Newly pregnant - questions on hospital choice, care level and cost

fiona-f

Hi, delighted my GP just confirmed my pregnancy but I am still very confused about the practicalities of what comes next. I am in Dublin and she advised me to look at the websites of the various hospitals and pick whichever I liked along with whichever level of care : public, semi or private. I have two major questions though - is there anywhere I can clearly find out how much the non-public options would cost me out of my pocket for Coombe, Rotund, Mount Carmel, Holmes street? The various fees listed on the websites are really confusing. I have VHI insurance.

Also simply how do you choose between the different hospitals? I have absolutely knowledge of such things and find it really stressful to make a choice when I have such little understanding of anything medical. My GP just said they're probably all the same., which isn't much help.

Sorry if these questions have already been asked, I did a search here and elsewhere but couldn't find anything straightforward. Thanks so much for any help.

Moonbeam

choosing the one nearest to work usually works the best.
Ring each hospital and ask them abut their pricing,mostly it depends on your health insurance and how much they will pay towards it.

holding

My GP recommended the Rotunda, based on it being one of two hospitals close to where we live (the other one was Drogheda I think), plus the fact that she herself had recently had 2 children there, and had found it great.

We chose to go public after talking to a lot of friends who were recent parents, and seeing how they listed the pros and cons of going public/ private etc. I am low risk, and we decided to go public.

fiona-f

Thanks, rang my insurance company and was horrified to learn they will only cover e50 (not a typo, just fifty) of private or semi private consultant fees. Plus they emphasised really strongly the massive chance of not getting private or semi private room in Dublin as all hospitals so busy. So I am even more confused now and feel like the system is set up to extort money through fear of not getting the best at the same time with no guarantee of much of anything even though you pay over money. I have never been I'll in my life thankfully and am dazed by such a bizarre system. Public looks like increasingly the better option and I am ashamed of myself having blindly paid health insurance premiums all these years without ever realising how little I would get in return on the very first occasion on which I try to get some benefit from it.

Sorry for the rant, I just can't get over how stupid I''ve been to trust that paying my ever increasing health insurance every year meant I would be looked after.

MurdyWurdy

We did our research (online and asked around a lot) and decided on the hospital closest to us and that going private or semi-private was not worth it. The difference from what we could see is in that fact that you may get a private room while you stay in hospital (if there are none available you will be put in a public ward and still have to pay private fees) and you see the same consultant for your prenatal appointment and he/she will attend the birth, if possible. I know someone who couldn't get a private room and someone whose consultant didn't attend the birth anyway so we just thought it wasn't worth €5000. We'd rather spend that on the baby or other things. Also, if you're public you can be waiting a long time in the hospital to be seen for your appointments but again, that's not a big concern for us.

It depends on your priorities I guess, I know a lady who was having her first baby at 39 and she was a bit worried about that so wanted the comfort of always seeing the same consultant. I understand that some people would weigh up the options and choose to go private so it's really up to you.

I had to go into the maternity hospital over the weekend as I'm not very well and they were very good, we had to wait a bit to be seen (about an hour) but we couldn't fault the treatment and the wait really wasn't that bad.

Blueskye

I'm not in Dublin so only 1 hospital here which makes choosing easier I guess!

We had planned to go public but at 12 week scan the registrar made a few important errors which luckily I noticed and we discovered we're having a higher risk pregnancy (identical twins) so we've decided to go private. Best decision ever. The difference so far in care and information and reassurance has already been worth it. But I don't know if I'd bother for a more 'straight forward' pregnancy.

seamus

fiona-f wrote: »

Thanks, rang my insurance company and was horrified to learn they will only cover e50 (not a typo, just fifty) of private or semi private consultant fees.

They do cover everything else though, including your room (which is insanely expensive). We went semi-private in the Rotunda.

The way the Rotunda works is that you choose Public, semi-private or private. Public obviously is what it says on the tin. You attend your prenatal appointments in the public hospital and you stay in a public ward, ten women to a room.

Semi-private involves paying €1200 upfront and then everything else is covered. You attend for your prenatal appointments in the semi-private clinic, which is a very nice quiet building on the campus, as opposed to the insanely busy and noisy public building.
You stay in a semi-private room, which is a 3-person room. Tbh it's a little cramped, but it is nice and quiet and there are only 3 of you sharing a nice big bathroom.
Your appointments and delivery are managed by the senior registrar who happens to be on that day, with the consultant available if he's required.

Private involves selecting your consultant from the beginning, who you then attend for your appointments and who in theory manages your delivery (though if he's away in Vegas, I suppose you're stuck with whoever's available). You get your private, one-person room. The cost is variable depending on which consultant you choose.

Everyone attends the same PIU when they come in the door in labour, and everyone uses the same labour ward. So there's not really any difference in care on that front.

Yes they are busy, so there's always a chance that you will end up in the public ward if there are no semi/private beds available, but they will bump you up to one as soon as they become available. Which they do, unless you're in hospital for less than 24 hours.

We would probably go semi-private again. I can't really imagine being in a full ten-person ward when you're in such a vulnerable position. Especially during the day when there will be a lot of random visitors wandering about. I imagine that they're also much stricter about visiting hours in there too, whereas I found that I was basically allowed free reign to go in and out of the semi-private ward, even before/after the morning and evening cut-off.

davegilly

I think the private/semi-private routine is one of Ireland's greatest con jobs. It's like saying if you value your baby then you need to pay €4K otherwise you are a bad parent.

We have gone both the private (first) and public (second) route and I am embarrassed that I ever went private. What a complete and utter waste of money.

We were in the Coombe for both and the private experience was grand. Appointments went fine but I did have to wait almost an hour on one occasion. I have no complaints about the service to be honest and our child was born perfectly healthy. Off I went to my private room (that I shelled out nearly €4K for) for three days.
My friend was in around the same time but went through the public system. The longest she had to wait for her appointment was 2 hours. She had pretty much had an identical experience to what I had (apart from the private room and slightly longer waiting times for appointments) except I paid nearly €4K for my baby and she paid €0. Some fool me

I went public the second time and the service was brilliant. Couldn't fault it, the only difference I could see from private to be honest is that I was in a room for 6 rather than 1 but as it was my second I went home after 2 days. I had a difficult birth the second time round and had 2 doctors and 3 midwives in the delivery suite during the delivery due to complications but I didn't have to pay nearly €4K to get them into the suite.

Don't let anyone scaremonger you into believing that you will receive any different service in the labour and delivery suite if you are public or private because you will not. They only thing the doctors and midwives care about in those suites is that your baby is delivered safe and healthy and they don't give one jot whether you are public or private.

If you really do need peace of mind for whatever reason (this is nonsense though as the care you receive is the same) or you really have to have a private room (this is not guaranteed regardless) and you have plenty of money to spare then go the private system otherwise go the public system and use the €4K when you have your baby to pamper yourself for a few days in the Four Seasons You will deserve it!!!

highly1111

I've gone public in Holles st on both of mine. I'm pregnant again and was back in only this morning on my 3rd. In all 3 pregnancies I've seen the same consultant EVERY time except once when there was horrific snow and ice. Each weekday morning is covered by a different consultant. All my appointments are on a Monday and always have been since my first pregnancy. I looked up the consultants and chose Michael Foley (friends had seen him privately) so I asked for a Monday slot & am now under his care. I have never been in holles st for more than an hour except for having to do a glucose test on my last pregnancy and that was on a Friday.

I had complications with my first delivery and actually had 2 consultants there. My sister on the other hand went private in mount Carmel and her consultant wasn't there for any of her 3 deliveries. Granted it wasn't Foley but even if I was private it may not have been. Had a straightforward delivery on my second with 2 midwives.

Public in holles is 6 beds a ward. The staff are amazing. I stayed in 2 nights with both babies.and will again. I firmly believe if you're low risk, no reason to be worried about anything and you're fit and healthy that you'd be mad to go private.

Good luck and congrats. Its such an exciting time

by the way, I got a private scan in mount Carmel at 11 weeks, was seen in holles with scan at 13 weeks am back with doc at 17, big scan in holles at 21 weeks and back with consultant in holles at 25 weeks. From then it'll be 31 & 36, 38 & 40 weeks (most probably - may be a little less because of 3rd pg - but they'll all be Mondays with Foley)

highly1111

Here's the link with different consultants on the different days in Holles st

http://www.nmh.ie/public-care/consultant-led-clinic-in-outpatients-department.292.html

Ginny

We had our son nearly 5 months ago in the Rotunda, we went public, the longest I think I was there for an appointment was 2 hours and that was my booking appointment which had 4 separate parts. I had some complications at the end and was solely looked after by one of the assistant masters. The prenatal and postnatal care was second to none. It was the busiest time of the year while we were in there, yes the postnatal ward was full with 9 other mothers( but you can leave usually within 12-24 hours, I had the baby at 7 and was offered early release at midday the next day) but the semi private wards were overfull too, some were 4 to a 3person room. Honestly I doubt there was any difference in the care I received in comparison to semi private care. We both have private insurance but the 1200 upfront was to us much better put towards some unpaid maternity leave.

Moonbeam

This is my 3rd in Holles St.
I was in the merrion wing for the 1st stay and a 6 people semi private ward he 2nd time.
There is really no comparison ,the Merrion wing was bliss.
It was quite I had my own bath and shower,a nurse to show me how to breast feed,offered to take the baby at night,could always find a nurse it was lovely.
The semi private room was terrible the showers were across the corridor and there were only 2 between many people,4 of the husbands never left,I was the only one that opened my curtain and no one spoke to me,the one time I wanted a nurse could not find one.
This time I am on my 3rd and am very low risk so went through the midwive clinic,they are brilliant and the visits last more then 90 seconds. I have my 5th and final appt tomorrow but hopefully baby comes before that:)
The midwives and staff in Holles St are amazing and I really can not fault them at all:)

davegilly

Moonbeam wrote: »

I was in the merrion wing for the 1st stay and a 6 people semi private ward he 2nd time.
There is really no comparison ,the Merrion wing was bliss.

Of course there is a difference however you have to ask yourself is 2 nights in a room on your own in a hospital worth €4K??? Because in essence this is the only major difference and even after you have forked out your €4K there is still NO guarantee you will even get a private room.

As for the nurse situation, I was in both private and public and hand on heart, I never felt in anyway undertreated in the public system. I had a nurse to help me with breastfeeding whenever I wanted one, I had a nurse to help me bath my baby. And why in the name of god would I want a nurse to take my baby away at night for me?? I was waiting long enough to see him I wanted to spend every second with him

It's important people understand that the actual service that matters - you and your baby's well-being - is identical whether you are public, private or semi private. It doesn't matter how much you have paid a consultant, if there is a complicated delivery in the suite next to you and she is a public patient then that is where he will be and not with you and don't fool yourself into thinking otherwise.

If you are high, medium or low risk. It doesn't matter. You will receive the same care regardless of how much you have paid because all they want is to deliver to you a healthy baby.

When I look back now at the scam (there is no other way to describe a €4K bedroom) that I paid up to it angers me. I paid health insurance all my life and I still had to pay €4K to have my first baby and not only that, because I didn't go through the public system I had to pay for everything else too including ante natal classes which are free on the public system. What a joke. I'm embarrassed to even say it now

GRMA

Steer clear of Drogheda.

How Strange

First of all you should decide whether you want consultant led care or midwife led. If you consider midwife led then look at whether your residential area is in the domino scheme and what hospital it is attached to.

The domino scheme is where you meet a midwife in a clinic away from the hospital for your visits. The huge advantages are 1) it's free 2) you have a team of midwives caring for you and at least one will be present when you go into labour 3) you don't have to go to hospital for your appointments. You get an app in the clinic and you're the only person there at that time

The only disadvantage I can see in comparison to consultant led care is you don't get a mini scan at your apps but the consultant goes over it so quick you don't get to see anything anyway.

Going with a midwife doesn't mean you're excluded from the hospital. If there are any issues or concerns you'll be temporarily referred to a consultant and only referred back if/when you get the all clear.

Personally I prefer midwife led care. It's more personal.

Hannibal Smith

with holles street semi private they charge you a fee of 900 (May have changed in last year). send your receipt into your insurance
company...you won't get it all back...but you will get some back....then send a copy of the receipt into your local tax office with your medical expenses form and a copy of the amount you already received from the insurance company, so you're not double claiming. again you won't get it all back, but its better than nothing.

I'm just giving holles st as an example because that's the only one I used....I'm sure most other hospitals work similarly??

the health insurance will then cover your birth, anasthesiast (sp), hospital stay etc.

the insurance company are right in one respect..you are taking a chance that you'll get a private /semi private room because the hospitals are packed at the moment...but there's also the chance there might be less of a queue at appointments.

I went with holles st because it was near work for appointments, but just imagine trying to get to the hospital from home...is it too far away?

FunkSoulSista

How Strange wrote: »

First of all you should decide whether you want consultant led care or midwife led. If you consider midwife led then look at whether your residential area is in the domino scheme and what hospital it is attached to.

The domino scheme is where you meet a midwife in a clinic away from the hospital for your visits. The huge advantages are 1) it's free 2) you have a team of midwives caring for you and at least one will be present when you go into labour 3) you don't have to go to hospital for your appointments. You get an app in the clinic and you're the only person there at that time

The only disadvantage I can see in comparison to consultant led care is you don't get a mini scan at your apps but the consultant goes over it so quick you don't get to see anything anyway.

Going with a midwife doesn't mean you're excluded from the hospital. If there are any issues or concerns you'll be temporarily referred to a consultant and only referred back if/when you get the all clear.

Personally I prefer midwife led care. It's more personal.

I can vouch for this too, its a great concept. So handy going locally for appointments instead of into the hospital each time. You get to know the midwives and they will be coming out to your house for the first week after birth also.

fiona-f

Thanks everyone for all your replies, it's been really helpful and I feel a lot better about many aspects of it now. I still haven't made a decision but hearing your experiences and opinions is really useful. Like one of the posters above, the system does seem like a scam - I think it would bother me less if choosing one of the non-public options at least guaranteed the level you paid for.

yellow hen

I didn't see this earlier so ill add my tuppence worth.

I was in the exact same position as you 6 months ago. We live closest to the Coombe so we always thought we'd go there. I work in a medical field so always wanted to attend a teaching hospital as opposed to a private hospital. I thought the Coombe was aesthetically grim but all my family and friends spoke highly of the staff so I thought I'd get over the decor. We too had vhi and considered private but couldn't justify the cost to be honest. Semi private in the coombe is a 4bed room and public is a 6bed room.

I don't mind not seeing the same consultant on every visit either. All of them have trained for about 12 years so they can all read my chart! We opted for semi private which costs about €1000. Vhi will refund €300 of that and we can get a further €200 back in tax.

We opted to do shared care with our gp. So far we've been to the Coombe four times (incl dating and anomaly scan) and to the go twice. We've never waited anymore more than 30mins and all staff in the Coombe have been love, patient and very reassuring to a nervous first time mum.

The Coombe was ideal for us but I imagine the experience in the rotunda or holles st is much the same. As others have said, pick what's most convenient for you and your partner. Best of luck with your decision.

How Strange

yellow hen the coombe certainly is grim. Before getting pregnant all I thought of was the awful building and the women in their dressing gowns smoking at the bus stop. However so far I've been completely happy with the coombe and it's staff and would recommend it to anyone.

yellow hen

How Strange wrote: »

yellow hen the coombe certainly is grim. Before getting pregnant all I thought of was the awful building and the women in their dressing gowns smoking at the bus stop. However so far I've been completely happy with the coombe and it's staff and would recommend it to anyone.

To be honest, once you get into it, you forget about the decor and just get on with it. I too have been very happy so far.

happydayz8

Moonbeam wrote: »

This is my 3rd in Holles St.
I was in the merrion wing for the 1st stay and a 6 people semi private ward he 2nd time.
There is really no comparison ,the Merrion wing was bliss.
It was quite I had my own bath and shower,a nurse to show me how to breast feed,offered to take the baby at night,could always find a nurse it was lovely.
The semi private room was terrible the showers were across the corridor and there were only 2 between many people,4 of the husbands never left,I was the only one that opened my curtain and no one spoke to me,the one time I wanted a nurse could not find one.
This time I am on my 3rd and am very low risk so went through the midwive clinic,they are brilliant and the visits last more then 90 seconds. I have my 5th and final appt tomorrow but hopefully baby comes before that:)
The midwives and staff in Holles St are amazing and I really can not fault them at all:)

Hi Moonbeam. Just found out I'm expecting. Yay!!!. Want to go combined midwive clinic with holles street. Can all women avail of this or do you have to be in a specific area? I'm north city. Thanks for your help.

kitten_k

happydayz8 wrote: »

Hi Moonbeam. Just found out I'm expecting. Yay!!!. Want to go combined midwive clinic with holles street. Can all women avail of this or do you have to be in a specific area? I'm north city. Thanks for your help.

Happydayz - firstly congratulations!!

You can find all the info here (unfortunately only seems to be South Dublin and North Wicklow):

http://www.nmh.ie/maternity-care-options/community-midwives.220.html#domino

Moonbeam

happydayz8 wrote: »

Hi Moonbeam. Just found out I'm expecting. Yay!!!. Want to go combined midwive clinic with holles street. Can all women avail of this or do you have to be in a specific area? I'm north city. Thanks for your help.

Once you are considered no risk you can avail of it.
It is not dependent on location like the early transfer home scheme or the Domino scheme.
You just ask the consultant at your 1st appointment and make it known that is what you want.

happydayz8

Moonbeam wrote: »

Once you are considered no risk you can avail of it.
It is not dependent on location like the early transfer home scheme or the Domino scheme.
You just ask the consultant at your 1st appointment and make it known that is what you want.

Great news. Thanks! Now the question is semi privat or public. I think my insurance covers full semi but will have to check. Oh so much think about. :-)

Digs

happydayz8 wrote: »

Great news. Thanks! Now the question is semi privat or public. I think my insurance covers full semi but will have to check. Oh so much think about. :-)

Not to butt in but I tried getting on the domino scheme in holles street recently. I rang when I was 10 weeks and at that stage April (my due month) was booked up and 6 women were ahead of me on a waiting list so I wasn't able to do it

The number for the midwives clinic is on the holles street website so no harm in giving them a ring as soon as you can to put your name down!

Piper101

Just one more option for you that hasn't been mentioned. I'm going semi private shared care in mount Carmel. I can't fault it, the consultant actually listens to what I want and takes it on board and the midwives are a dream. The prices are really competitive, check out the website. A lot of people point out that they are not able to deal with emergencies for baby prior to 32 weeks but I didn't want to enter the pregnancy thinking something might go wrong and I'm now 41 weeks so not an issue for me lol.

Anyway, best of luck whatever you decide

wicklori

Piper101 wrote: »

Just one more option for you that hasn't been mentioned. I'm going semi private shared care in mount Carmel. I can't fault it, the consultant actually listens to what I want and takes it on board and the midwives are a dream. The prices are really competitive, check out the website. A lot of people point out that they are not able to deal with emergencies for baby prior to 32 weeks but I didn't want to enter the pregnancy thinking something might go wrong and I'm now 41 weeks so not an issue for me lol.

Anyway, best of luck whatever you decide

I am also going to MC. That nonsense about 'they can't deal with emergencies before this stage and baby could have to be transferred at that stage...' drives me mad! I am from the country and that is the case with many hospitals outside of Dublin. You are totally right-pregnancy isn't a disease and I feel we should be starting off thinking negative thoughts.

My feeling was I wanted my baby to enter the world in as peaceful and quiet environment as possible. That is definately the sense I get in MC. I know we are very fortunate to be in a position to pay for this but we think this is our priority right now. Initially it wasn't important to me to always have the same consultant, but the longer my pregnancy goes on the more I appreciate it.

If I had previous pregnancies I can see that if they were smooth experiences I would probably be very happy to avail of midwife led care, but we had no idea what we getting into so....

happydayz8

I got my first appointment in Holles Street. I think it is a public appointment as according to the girl I was talking to I can only do Midwife led care public. I asked if I can have a private room (my VHI covers this) and she didn't know. I'm trying to get through to their accounts department but not much luck. Any one know if I can do the public Midwife Led care but private ward? I know there is no guarantee but as the insurance is paying any way I've nothing to loose. This is all so complicated

wicklori

My understanding of the Domino scheme is that it is public, full stop. As you don't really stay in the hospital your room is less important though so maybe don't let that put you off?

happydayz8

its not Domino. Its the midwife led care. So instead of meeting a consultant I'll be meeting a Midwife from a team and they will be my support in labour. I will not need to see a doctor unless required.