay for either a private or semi private room. The delivery cost, anethesiologist, midwife etc are all the same cost regardless of the room afterward. For a few of the semi-p 'consultant-led' options, you still see the same consultant each time, still get the same scans etc, so I can't understand why the consultant price is higher because you are in a room on your own? surely he/she does the same job, regardless of what type of room you end up in! I understand an extra cost was the room type, but it's a bit wierd that the consultant charges more because of the room you choose???

Have been given a few recommendations for consultants from boardsies, so hoping to get in touch with them all today and see which I feel best suits my needs after speaking with them.

Peanut2011

Hello Lady! wrote: »

So the idea of a lovely quiet room all to myself seems wonderful - but not so wonderful that I could justify spending an additional €1500-€2000 on the consultant fees!

That is the thing that seems strange to me - my insurance will pay for either a private or semi private room.

OP, from your answers you really seem to know what and why you are looking at this and it is refreshing to see that someone is actually looking at this from different angle and not from the snobbish point (met so many that had this view).

Before you book yourself for private / semi private, I would recommend that you check with the hospital you are going with what their interpretation of private / semi private room is.

In some cases semi private room is one with 4-8 beds and private is up to two. Also, many hospitals will not guarantee that you will get the type of the room you chose.

Hello Lady!

thanks peanut - one step ahead of ya!

At the moment, I am pretty sure it'll be the Rotunda. Their private rooms are in the Lillie Suite which are guaranteed single rooms. Semi private is made up of three four-bed rooms, and one three-bed room. Public wards in the rotunda cater for 4-10 patients per ward, and I believe there are very few 4 bed wards and they are generally kept free for women who have had difficult births or complications. I REALLY wouldn't fancy sharing with 10 other women, what with my freaky paranoia about nocturnal farting! lol

I wonder, if I negotiate hard enough, could I get the semi-private consultant package and the private room?? that would be the ideal for me, but in reality I reckon it'll be a semi-private option and I will just have to get over my weirdness about sharing. I suppose after the 'mortification' factor that goes with most stages of pregnancy, the last thing I will be embarrased about are night time toots!

Moonbeam

The best thing about a private room is the lovely ensuite bath and shower all to yourself.
I was horrified the 2nd time when there were no showers in the room and we had to cross a corridor and there were 2 or 3 shared showers.

Ciarabear

Moonbeam wrote: »

The best thing about a private room is the lovely ensuite bath and shower all to yourself.
I was horrified the 2nd time when there were no showers in the room and we had to cross a corridor and there were 2 or 3 shared showers.

You do realise that the shower in your private room would have been shared with someone else at some stage too? You make it sound as though you were literally sharing the cubicle with another Mum at the time you were showering.

Personally, I consider 3/4K an excessive spend to rent a bed and shower for 48 hours and would prefer to invest that money in my child in a more tangible way

Moonbeam

no I do not think we do .
Will this be your 1st child?

Bagheera

Hellolady is combined care an option for you at all? I'm going for combined care in mount Carmel this time round. My insurance covers the majority of the accommodation and the GP visits are free. If you're considered high risk this is obviously no good to you but just wondering.

Bathrooms in private rooms are cleaned between patients! Whereas I was in a SP ward last time and encountered a rather large blood clot on the floor of the shower. It was my first shower after delivery and it had taken quite an effort to get there so I went ahead and showered, but I was pretty disgusted. We all have issues with bleeding post partum but I cleaned up after myself!! So I'm definitely with moonbeam re the shared bathroom.

freudiangirl

We could have gone private , but in Cork there is only one hospital CUMH and you are not guaranteed a private room.

I had my first baby as public patient in cumh and care was great. I was in a two bed ward after baby and had room to myself for 2nd night.

This is number two, we are going public again.

Your needs are met regardless of how much you pay.