Domino scheme, Holles Street

Stellasmurf

Hello ladies,
I am due in December and trying to decide on what route of care to go down.
Would anyone have any advise or recent experience of the domino scheme in Holles Street?

Alternatively how did you decide to go public or private in Holles Street?
I thought I would go private but my doctor is actually advising me to go public and said the only really advantage would likely be a cut in waiting times during visits.

Millem

Stellasmurf wrote: »

Hello ladies,
I am due in December and trying to decide on what route of care to go down.
Would anyone have any advise or recent experience of the domino scheme in Holles Street?

Alternatively how did you decide to go public or private in Holles Street?
I thought I would go private but my doctor is actually advising me to go public and said the only really advantage would likely be a cut in waiting times during visits.

congrats!
When you go private you are paying for your visits to be with your chosen consultant. You don’t go to GP. Your consultant will more than likely scan you at every visit. You are only dealing with one person.

Cakerbaker

Domino is midwife led. Some of your appointments are with midwives, others with your gp. You won’t meet any consultants in the hospital unless medically necessary. You will only be accepted onto the domino scheme if you are very low risk. It’s aimed at women who want as natural a birth as possible, with minimal intervention and low levels of pain relief (though obviously these are available if they end up being necessary).

Again with domino you leave the hospital 6/8 hours after having the baby (assuming everything goes well) and midwives visit you at home every day for the next 5-7 days. If you live in an area with a Holles st clinic you can have your appointments there instead of the hospital. I’ve always had really short / practically no wait times at the appointments. I’m my pregnancies (well so far in my second) I only went to hospital for my 20 week scan and then to actually have my first!

Just in case you haven’t spotted this already ...http://www.nmh.ie/maternity-care-options/community-midwives.220.html

Also the staff in the domino unit are really helpful if you ring with any questions.

Its a personal decision really. If you think you would like to have things managed medically then consultant led (be it private or public) is probably the way to go. I kinda just go with the flow and see it as a natural process that I don’t need to be medically managed so midwife led suits me perfectly (though I do appreciate that I’m lucky to have very low risk straight forward pregnancies (so far!))

lazygal

I went private twice and decided to go private again.
I am so glad I made this choice because two of the three pregnancies have been complicated for different reasons and I love having one consultant dealing with me. She's seen me at every visit, delivered the first two and provided a lot of extra care on this pregnancy, I've been surprised myself how much contact I've had. I also had sections and will be having another and I found the private room to be invaluable. I know this is all anecdotal but I never expected complications and the continuity of care has been mentally really important for me. Had I been in the Domino scheme I would have been shunted out twice now, and had to deal with whichever consultant was dealing with the clinic on the day I happened to be there.
For me the advantages of this type of care have been worth every single cent for the peace of mind alone. I know people who had straightforward pregnancies and deliveries under midwife led care who were very happy with that option too.

ETA the waiting times might not be that different if the consultant is attending to a birth during his or her clinic! We waited a while because of this, but it was reassuring know she would be there when we needed her!

Stellasmurf

Thank you; if you go public are you likely dealing with multiple consultants?

I rang about the domino scheme today. When they asked if I would be willing to have a mostly natural birth, I hesitated. The thought of no drugs/epidural while being in pain giving birth scares me. Am I being selfish? I’ve no idea of effects, etc. Anyone any experience?

Digs

The idea with the domino scheme is that you’re more open to a more “natural” approach to pregnancy and labour. That doesn’t mean drugs etc won’t be available to you during labour should you need them! They do encourage you to approach it with an open mind though.

I would have definitley done domino scheme but am just outside the catchment area for Holles Street so am going public for the third time. I have no quibbles about my experiences so far, the wards afterwards are busy and noisey though, I’d didnt sleep a wink the two days I was in on my first and as a result I was home hours after having my second which suited me perfectly, you can do this even if you’re not on the domino scheme. I had no interest in hanging about. I had two smooth, uncomplicated pregnancies and labours though so had no need to hang about the hospital.

Both my labours have been without drugs/epidurals. I had gas & air on my first but it made me want to puke so didn’t ask for it on my second! My labours were 1.5hrs and 37mins respectively though so I might have been singing from a different songsheet had they been longer but my intention was to go as long as I could without an epidural anyway, I’d rather the option to move about during labour and the ability to be up and about afterwards quickly. It’s a personal decision though.

If you’re in the hospital public you can choose to go midwife led which is like the domino scheme except you see the midwives in the hospital. Or you can chose consultant led. You do this as part of the combined care scheme which means you split your visits between your consultant/midwife in the hospital and your own GP.

ETA: on my first pregnancy I was under Dr Agnews clinic and saw him at every single appointment bar none. My second pregnancy was Dr Keane and I saw him probably 3 times and someone on his team the other times. Both times midwives delivered my babies which suited me perfectly.

Cakerbaker

I wanted a natural delivery on my first but ended up with an epidural following an oxytocin induction. To be honest it’s made me more determined to have a natural delivery this time (assuming everything goes well obviously). I just hated the lack of control following the induction and epidural. I had done pregnancy yoga, had loads of exercises and breathing exercises planned to help me through the labour but didn’t get to use it cos I was pretty much confined to bed on a monitor! It’s very much a personal decision though.

dreamstar

Hi Stellasmurf,
It can be very hard to know what to do on your first. I attended Holles St for my first who was born last February and am currently attending again on my second. Due to medical history I had to attend the consultant lead clinic on both and I chose to go public.
I have to say I cannot speak highly enough of the care I got and am getting. So when you go public you will be under one consultant but it is generally his/her team of doctors you will see. I did see the same doctor every time the last time though. And I have only been twice this time but seen the same doctor both times. So you attend the clinic and see the midwife first who does urine sample etc and then wait for the doctor. These clinics can be busy - the longest I was there was 2 hours so I didn't think it was that bad. The plus I found with this clinic is that you get a quick scan every time.
As for the wards afterwards, they are busy. I personally never had a problem with this and actually, I probably would have gone mad in a quiet room on my own! I got to know the girls on the ward and actually liked the company.
But it's all personal preference really. Best of luck!

firebird84

I attended Holles Street public for my first and now am private at the Rotunda for my second. My experience so far is like night and day but I can't talk to comparison between the births yet. There wasn't anything particularly wrong with Holles Street but I didn't see the same doctor, and it was basically like a conveyor belt at appts, get in you in and get you out as quick as possible. I had no complications so it didn't bother me but I every time I had any kind of question it was frustrating because it seemed like they didn't have much time for you.

Rotunda Private in comparison is so quiet and calm and the staff have loads of time for you. My booking appt with the midwife was much longer and they went through absolutely everything, answered every question I had in great detail. My consultant is also great and it's nice always seeing her when I go in so you don't have to repeat yourself 10 times because doctors can't read each others notes.

Edit: I haven't experienced Domino but I hear it's much more preferable to regular public in HS. I'm not fussy about talking to a consultant vs a midwife, it's dealing with a different person every time that I found to be annoying.

mirrorwall14

Stellasmurf wrote: »

Thank you; if you go public are you likely dealing with multiple consultants?

I rang about the domino scheme today. When they asked if I would be willing to have a mostly natural birth, I hesitated. The thought of no drugs/epidural while being in pain giving birth scares me. Am I being selfish? I’ve no idea of effects, etc. Anyone any experience?

The coombe at least you are led by one consultants team. i had a rough pregnancy first time around and by the time I gave birth I knew his entire team and it was his reg that delivered me which was pretty nice!

Honestly, I'd love to be able to afford private but the cost is just way too far for us when there is a myriad of other things we have that it could be spent on. The care was very very good on public, I'd be going for private for more peaceful visits, a bit more support without needing to jump up and down for it, and for post natal. Thats just not enough for me to justify spending 3.5k+ when I'll do just fine in public

I ended up giving birth with just gas and air. My labour was too fast for anything else. Personally I will take all the drugs this time around but hey look, he came out, he is perfect and mine so at the end of the day thats all that matters

catrionanic

I went public on my first in Holles St, and am doing domino this time. Domino gets booked up really quickly (you need to book in almost as soon as you get your bfp), so if in doubt it may be worth just registering for it and you can always change your mind later.

The biggest advantage of domino are short waiting times (you can be waiting for a few hours at a time on appointments in the public clinic), you can attend a local satellite clinic rather than coming into hospital each time, and you can go home just a few hours after delivery but have a daily visit from a midwife every day for 10 days. You also tend to see the same midwife regularly, as opposed to different doctors each time in the hospital.

Re: pain relief, I remember a midwife telling me on my first that the domino midwives still give epidurals to around 40% of women (although this is around 70% outside of the domino scheme... but I suppose that includes all the inductions and complicated cases which the domino midwives don’t take). I had an epi on my first and will 100% be asking for one this time too if I feel I need it (and ignore it’s anything like my first, I definitely will!!).

But if you don’t mind long waiting times and seeing different consultants, public clinic is great too. I was always very happy with my care. On the domino scheme, you just have one scan at 20 weeks, but I’m the public clinic they do a quick two-minute scan at every appointment. This was nice, but towards the end of pregnancy when you’re in every week or two, the novelty does wear off!

Cash_Q

mirrorwall14 wrote:

The coombe at least you are led by one consultants team

I'll am going public with the Coombe and the Domino scheme would have really appealed to me but I have an underactive thyroid so I was placed under a consultant.

Will I see him or a member of his team for each appointment then? I have an appointment with him around 18 weeks but don't really know what to expect in terms of continuity of care, just trying to take it one appointment at a time at this stage.

mirrorwall14

Cash_Q wrote: »

I'll am going public with the Coombe and the Domino scheme would have really appealed to me but I have an underactive thyroid so I was placed under a consultant.

Will I see him or a member of his team for each appointment then? I have an appointment with him around 18 weeks but don't really know what to expect in terms of continuity of care, just trying to take it one appointment at a time at this stage.

You'll see him or a member of hist team at every appointment. I didn't see my main consultant all that often in clinic but saw her on my admissions. I seemed to see her senior reg a fair bit which suited me as I liked her!

Cash_Q

Ok thanks Mirrorwall14 that sounds good