Issues about Giving Birth in Perth

Hi hi!

Thanks for agreeing to be in touch!

As I mentioned on your blog, my hubby, son and I are Australian PRs (we got our visa early this year), but we have yet to go over because of personal and work commitments for now. We were contemplating going over next year, but with no fixed time as yet. Then recently, we realised that I am pregnant with our second child. As happy as we are with the good news, it has also put a little pressure on us as we need to decide where to give birth. We don't want to jeopardise our PR status, neither do we want to be separated while applying for our 2nd child's PR.

I saw you reply a fellow Singapore on the same issue, which has helped us quite a bit in our considerations.

Some further questions I have:
1) How was the prenatal, delivery and postnatal care like at KEMH? Your wife might be the one giving her opinion on this...:D I heard horror stories about people giving birth in Australia, specifically on the cleaning and stitching up of the mother which is a big concern of mine.

2) Are they pro-epidural or more for natural birth with no painkilling aid?

3) Would you know if Medicare is applicable to my delivery, considering I'm already pregnant at the point of registration? I can't find any info on this on Medicare web site, I have e-mailed them but no reply so far.

4) How did you cope with having to look after your wife and new born daughter after the birth? One of our concerns of giving birth in Perth is lack of support. To add to that, I would most likely be looking after our older son and the baby myself during the daytime, as my husband will be working. We're not sure how easy it is to apply for leave as he would probably still be on probation etc?

Hope to hear from you soon!

Cheers,
-S-



******

Hello,


Congratulations to your pregnancy. I understand that giving birth in Australia in a very trying consideration. Personally I would not suggest any option that involves separation because it defeats the purpose of migration, assuming you are planing to move to Australia mainly for your family. So it should be down to either giving birth in Australia or moving over at a much later time together as a family when your baby at least 1-2 years old, for you will need the time to apply for his/her Australian PR anyway.


You may have already read one of my previous post [link] where I covered a little about this topic. So I will not repeat my stale story and opinion again here. So I'll go straight to your questions.


Q1-
As a first-time parent, I have no case for comparison between prenatal, delivery and postnatal care. of Singapore and Perth hospitals. Personally, I had nightmares with KK Hospital. I wrote about it previously [link] which is now rather embarrassing to read actually. Since I boycotted KK Hospital and left for Perth in a huff when my wife was 5 months pregnant, we did the rest of our pre-natal in King Edward Memorial Hospital (KEMH). Given the big hoo hah of every single of our visit to KKH, the complete lack of fuss at KEMH left us wondering if they were negligent. We did voice our concerns to the doctors and they took their time to address to them. For some reason, we felt a sense of calm throughout and were quietly confident that everything would turn out well.


In regards to delivery, I went through a topsy turvy one. It didn't help being an inexperience first time dad-to-be. None of my close friends in Singapore were fathers yet at that point in time, so I had totally no mental preparation or knowledge about what I could be expecting. To make things worse, the delivery could not proceed even after inducing until a stage the doctor discovered that our baby was in distress, running out of oxygen in the womb. I don't want to force you to go through our drama [link] but you can read it for reference if you want to understand more about the professionalism of the staff in KEMH. Though I have no basis for comparison between KEMH and any Singapore maternal hospital, KEMH passed with flying colours for me. The fact that I have a healthy chubby toddler to give me kisses every day after work is the best testament.


Only early this week, I remembered my wife playing with toddler Albany, pointing to her rather neat faded scar (no more than 9 cm, I measured) telling her that was where she came from. I distinctively remember she did not have any issues with the it. In fact, her scar only remains to make me love her even more. The wound was actually stapled instead of stitched and they were removed without a glitch at the latter stage of the visiting mid wife period. During the early period of afterbirth, the hospital will send a midwife to your home every few days to check on you. As my wife was a first-time mother, she was taught basics such as how to breastfeed etc. The baby was weighed during every visit. We even almost had to be made to 'return' the baby to the hospital because they found that her weight reduction over the limit. We were impressed how the Australian government made sure that parents take care of their newborns properly by providing these midwives as support. I felt that that really help us tremendously, being so lost as first-time parents in a new country.


Q2-
We were offered 3 kinds of pain relief methods and were told about their advantages and disadvantages;

1) Laughing gas
2) Epidural
3) Morphine

As my wife was the tough cookie type, she initially only opted for the laughing gas. As her labour was prolonged because of complications, she had to take up epidural eventually. The hospital is completely neutral in painkilling preferences and do not advice for or against any option that the mother chooses.


Q3-
Yes, if you already hold a Medicare card at your point of delivery.


Q4-
I have to admit it was rough but somehow we pulled through. I did what a man had to, anything and everything that I could to make things better for us. In your case, I don't think you will struggle as much with a newborn, given that it will be your second. But your older child will be a concern. I believe your husband will be allowed to take leave to help out at home after birth until you can cope by yourself, regardless he is on probation or not.


In case of emergencies, it is good to have a few contacts on hand. The Singaporean community in Perth may not be as active as the ones in the Eastern state but we are quite a tightly knitted bunch. Not every one of us may be game to help to shift house, kill a rat or have a impromptu cup of coffee at one another's house all the time, but when it comes to struggling with a new born, you should be able to receive some helping hands from some of us (if you stay close enough) when the occasional need arises.


Getting one of the mother-in-laws over for the initial 1-2 months can really calm some nerves. Though these folks are naggy, we know they are pure gold when it comes to such things. I will strongly advise for such an arrangement if this option is available.

11 comments:

  1. Hey

    I am also a bloody Sinkie. My son was born in Melbourne, Australia- Mercy Hospital. It was a great experience for my wife and I. As we discover her pregnancy after arriving in Australia, we seek a GP to confirm the pregnancy and FOC blood test was done except for ultrasound which a portion is claimable. Subsequently, we were advise to chose the hospital which was Mercy a catholic funded public hospital. Hence we begin our journey with Health Well Women Clinic from monthly check and advise until weekly and finally her delivery in the hospital.

    During her delivery, my mother in law and I were there to witness the process. From induction to anesthesia, the midwife was supporting throughout the delivery process. Overall, the hospital service was comparable to Thomas Medical Centre as my wife was put into a 2 bedded room with 3 choice meals per day. During the baby check, the doctor discover that my son has a rare aortic stenosis valve abnormalities condition . Therefore, they discharged my wife he was left in the care of the professional. In fact, he was transfer to Monash Children hospital for further observation and tests (cardio, mri and etc). The medical staff was very though with the check. All in all, he stayed in the hospital for 38 days. It was the toughest day of our lives. Where hospital become our frequent place.

    On the day of discharge, we walk out with only a $18 bill for a bring home medication. Imagine if we are in Singapore, I think I break into cold sweat. Most probably, it will cost me a bomb of $50 to 100k. That's why, we find that to move out of SG was a correct decision we had taken.

    Today we are proud to say that our son is doing well with follow up specialist appointment, which 99% is FOC except for one which we pay $9. I really admire the Aust govt for their Medicare system which give the rich and poor access to the medical services.

    As for the citizenship, he is dual passport holder Aust by birth.

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  2. Hi there, I'm an Australian PR but my wife isn't. She's now 5 months into her pregnancy. We were planning to keep to our idea of moving to Perth in July/August 2014 with our newborn. Is that not a good idea? What am I missing here? Help!

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  3. you don't need help. you have a plan already so follow it through

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  4. I like to remind all Australian reading this that we all pay for the public health system through the taxation plus the EXTRA medicare levy if your annual taxable income is above a limit.

    It is not FOC. We all pay for it. At personal income taxation rate up to 47%, we ultimately subscribe to a universal health care scheme. Medicare only means there is minimal individual out of pocket expenses, that's all.

    The system makes healthy people who don't use the public health system pay for other people who uses it. (I don't want to use the word 'penalise')

    Please just don't call it FOC

    Thank you.

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  5. XYZ no doubt we pay Medicare Levy. It is worth every single cents. Sometime people living in OZ do not know how blessed they are.

    As I came from a different system, therefore I can see the differences in the healthcare system. In Singapore, if you do not have MONEY, you can jolly well forget about important surgery even it is life threatening. As the govt could not give a damn about you. You need to pay through our nose to get the medical services and generic medication whom the govt claim is at a subsidize rate. Btw I used to be generic medical sales rep in SG. I known that the cost of some of the general medicine is barely a few cents. Therefore their claim are Bullshit.

    In Singapore, when you are admitted to public hospital, you need to ensure that you had money to pay. Otherwise, you end up with hospital chasing you for payment. In OZ, at least you do not need to worry about it, just that you will be put on queue for schedule consultation and etc.

    Hence in conclusion, I am more than happy to pay the MEDICARE LEVY in order to enjoy the access to the healthcare services.

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    1. OZ boy

      I worked in the Singapore and Australian healthcare system.

      Firstly:
      If you truly have a life threatening condition in Singapore or Australia, you will be treated regardless of your ability to pay. If you are going to die within hours or several days, you will be treated.

      But if you have a 'serious condition' but not (immediately) life threatening, if you are not entitled to the public healthcare in Australia and Singapore, then you will need to show either ability to pay for your treatment or commit to paying off your debt, or go back to your country of origin once your condition is stabilised.

      Doesn't matter who you are, where you come from. Even the British have to go back to UK for treatment as their reciprocal agreement doesnt cover everything.

      Secondly:

      Every Australian is entitled to Medicare benefits. Because of this the healthcare system is overwhelmed as a result. Working in rural Australia I know people who have to wait for 2 years before getting seen for their problems in public hospital clinic. This waiting period does not include waiting time for having an operation if they need one.

      People living in capital cities who cry foul for long waiting lists for surgery simply have no idea what it means to be really waiting to be seen under Medicare.

      Lastly:

      I am not sure how much you earn and it doesnt matter and is none of my business. But there is 2 Medicare Levies. Medicare Levy for most Australian earning a minimum income, and the extra Medicare Levy Surcharge for people who earn beyond a certain income, in addition to Medicare Levy

      So life and taxation is not the same for all of us. Those who have more income do pay much more for Medicare tax.

      The only thing is that I rather stay healthy than be sick and have to use the health system to use my "entitlement" as some people was heard to say when they complain about the system. Let me reassure you the real healthcare cost for the public hospital for a single visit for surgery is nothing close to what an individual would have paid for Medicare Levy for 10 years, since the system is very inefficient.

      Furthermore the irony is that what we are paying for is people using the system NOW. When we grow older and not working anymore, then other working people is supposed to pay for our healthcare system when we get sick as we age.

      Let's pray us that someone else is willing to pay for our care.

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    2. hey XYZ

      I was also in the healthcare industry. I remember how a dialysis patient tell me the worries she is experiencing since her medisave fund is emptying by the days.

      Well healthcare is one of the worries concern in SG, my dad was advise to go for a $15k bypass operation in a Public hospital. However, he chose not to in view of the cost, today he is still doing fine which I am not sure is a diagnosis error or fleeing the sheep act. Anyway that is a whole new topic on medical ethics.

      I shall leave you with a healthcare concern article for your pleasure reading http://www.tremeritus.com/2013/11/18/gan-govt-to-pay-more-than-40-of-healthcare-cost/

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    3. Hi OZ boy

      Read the article, I suppose the part that was the basis of interest is the fact that Singapore government account for much less public spending on healthcare compared to the rest of First world countries.

      But let me also tell you this. Of all the countries listed in the chart, Singapore taxation rate is the lowest.

      In fact if you look at total tax revenue as a percentage of gross domestic product, Singapore is 14% whereas the closest rival is 26%, the US (which is curiously just next to Singapore in the chart)

      2 other comments:
      1. This dialysis patient worrying about her fund: Ultimately was she refused treatment by the hospital because she couldn't pay?
      I don't know her story personally but I am going out on a limp here but I bet the answer is no.

      2. Your father still did not have a heart attack even when he was advised to have a bypass? Good for him! But that doesnt mean he does not have a coronary heart condition. He may be just lucky, who knows?*

      (*maybe his heart doctor knows)

      He was quoted $15K? That was pretty much the lower end of the price in SG. In private SG hospitals the cost is $23-33K.
      In NSW public hospital, the cost is A$33K which is S$38K.

      Is the Australian care in public hospital better than SG public hospital? I doubt so.

      The only difference is that your father would not be paying A$33k directly out of his pocket, but the cost is distributed to all tax payers whether or not they use the health system.

      In case you are thinking I am some SG government troll, I am not.

      I do not love the SG government but I do not hate them either (or at least not blindingly).

      I just want to put things into perspective: that healthcare anywhere is never FOC* or something for nothing and SG government doesnt cover as much public hospital bill as other First world countries, since SG doesnt tax people as much either.

      If you consider the extreme example: anyone local or foreigner who gets injured in New Zealand will be treated in public hospital without out of pocket expense.

      How did they manage that?

      The fact is: the government pays for it through taxation of NZ people but you cannot sue anyone for liability even if the company or the government or some people is negligent for the injury or accident. No personal compensation.

      So ultimately everyone pays.

      http://en.wikipedia.org/wiki/Health_care_in_New_Zealand

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  6. Hey thanks for your tots and feedback! Sorry I took so long to respond. Can't believe I kept checking my e-mail, until last night I had the idea to check your blog. Yes, do feel free to roll your eyes. :D
    Am very appreciative of your detailed answers. We have a better idea of what to expect in Perth now. A word of thanks to Oz Boy too. Btw, Oz Boy, so your child is dual citizenship for now? So you came back to Singapore to register him? How long does that take?

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  7. Hey Sharon,

    For a child that is born overseas, the parent will need to apply for Singapore Citizenship by descent. You need to certified all the documents by a notary/lawyer/ Oz Justice of Peace (JP) prior forwarding the doc by post to Singapore Consulate (Canberra). It will take about 3-6 months to process it. BTW, JP certification is a FOC community service subject to their schedule.

    From my past experience, don't bother to ask ICA to issue a birth cert to you as I had tried. The abovementioned step was what I did after returning from Singapore ICA counter enquiry. At the same time, don't worries about declaring his Oz passport in the application form. As the SG citizenship will indicate a date for him to pledge his allegiance which is 20 years later.

    The infor is only for citizenship cert application. If the child really need to travel, get a OZ passport which will be issue with 3 weeks upon application. I hope this help and good luck with the OZ delivery.

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    Replies
    1. Sorry OZ boy

      Can I also add this from Wiki:

      The position of the Singapore Government is that dual citizenship is not allowed.[7] This position appears to be targeted as persons who are Singapore citizens and wish to voluntarily and intentionally acquire foreign citizenship. The laws regarding Singapore citizenship is found in the Constitution of Singapore.

      A dual citizen may have acquired citizenship by birth in a foreign country, by descent from a foreign citizen parent, or by naturalisation. Singapore citizens who voluntarily and intentionally acquire citizenship of a foreign country after the age of 18 may be deprived of their Singapore citizenship by the Government.[8] Foreigners who naturalise as Singaporean citizens are required to renounce all foreign citizenships.[9] Persons who are born outside of Singapore and have at least one parent who is a Singapore citizen may register with a Singapore consulate within a year to acquire Singapore citizenship by descent. However,such persons must renounce their foreign citizenship, if any, before reaching 22 years old. The Constitution of Singapore is silent on a Singapore citizen who acquired citizenship by birth and is a foreign citizen by descent. So long as such a person refrains from exercising his rights of the foreign citizenship, the Government has no grounds to deprive him of his Singapore citizenship and he may hold on to dual citizenship.[10]

      So my reading of this if you really really want your child to have dual citizenship:

      1. Don't ask don't tell: Get the SG birth cert before applying for Aussie one. Better still apply both at the same time so that you can honestly say you have neither!

      If you already got the Aussie citizenship and SG government don't ask too much when you apply via Singapore High Com, then don't declare if you don't have to.

      2. If you don't want SG to know your child has Aussie citzenship then don't let then know he has Aussie passport. Use SG passport to enter SG and leave SG.

      3. If the child is a boy, then think very carefully as he will have to do NS (99.99% of the time).

      See
      http://therealsingapore.com/content/dual-citizenship-holder-i-was-forced-serve-ns-and-prevented-leaving
      http://www.singaporelawreview.org/2012/03/what-does-it-mean-to-be-singaporean/
      https://www.gov.uk/foreign-travel-advice/singapore/local-laws-and-customs

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