Older blog entries for hypatia (starting at number 342)

Meet the Ada Initiative: supporters party, San Francisco, Mon July 16

I’m in the US for a couple of weeks. The Ada Initiative, my non-profit organisation supporting women in open technology and culture, is having a party while I am there:

We invite you to join us in downtown San Francisco for an informal meetup! Ada Initiative co-founders Mary Gardiner and Valerie Aurora will be there, along with many of our board members and advisors. Mary is visiting San Francisco on her way back from keynoting the Wikimania conference, and wants to meet as many Bay area Ada Initiative supporters as she can.

Date: Monday July 16
Time: 7:30pm to 9:00pm

This is a self-hosted gathering at Jillian’s, a restaurant and bar in the Metreon.

Jillian’s
101 4th St
San Francisco, CA 94103
USA

Please register so we know how many people to expect.

We thank anyone who takes this opportunity to donate, but this gathering is open to everyone who supports women in open technology and culture in any manner.

Valerie and I are also having lunch on the Google Mountain View campus the following day (Tues Jul 17) in order to meet supporters there. It’s only open to Googlers and their invited guests though. Send an email to contact@adainitiative.org if that describes you, you want to come, and you haven’t yet heard about this.

If you know me personally, and you didn’t know that I am in DC all this week and San Francisco for half of next week, send me an email at the usual address and we might meet up.

Syndicated 2012-07-10 18:00:24 from lecta

On opting out

Captain Awkward has a thread on lateness and keeping in contact with people who are constantly late or no-shows. Her answer is worth reading, because she takes both sides seriously: the way being late feeds into anxiety or depression disorders sometimes (and has for her), and the way to structure social engagements with people who are in that place (whether due to mental health issues or not, it doesn’t require disclosure).

She’s specifically asked that people who are good with time and todo lists (I am, relatively) not drop in with “handy hints”, which is fair enough, but now I’m finding some of the”just loosen up, I have rejected our culture’s terrible clock ticking obsession, and I think that makes me a better person” (uh, paraphrased) comments irritating. I’m posting here rather than there because of the relative privilege of being good with my culture’s approach to time, though.


So, private system birthing is expensive regardless of insurance.

Finally, tests like ultrasounds are usually Medicare plus out-of-pocket too.

Now, birth choices in Australia.

Homebirth. There are some very small number of hospitals in Australia that will allow their midwife staff to attend some homebirths. It’s very easy to get disqualified from such a program. I would be on several grounds (some more legit than the one I’m about to give you), including the simple fact that my son’s birthweight was over 4.0kg.

You might also birth with a privately practicing midwife, or, in theory, with a private midwife collaborating with an obstetrician as backup (there are very few such arrangements so far). Most, although not all, private midwives will also only work with pretty low-risk women (singleton pregnancies, head-down, no high blood pressure or diabetes, that sort of thing, about 80% of pregnancies get a low-risk classification IIRC).

Is private insurance useful? Some private health funds provide some limited cover for this, I believe, on the order of $1k to$2k of the midwife’s fee, which is around \$5k last time I looked. In the collaboration setup Medicare contributes too, I think?

Birth centre These are midwife-only maternity units attached to public hospitals. (Sometimes at some physical distance, eg Ryde Hospital only has a birth centre, with transfers to Royal North Shore several suburbs away.) You need to be assessed as low risk and if that assessment changes (and this isn’t uncommon, eg, your baby is breech or you get diabetes or pre-eclampsia) you get summarily transferred to the doctors and your whole care team often is suddenly switched out from under you. (Also they usually don’t do epidurals, I think? So the transfer rate for pain relief is not insubstantial I believe.)

Is private insurance useful? No, this is publicly funded.

Public hospital, midwife’s clinic If you go to a public hospital, and are assessed as low risk, almost all of your pregnancy management will be by midwives. Often they “caseload” now, meaning you see the same one each time. Again, if you become high risk, swish, off to the doctors.

Is private insurance useful? No, this is publicly funded.

Public hospital, doctor’s clinic. If you aren’t low risk, this is you. (This was me.) Chronic health problems or pregnancy complications (like pre-eclampsia) put you here. For your appointments, or at least most of them, you see an OB registrar or staff specialist. On high rotation, often, that is, you won’t usually see the same one many times. If you have a vaginal birth it may still be midwife-only, or largely midwife managed.

Is private insurance useful? No, this is publicly funded.

Public hospital, private doctor’s patient. In this case, you choose your doctor, see them mostly in their own clinic, birth in a public hospital (with you or your private insurer paying for the facilities) with the doctor of your choice attending. This is subject to gap fees for the doctor.

Is private insurance useful? Yes, pays for your accommodation and some of the OB’s and anaethestist’s (if needed) gap.

Public hospital, private midwife’s patient. This depends on a midwife/obstetrician collaborative practice. As I said, rare, but there’s at least one that allows a public hospital birth (private admission) with the midwife of your choice: Melissa Maiman in Sydney.

Is private insurance useful? Yes, pays for your accommodation. Not sure what happens if an OB and/or anaethestist are needed.

Private hospital, private doctor’s patient. There’s no midwife-managed option. If you’re birthing in a private hospital, you need a doctor of your choice attending. Again, pre-birth consultations in their own clinic, and subject to gap fees.

It’s definitely worth noting that while your private doctor will be an obstretrician and can manage higher risk pregnancies, for really serious stuff like prematurity earlier than a certain point, pregnancies with more than 2 babies on board (I think) and similar, they will actually refer you into the public system!

Is private insurance useful? Yes, pays for your accommodation and some of the OB’s and anaethestist’s (if needed) gap.

Public hospital, high risk clinic. I don’t know much about this, I’m told it’s the next level up in risk, and it well might be my next pregnancy. Joy. This is where you end up with OBs with a high risk interest, maternal-fetal medicine specialists (OBs with a formal subspecialty in very high risk pregnancies), renal physicians, endocrinologists, etc. This often involves referral to a tertiary hospital. (Sometimes specialists can consult without you being in one of these, like, an endocrinologist might monitor diabetes or thyroid hormones with you in the regular doctor’s clinic or seeing a private OB.) Birth choices guides don’t talk about this option very much, because you don’t really have a choice at this point (except birthing unattended or with a very risk-tolerant private midwife).

Is private insurance useful? I’m not sure, to be honest. It probably depends on the risk profile of your actual birth, I guess? If your birth is able to be attended by a regular private OB, maybe they let you do this? But you can do this publicly too.

My Birth has a lot of information on birth procedures and the outcomes of different birthing providers, from a low intervention advocacy standpoint. One thing of note which gets picked up a lot by low intervention advocates is that despite the private birthing system referring all their hardest cases back to public, and despite the public patient profile being poorer with less good preventative health care and so on, private hospitals have much higher intervention rates.

Conclusion

It really depends on where you want to birth and with who attending. If the idea of the same doctor doing your pregnancy management and attending your birth appeals, that’s tending towards private birthing and thus private health insurance. But it has high out of pocket costs on top of the insurance premiums. (Note also that private health insurance policies are expensive if you include obstetric coverage, and will always have a 12 month waiting period for it, so you must obtain it before pregnancy.)

I was reasonably happy as a doctor’s clinic patient for my first birth. If I was low-risk I’d probably likewise go public, ideally with a birth centre or caseload midwife pregnancy+birth.

Syndicated 2012-05-07 11:37:56 from lecta

Come to AdaCamp DC, July 10–11

Applications now open for AdaCamp DC

AdaCamp DC will be July 10 – 11, 2012, in Washington DC, co-located with Wikimania 2012. We are likely to have more applications than available slots, so apply now to have the best chance of attending. Applications close June 15 (May 11 for those requesting travel assistance).

Who should apply

AdaCamp DC will bring together a wide variety of people from open technology and culture, all of whom are working to support women in open tech/culture. We’re looking for people who:

• Participate in open technology and culture: any field involving open/grassroots/community participation and sharing the results of your work for free: open data, open source software, wikis, open government, open libraries, remix/fan culture, open video, and more
• Can share information about women’s experiences in that field, including talking about women’s achievements and the challenges they face
• Want to work together and share strategies to support and promote women in the field
• Share the Ada Initiative’s feminist approach to supporting and promoting women in open technology and culture
• Are young and old; students, professionals and hobbyists; from a diverse range of backgrounds; and reflect the breadth of the open technology and culture field

AdaCamp is open to people of all genders. However, since AdaCamp and the Ada Initiative exist to support and promote women in open technology and culture, prospective attendees who are not themselves women will need to demonstrate a high level of prior engagement and experience with the issues faced by women in those fields in order to be invited.