High Risk OB Recommendations?

I’m 39 and 14 weeks pregnant with my second child. I have hemophilia and a few other conditions that place me in the “high risk” category. I loved my previous OB, but he has since moved out of state so I’m back at square one for this pregnancy. I live in Oakland but have been advised that very few OBs have admitting privileges to Alta Bates and that the hospital hasn’t been updated in quite a while. I’m currently being seen by an OB at John Muir along with the team of hematologists in perinatologists, but I haven’t been pleased with the care I’ve received. I considered switching to UCSF, but found out that those in the high risk category are assigned a provider based on the provider’s specializations and on the day of delivery might be seen by one of 50 different providers. This feels very impersonal and concerning as I have several risk factors that need to be weighed very delicately and having absolutely no prior relationship with the person delivering me seems very impersonal and scary. Traveling all the way down to Stanford seems impractical and potentially unsafe. Does anyone have any high risk suggestions in the East Bay that I haven’t considered? I have Anthem PPO for my insurance. Any tips are very welcome!

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I'm considered high risk and being seen at a newish clinic in Berkeley (right next to Alta Bates) called Millie. My midwife is Talia Borgo. I don't know what types of high risk pregnancies they feel comfortable supporting but they deliver at Alta Bates (though they're still getting all their midwives admission privileges, not everyone has them). I had Anthem PPO last year and I went to see them for a previous pregnancy. 

I went to UCSF for my high risk pregnancy. It's true, you don't have a dedicated OB. You are seen by a team of doctors and it basically changes every single time. While I suppose it is a bit impersonal, I didn't feel like I wasn't getting quality care. I find that they are very good at conveying information between providers and they are also very good about listening to patient concerns. If I have another high risk pregnancy, I will return to UCSF.

Sutter East Bay does have high risk OBs (they're in the Maternal & Fetal Medicine department). I believe I had one or two appointments with Janet M. Goldman (who has admitting privileges to Alta Bates), who seemed well-informed and nice, but I had to transfer to UCSF or Stanford to have access to a Level IV NICU after delivery. 

If you do end up deciding between UCSF and Stanford, I think you should give UCSF some real consideration, just due to distance. Stanford does have offices here in the east bay, but in the last few weeks of your pregnancy, you have to do all your appointments from Stanford hospital, so that would be a lot of commuting. Also, once you give birth, it might be a little easier to be closer to home during your hospital stay, because of your other child. I had a friend who saw an OB with Stanford and she ultimately gave birth at Alta Bates with a different OB because she was not able to get to Stanford in time to deliver.

I'm AMA but otherwise not high risk, but can share that I have been very happy with the Sutter East Bay Medical Foundation practice on Milvia St. My OB is Dr. Madhavan, who is wonderful, but I've also seen some of the others over the course of my pregnancies and have liked them all. They all have admitting privileges at Alta Bates, which I also only have positive experiences of. It may not look as new as, say, the UCSF Mission Bay hospital, but I've had good experiences and no complaints. 

My pregnancy was uncomplicated, so can’t speak to the specifics of high-risk care (tho I was technically high risk bc delivering at age 38) but I had a great experience with the OB team at Sutter East Bay Medical Foundation and have known several others who had good experiences with them, including one friend who is pregnant now while managing an autoimmune disorder. They are also a group practice but more like a dozen OBs than 50. My primary OB was Rebecca Taub who trained at UCSF, but I had positive experiences with everyone I saw in the practice. My friend with the more complex pregnancy sees Dr. Pahlavan who I’ve heard great things about. The group does all their deliveries at Alta Bates, they are midwife-led but you can request an OB attend your delivery.  

One other thing: my experience delivering at AB was very positive, did not feel like the hospital needed updating (tho it’s true it’s not as shiny as UCSF), the staff nurses on L&D and NICU where the baby spent one night were all wonderful! 

I highly recommend UCSF. I originally was getting prenatal care through Kaiser Oakland but got referred to UCSF because of a serious complication, and it was like night and day. You don’t always see the same provider but they are all excellent and extremely thorough. My Kaiser appointments with OB were all like 10 min so I didn’t get to know her anyway, versus UCSF appointments were scheduled for 40 minutes and the doctor never left until I had all my questions answered. They have so many experts on specific health issues, and one of them will oversee your care if needed- they found out I had HELLP syndrome (which Kaiser missed) and they have a doctor who’s the world expert on the condition. I only met her once but every Dr I saw after consulted with her and she oversaw my care. Same with the nurses and hospital staff. Since they are a teaching hospital things can take longer, but I think they are more thorough for that reason. 

I have a blood clotting disorder (history of DVTs & PEs), was very high risk in both my deliveries, and delivered both times at UCSF. I would absolutely recommend them for your situation, if you can become comfortable with the unknown regarding who will ultimately be there for delivery. In the lead up to delivery, my UCSF hematologist, Dr. Andrew Leavitt - who is absolutely phenonemal (the best doctor I have ever interacted with - I'd probably try to continue to see him even if I moved out of state!) - worked closely with the main UCSF perinatologist I was seeing to determine a plan of action for the delivery (which included a planned induction to mangage care appropriately). I was part of the discussion all along the way, and felt like all of the UCSF staff I interacted with cared deeply that I was comfortable with the plan (and various contingencies), and were open to discussing the data and research behind their recommendations. When it came time for delivery the team at UCSF assigned nurses who were highly experienced in caring for high risk cases, and had specific experience in handling patients with blood clotting issues and the accompying medical needs (e.g. at one point I was connected up to three different IV poles). While the doctors did change over the course of my labor during shift changes, it was clear that everyone coming into my room was well-briefed on the specifics of my case and needs. And when my second delivery accererated faster than planned, the most experienced doctors (at least three of them!) were in my room in minutes to help manage the situation. All in all, I felt like I got world-class medical care at UCSF, and that they were very capable of handling my relatively challenging medical situation.

Glad to message further on it, if you'd like!

Hi, I had a high risk pregnancy that was uneventful until labor. Then a lot of things went wrong: emergency C-section, NICU. (Baby got out within three days and is completely healthy now.) OBs at Sutter's Milvia practice were great throughout  pregnancy, during the nightmarish delivery, and afterwards in follow-up. Yes, Alta Bates' rooms are older but they are also big and you get one to yourself, with a separate bed for your partner or loved one. All this to say, if you can get in with the Sutter OBs, Alta Bates might be worth considering 

Congratulations on your pregnancy! I also live in Oakland, was considered high-risk in pregnancy (autoimmune disease), and delivered my first child at UCSF last spring—I was really, really impressed with the care I received.  At first, I was put off by the idea of being matched with any provider. I deciding to participate in the Centering Pregnancy program, which I highly recommend: I was placed in a small cohort of women with similar due dates, and we met as a group led by an OBGYN, midwife, and midwifery student. In these two hour sessions, we'd spend one hour on prenatal education, and one hour peeling off for individual check-ins with the providers while the rest of the group chatted. I really appreciated getting to know our two providers so well, and I found the insights and support of the group invaluable (we're still in touch!). I happened to get really lucky: my OB admitted me when I was in labor, and my midwife ultimately delivered my baby. That said, even if those two amazing women hadn't been part of the birth, I would still rave about their care and attention (both visited me in the weeks that followed when my baby needed time in the NICU).

As soon as I was established in the Centering program, my two providers immediately referred me to a high-risk OB who followed me throughout pregnancy and postpartum. While that doctor wasn't present at my birth (and we primarily met by Zoom), she was an invaluable advocate—when I needed to see specialists, she set up appointments for me in record time, she communicated frequently with my OB and midwife, she gave me a cell phone number to reach her anytime, and her notes and recommendations on my chart impacted my care when I delivered. Postpartum, when I was dealing with really rough breastfeeding challenges, she worked with the hospital's lactation consultants to refer me to a breastfeeding medicine doctor. It was clear to me that her reputation carried weight; she made things happen for me instantly and commanded a lot of respect in the UCSF community—I was super grateful to have her on my team.

Hope this helps! Feel free to contact me if you'd like specific names of providers.

I had a high risk pregnancy at UCSF and had a great experience. The delivery nurses and doctors were amazing. I felt that my safety but also my dignity were their top priority and my wishes were respected to the extent possible. I think you will be in good hands even if it is a doctor who hasn’t seen you before.

I know you said east bay but the best doc in the Bay Area for this is Dr. Laurie Green bar none. If you can get on her panel you’re in excellent hands. She’s in SF. 

Another response in support of UCSF. It's true that you won't necessarily see the same providers each visit, but the care and facilities are exceptional. I established care at four different Bay Area clinics throughout my pregnancy (due to moving and then later due to significant, high-risk complications... this includes the UBCP MFMs in Berkeley, which I do not recommend), and not once did I feel safe and supported until I was at UCSF. I'm planning to get pregnant again and will automatically be considered high risk, and I'm excited to be starting with them from the jump. 

Don’t have a specific recommendation to make, sadly—I was in a similar boat a few months ago and ended up in John Muir. I’m here to say do your best to stay with Alta Bates. They are amazing and deliver many many many more babies annually than UCSF, including high risk. While my doctor was good (Monardo), my overall experience with her office, the other OBs in the group (vital), and the John Muir hospital were really, really not good. I ended up in the emergency room at Alta Bates a week postpartum (because one of OBs at John Muir was outright negligent in the discharge process—truly, that’s how women die in this county at Third World rates), was admitted to the maternity unit even though I didn’t deliver there (they let me bring the baby along so I won’t lose breastfeeding—they are beyond great, really),  and it was night and day compared to John Muir. In hindsight I should have maybe suffered through the Sutter Milvia factory farm just so I could deliver at AB.

I would try to go to Alta Bates or UCSF. 

I have had two high risk pregnancies. (One GD and one diabetes). The second time, I was happy with the care I received from the Sutter East Bay OBGYN group (with privileges at Alta Bates). I see a regular OBGYN, and also a Maternal Fetal Medicine specialist, and I feel the MFM is much better than my previous MFMs. And my previous experience at Alta Bates delivering was pretty good.

That said, unless you have a scheduled c-section, I think you’re going to get whomever is on-call as your doctor for delivery with any practice. There aren’t really any drs that run a small practice who go on call for each patient anymore, I don’t think. At Alta Bates, the on-call OBs seem to have an MFM they can consult with remotely.