Gestational diabetes care at Kaiser

Hello,

I'd love to hear about any recent experiences folks have had with a gestational diabetes diagnosis while being cared for at Kaiser. 

Kaiser Oakland is very close, but I'm willing to other Kaisers for a great provider. So far, I have been unimpressed by my experiences at Kaiser Oakland and am wondering if this is due to the providers I've encountered, or the general systems in place there. 

A little context: This is my second pregnancy. I gave birth to my first at Alta Bates (induced, uncomplicated vaginal birth to a 9lb 5oz boy- very similar in size to his father and smaller than my father at birth). I had hoped for a homebirth, but after the dx moved forward with East Bay Perinatal and delivery at Alta Bates. I appreciated that there was a nurse midwife on staff that was able to deliver us and never pushed for a c-section, while every OB we encountered mentioned it at least once in the course of our conversations. I'm all for full disclosure of possible complications and keeping an awareness of what eventualities may come to pass, but am put off by the general GD=big baby=c-section mentality that many providers I encountered seemed to possess. 

If you've encountered a provider at Kaiser who has been willing to look at the patient as an individual and not just a diagnosis I would be very interested in learning about them. 

Thank you.

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I attempted a home birth for my second, while getting concurrent care at Kaiser Oakland, and felt frustrated and belittled by them as far as sizing my baby in utero. I ended up transferring to Kaiser San Leandro at 37 weeks and having a c section there (breech baby). I found that Dr Hong in San Leandro was very responsive to my concerns and listened to and believed me about what I was saying about my baby's size vs the sizing ultrasound at Kaiser Oakland. My baby ended being 8 lbs, which is not that huge. 

The only issue is- you can see midwives in the clinic in Oakland, but for delivery they supervise residents to attend to your birth. In San Leandro, you see OBs, and midwives attend to your birth (no residents). That ended up being what we needed since we already had a homebirth midwife. Good luck to you!

Hi, I had a very positive experience at  Mission Bay San Francisco. I loved my OB and the remote GDM care and management they provided. Also educated me about the medical risks for GDM babies and thus the desire for a C-section (not just coz they are big). But ultimately I was given a choice. BTw i’m very small. May be the provider..?

I don’t have personal experience with GD but have a couple of thoughts. I delivered my first baby at Kaiser Oakland in June 2017 and am now 22 weeks pregnant with my second. I’ve had a great experience so far both times. I was sure I wanted an unmedicated labor with my first and the staff completely respected that, although they checked with me to make sure when my labor dragged into 36 hours. I felt like my choices were respected. Also, I have a friend who had GD a couple years ago when she was with Kaiser and she was never pressured into a c-section at all. Granted, her GD was well-managed and her baby was actually on the smaller side but my sense is that Kaiser wants to avoid C-sections whenever possible. Good luck!

I apologize for not having a response to your question about Kaiser. But I really wanted to weigh in on the gest diabetes=big baby issue. This is just not the case and they should not be pushing this on you. I had mild gest diabetes that was managed with diet until the last 4 days of the pregnancy in which I used insulin. My child was always right in the middle of the weight distribution. I did a lot of research about this and found that mild GD is not necessarily related to large babies. It's typically when the woman had uncontrolled diabetes BEFORE her pregnancy and had uncontrolled GD are the babies bigger. Push back on them about this c-section stuff! 

I had gestational diabetes for first and 2nd pregnancy and was seen by Dr. Solh at Kaiser. She was a referral from OB that I really love in Richmond that would be too far from where I live for prenatal care. I also dreamed of having a home birth and using no medication but since I had gestational diabetes, I decided that a hospital birth would be most safe and I was still able to be med free. I've always had Kaiser and in general you are a number, they seem to follow a certain procedure until you really get to know your provider, advocate for yourself and your provider knows you..in my experience this happens through email. Dr. Solh has been responsive to my lengthy email attachments. What I didn't like was with gestational diabetes they use a "regional center" you work with a nurse and they lecture you about diet and take your weekly glucose numbers, this was a joke and not good care so I really advocated to work with her (I can say more about why this was important for me) but it's not something that most people do. 2nd pregnancy I also had gestational diabetes and thought it would be great to be in their new "centering program" work with midwife since I like that approach and think there's always things to learn being in group however if in centering I had to be monitored by regional center not OB which was odd so I declined to continue. There were pros and cons of working with provider mentioned but overall first pregnancy was a dream and second took a lot of advocacy, even during delivery but Kaiser San Leandro is a really nice facility and care I got with OB was good. Biggest con is appointments always started at least 30 min. late and best advice to schedule NST easy so you get dates/times that work best for you (they also always started later than scheduled appointment).

I had a good experience with both Dr. Kaaren Nelson-Munson and Dr. Lindsey Pierce, both in family medicine.  Was never pushed for a c-section or any intervention, and during birth at Kaiser Oakland was given a lot of support and never pushed to do anything (this really depends on your nurse though, because your gyn will not be present at the birth).  They also have nurse midwives at Oakland who oversee the residents and I had a good experience with them.

I just recently went through a GD pregnancy last year at Kaiser Oakland (and unfortunately it seems now that this has translated to type 2 diabetes postpartum) and I had maybe the opposite problem as you. This was my second pregnancy and my first was a c-section with twins. Everyone I talked to at Kaiser, and my OB very much kept insisting that I was a great candidate for a VBAC. They didn't push me toward vbac necessarily, but made it clear that this is what most women choose to go for and very rarely brought up the idea of a repeat c-section.

The gestational diabetes diagnosis didn't really affect the choice of vbac or c-section at all. The only thing they were strict on was the possibility of an induction which they did push for once I was past 38 weeks and my baby was measuring to be pretty big, but even then I asked them to wait on the induction and they were ok with doing so since my baby and I were pretty healthy on the whole. I did end up having a successful vbac after my water broke on its own. It wasn't a great experience. I kinda wish I had gone for the c-section instead (my first c-section was super easy, both the surgery and the recovery while my vbac recovery was very rough). But my OB at Kaiser never was pushy about c-sections at all and on the whole she has been a great OB. Her name is Dr. Medha Donde.