As a midwife I have worked at both hospitals and as a Mother I have also birthed at both. Both have strengths and both have limitations, and I must say I have had positive experiences at both hospitals professionally and personally.
There really is no right or wrong. But there is likely a better fit for you.
This blog is for those who have already decided on utilising the local public hospital but are undecided between Nepean and Katoomba.
If you are still weighing up all your care options- I suggest you look at This blog on Models of Care.
You can also take this Models of Care Quiz I created to help you get clarity on what model is the best fit for you.
For you it may just be a question of which hospital am I in the catchment for, so I will start by saying that if you are between Penrith and Warrimoo, you are in the catchment for Nepean and if you are Between Springwood and Mt Victoria, you are in the catchment for Katoomba. But for others, you may have more questions, and I am going to attempt to help.
Below are some of the Strengths and Limitations of each hospital that you may be helpful to consider:
Blue Mountains Hospital in Katoomba:
Strengths:
-Katoomba hospital is a smaller hospital and only accepts low risk women, this is both a strength and a limitation. To this point, it is a strength in the way that this affects the culture of the unit. When you are birthing in an environment run by staff that see low risk women with minimal complications often, you will likely find that this environment is one that is expecting things will go well more often than not. It is difficult to achieve that culture when you are looking after lots of high-risk women and fearing complications because you see them arise more often.
-Recent introduction of a continuity of care model, where you can see the same midwife in your pregnancy and in your postpartum recovery. Continuity of Care with a midwife has the biggest impact on the positive experience women have, so this program is a very exciting addition to Katoomba hospital.
-Smaller unit also means you are more likely to encounter similar midwives throughout the duration of your care on top of your allocated midwife- for antenatal, birth and postpartum care.
-You will already be eligible for the midwifery at home service provided you live in the catchment, which will ideally involve your appointed midwife.
-There is less wait time for appointments, smaller waiting room and free parking on the grounds and directly across the road from the hospital- logistically a bit easier.
-Women receiving inpatient antenatal and postnatal care are given single rooms. A particular benefit of this is that partners can stay with you overnight.
-All maternity services function out of one unit- antenatal clinic, antenatal ward, the 2 birthing rooms, assessment unit and postnatal ward. You will likely only need to find one area for all the care you will receive.
The paediatric unit is also located directly next to the Maternity unit, so in the incidence that your baby may need paediatric care that can be appropriately managed at Blue Mountains, there is opportunity to avoid separation of Mother and Baby.
-Discharge times are more relaxed as there is less of a push for beds, being a smaller unit.
Limitations:
-Blue Mountains can only take on low risk women, so if risk factors were present at your booking in or developed during your pregnancy, your care may need to be transferred to Nepean. This can look a variety of different ways dependent on your risk factors and worth a conversation.
-Blue Mountains have recently commenced a continuity of care model as above, but having your allocated midwife present for your birth is not part of this model, like you could potentially have in a caseload model as is available at Nepean.
-There isn’t medical staffing 24/7 like Nepean. Depending on the day and time doctors may need to be called in, rather than being present and available like at Nepean. (Hence the criteria around low risk women). This could affect you in the following ways.
- If your baby required management outside of certain boundaries that the paediatricians could manage, care may be transferred to Nepean.
- This may also affect your ability to get access to an epidural, if this is your plan, in the time frame that is optimal for you.
- This could affect the medical management including plans for induction if this is required.
Nepean:
Strengths:
-Continuity of care models available. Caseload is the ultimate continuity of care model, where you are allocated a midwife for your pregnancy, birth and postpartum care. This model is not currently available at Blue Mountains.If you are not able to obtain a place in caseload there are other options such as MAPS- like Blue Mountains, where you have an allocated midwife during your pregnancy and then postpartum.There is also Aboriginal Midwifery programs if you identify as aboriginal or Torres Strait Islander you can be allocated a midwife for your pregnancy and postpartum care.There is also a large volumes of student midwives that train at Nepean and this can serve as an opportunity to have a student follow you through your pregnancy- which can be a rewarding experience of continuity of care also. (As a student I loved following through the women in my caseload).
-Big hospital with lots of medical coverage if that is something you need/want to be part of your care. Including:
- NICU and SCN on site.
- More reliable access to intervention should you need/want it 24/7.
- Doctors on site to manage any complications.
- High risk clinics and policies for care of High Risk families.
- Anaesthetist coverage on site in the hospital should you wish to acquire an Epidural or have need to escalate to a Caesarean quickly.
- No need to transfer to any other facility if complications develop for you or your baby.
-Nepean has newly renovated birthing suites and maternity care wards that are beautiful. The birthing spaces have been fitted out well with equipment to support you in labour, so if a birthing space is an important thing for you, this may be a strength.
Limitations:
-While the continuity of care programs is a strength, Spaces in a continuity of care model are really limited for the amount of people booking into Nepean. You must apply early to get a spot in a continuity program.Without a continuity of care model, you can feel a bit lost in the system, possibly seeing someone different each time you are at the hospital.
-Logistically the hospital is much bigger (though you may see this as a pro), antenatal clinic, antenatal ward, birthing suite, WAAU, postnatal ward, NICU and SCN are all located on different levels and in some cases different buildings. This can feel a bit overwhelming as you try to navigate where you need to be.
-No guarantee to be allocated a single room. While there are single rooms available, jurisdiction is given to managers and Team leaders as to who is allocated these rooms, with many factors going into consideration when allocating these rooms. If you are not in a single room, you are not permitted to have a support person stay with you overnight.
-Parking can be more difficult as it is a busy hospital. Street parking is available for free but depending on when you are coming in, you may not find one close to the hospital. There is paid parking available closer to the hospital, but even with paid parking you may need to allocate more time to find a parking spot and walk up to the hospital.
-If you live out of area (above Warrimoo), you will not get Midwifery at Home from Nepean, a referral would be made to Katoomba to pick you up- but they would not be obligated to accept care. So, if midwifery support at home is important to you then that might be worth considering too.
So, I guess the questions I would ask are,
What is most important to you?
What environment would make you feel safer?
Take notice of what you feel when you read through this blog, where do feel more peace?
Both options have limitations, what limitations are you able to accept with more ease, or potentially compensate for more easily?
If you are feeling as though you may need more support, I have just launched my new website The Mothering Collective, with a new offering coming soon to support pregnant women.
You can also CLICK HERE for other support available, that I could locate, in the Blue Mountains.
I truely hope this helps someone.
Much Love,
Rachel xxx
