When should I book ?
Ideally at about 8 weeks; this allows you to meet the team and have a full consultation with both Dr. Natalie the obstetrician and Jillian the midwife. Then, there is time for a lengthy discussion regarding testing for your pregnancy in the first trimester – this is important to spend time on as tests are gestational dependent and the science can be quite difficult to understand. Lastly, if a viability/dating scan is required, then this can be attended to at the rooms at this appointment as well.
What is the usual schedule of visits ?
4 weekly from booking until 28 weeks, 2 weekly from 28-36 weeks and then weekly from 36 weeks until birth.
Does Dr. Natalie "share care"?
Yes, for patients outside the Metropolitan catchment area (North of Palm Cove, South of Gordonvale and West of Kuranda). This would be "modified" shared care, and decided on a case-by-case basis.
We have recently changed our policy to include sharing care with Cairns Hospital - that is, you can have all your antenatal care in one place with Dr. Natalie, but book publically to have your baby. This means that the public hospital and their doctors and midwives would take over your care for the birth and if there were any complications antenatally.
From the 12th of December 2017, the Cairns Hospital have confirmed in writing their verbal instructions that none of the private obstetricians are able to access admitting rights for their patients. This means that obstetric patients under 34 weeks who require the Neonatal Intensive Care (NICU) support, will have no choice but to admit publically. This is disappointing, as it is physically impossible for Dr. Natalie and the other private obstetricians to safely cover both hospitals "on call" and would be frequently called away from a booked clinic. However, this is the decision of the Cairns Hospital Executive. If a private patient in this situation is asked, and chooses, to admit privately to the Cairns Hospital, they will not have a choice of obstetrician and be nominally assigned to one of the public specialists, and their Health Fund billed. They will not necessarily be treated exclusively by this obstetrician. I would encourage patients with questions to approach the Cairns Hospital Executive Director of Medical Services for further clarification.
How much will it cost?
This varies greatly depending on your health fund and Medicare entiltlement. Please contact the rooms to discuss your individual circumstances and come in for a quotation.
Does Dr. Kiesey-Calding charge a Pregnancy Management Fee (PMF)?
Yes. Details of this should be obtained by contacting reception staff, as this will vary depending on your circumstances and entitlements.
Broadly speaking however, after the PMF has been paid, then all visits at Cairns Obstetrics and Gynaecology are bulk billed. This includes scanning for growth and well-being or surveillance, CTG's and Antenatal visits. Visits at the Hospital that involve one of the other Specialists who are “on call” for Dr. Kiesey-Calding may generate a fee however.
If you are Medicare eligible, then you will be entitled to a rebate. No Health Fund will cover antenatal care, they will only cover any hospital admissions antenatally and the delivery. Contact Medicare and your Health Fund directly for more information regarding this.
At your second visit, a portion of the PMF is due as a "booking fee" and will be held as a part payment against the total amount of the PMF. Another part payment will be due after 20 weeks of pregnancy. Then the balance will be due and able to be submitted to Medicare for your rebate after your visit @28 weeks of pregnancy. These part-payments are non-refundable in the event that you seek care elsewhere and will cover the management of the pregnancy up to 28 weeks gestation.
The Pregnancy Management Fee has stayed the same since 2011, and offers a discount for previous patients of Dr. Natalie's, as well as a discount if it is a second or subsequent baby, regardless of where that baby was born.
Where can I deliver my baby ?
Either at the Cairns Private Hospital or the Cairns Hospital as a public patient - please see notes on "shared care" arrangements above.
Why do I need a paediatrician ?
After baby is born, a Specialist baby doctor (the paediatrician) checks that baby is healthy. A similar check is performed prior to baby going home, and the paediatrician will also visit every day of your admission in hospital. This will occur at both hospitals. After your discharge from hospital, your baby will be checked at 6 weeks of age by their paediatrician. You will need to check with that particular paediatrician regarding an appointment, usually through their secretaries at their private rooms. Please see the "contacts" page for paediatricians telephone numbers and details. Unless you had a preference, you will be allocated to the paediatrician taking their turn to be the "paediatrician of the day".
What ultrasound scans do I need?
"None" is the easy answer, as every ultrasound in pregnancy has to be referred by a doctor there are no "standard" scans. However, most people require a dating scan at 7-8 weeks, then a nuchal translucency at about 12 weeks, followed by a morphology scan at about 20 weeks. After this, scans for the growth and well-being of the baby are done on the basis of clinical need.
But don't I need an ultrasound at every visit? How will I know that everything is going okay?
This is in accordance of the first principles of ultrasound; "use the least amount of ultrasound energy and only when clinically necessary". There have also been large studies done on the outcomes for babies who have been "routinely" scanned - these don't show any better outcomes for these babies, but does show an increase in unnecessary intervention in pregnancies. Finally, there have also been studies done showing that senior midwives and obstetricians are as effective as "routine" scanning in picking up babies that are either small or large for their dates.
Your baby will be assessed clinically by Dr. Kiesey-Calding at your antenatal visits, and you will be offered ultrasound scanning if it is deemed clinically necessary.
I have received a bill for pathology - why ?
Pathology services are offered through private companies - namely Sullivan and Nicolaides Pathology (SNP) and Queensland Medical Pathology (QML). The government has stopped giving rebates to these companies for the pathology services that they provide to private patients. Out of pocket costs should be small and capped in the case of multiple tests. Any questions on this should be addressed to either SNP (1300 732 030) or QML (1800 350 046) directly, as Dr. Kiesey-Calding has nothing to do with this billing.