Oakland vs WC Kaiser Labor and Delivery

Hello, 

I was planning on delivering at Kaiser Oakland for my first baby this summer. However when recently interviewing a doula, she informed me that if I go to Kaiser Oakland and choose to have a midwife over a physician, that means residents will be part of my care team. I would like to decline any involvement with residents in my delivery and would prefer an experienced midwife. The doula reported that if I select to have a midwife oversee the delivery that residents are learning from the midwives and would provide medical care should it be needed during a midwife supervised labor. I would of course have an OB/Gyn oversee my delivery if I become high risk or if there are complications but I do not want residents to be part of my care team. The doula indicated to me that if you opt to have a physician over a midwife than you can decline residents, but I wasn't aware I could choose having and OB over a midwife if you are low risk. I thought Kaiser would automatically assign me to a midwife if low risk. She also indicated that at labor and delivery at Kaiser Walnut Creek or San Leandro the midwife teams do not include residents. Does anyone have knowledge of this? And what is the best way to refuse any resident care at Kaiser Oakland? Can this be done in the birth plan?

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I have had two low-risk deliveries at Kaiser Oakland and both included care by both an OBGYN and a midwife. In my first birth, they asked if a resident could join for delivery and I said yes, in my second birth it never came up. As far as I know, every delivery at Kaiser Oakland includes a midwife and an OB - I’m not sure what the policy is on residents. I would talk to you doctor or someone else at Kaiser and don’t rely on your doula who may not be correct.

I don't really understand your concern - you don't want doctors involved in your care team? Residents are doctors, not medical students. Sure, they are still training in their specialty, but they are perfectly competent and are under the supervision of not only midwives but attending physicians. Midwives run the show at Kaiser Oakland, and it's a great place to have a baby. I've had two babies at Kaiser Oakland and the whole staff is wonderful. Are you concerned that doctors will not support your birth plan? That hasn't been my experience - I actually think that having residents around is a bonus -- they are super attentive, friendly, and eager to provide excellent care, plus it's nice to be able to provide them with the experience they need in order to finish their training. 

I delivered at Kaiser Oakland in 2017, I was not high risk, but I was induced, the whole process took 3,5 days till birth. I saw a midwife twice, once for a brief consultation, once for 20 minutes to catch the baby at the end. I saw residents multiple times to induce my labor, to check my cervix, etc. I was very unhappy with most of the interactions with residents, but they have a mostly new team now, so this could be different. I never saw a OB/Gyn. The people I interacted with the most were L&d nurses, who were all really wonderful, and the one that was with me during pushing was amazing. I don't know about the ability to choose who takes care of you, I am curious about that. I am expecting a second baby in June and am also considering Walnut Creek. Have not had a chance to visit there yet though.

hi - I recommend emailing your obgyn, he/she will be able to provide current and accurate information for their process at Oakland kaiser. You can also sign up for a “labor and delivery” tour at Oakland kaiser and ask these questions. I delivered at Oakland kaiser less than 2 months ago and had a great experience. Residents were part of my care team but I found them to be very attentive and sympathetic. 

I have delivered 2 babies at Kaiser Oakland and I don't believe there is any way to opt out of residents.  To be honest, you don't have much contact with residents, doctors or midwifes for the majority of your labor.  The biggest determiner of your experience is the nurse you get in my opinion, and if you have a supportive doula and/or partner as well.  I had an amazing delivery nurse who helped me through the whole process and residents/midwives came in periodically to check but didn't make much of a difference in my opinion for a low-risk birth.  If you really don't want residents, then I suggest delivering in WC.  I toured San Leandro and found them way less baby friendly than Oakland or WC, but perhaps that has changed in the last 5 years since I had my first baby.  Do know, that if you deliver in WC, you may get a shared postpartum room, which I have heard can be uncomfortable, especially if you are on the side without the bathroom and have to walk past another person to go to the bathroom (which postpartum bathroom going is hard as it is!!).  For me, that was a deal breaker because I wanted to be sure I had privacy postpartum.  

Hi there! Congratulations on your upcoming baby!

Kaiser Oakland is a teaching hospital. Residents are the primary hands on doctors. Midwives oversee the resident of low risk patients and the OBs back the midwives up, while overseeing the residents of high risk patients. Don’t forget you might encounter other residents for like anesthesia (epidural) also. If you do not want residents to care for you, and are able/willing to go to another Kaiser Hospital, you should.

Kaiser San Leandro and Walnut Creek do not generally have residents and if they do, it would be one much further in their program. Midwives generally manage low risk patient and consult with the OB as needed. OBs manage the high risk. Both have a level 3 NICU...that you won’t need :) Both use CRNAs if you choose to get an epidural.

Walnut Creek has a great reputation, but the hospital does have some shared rooms in the postpartum ward (after you have the baby). San Leandro has all private rooms, but they’re not very big, so pack modestly.

Hope this helped. Congratulations again!

I delivered at Kaiser Walnut Creek and had an excellent experience!  The midwives were great, very experienced and new exactly what do to do. My labor lasted a couple of days , so cycled through a couple of shifts. I was living in Oakland, there was no traffic getting to Walnut Creek Kaiser and parking was quick and easy. I felt Oakland wasn't as organized and streamlined and the facility in Walnut Creek is very nice for delivery. Tour both places, go with your gut, good luck.

Kaiser Oakland is a teaching hospital, so there are residents involved in most care regardless of whether you have a midwife overseeing your delivery or not. I'm not sure if you can decline to have them participate, or how it might differ from care at WC or SL--your OB should be able to clarify that. For me, it was a plus--the residents who were there for my children's births were incredible, and perhaps because they were newly minted doctors, they were up on and proactively supportive of many of the newer baby-friendly practices in labor and delivery. (One resident was able to recommend a newer approach to address a complication of my first child's unmedicated birth that avoided the need for a more significant intervention that would have necessitated an epidural--that was huge!) I also had a nursing student who was trained as a doula prior to starting nursing school at one birth, which was a wonderful and unexpected experience. I appreciated the fact that my kids' births broadened the experiences of the residents and, I hope, helped them to grow into stronger doctors. If you do decide to deliver at Oakland (and we had great experiences there both times, so would recommend it, particularly if you live on that side of the tunnel) I'd go in with an open mind about residents.

I delivered my second child at Kaiser Oakland with an OB (I was followed by an OB prenatally, and did not choose a midwife for delivery) and I had resident involvement in my delivery... I think. To be honest I don't even remember who did the actual delivery. It's my feeling that if people choose to receive care at teaching hospitals (and therefore benefit from the excellent care they receive there as a result of the affiliation w/ teaching institutions) then they should be willing to participate in the teaching model. Residents are doctors. If you don't want resident involvement, then choose a hospital w/ no residents, by all means. But it seems wrong to me to try to reinvent the wheel for your personal ideas/preferences. If your preferences are in line with how the hospital you choose is already set up, your overall experience will be better and smoother, rather than "fighting the system". Best of luck!

Hi! I delivered my first baby at Kaiser Oakland last summer in July. I myself am a physician and I know just how green July interns are, and that gave me pause! I was high risk - admitted (and delivered) at 36 weeks for pretty nasty fetal heart decelerations. I came very, very close to having an emergent c-section under general anesthesia. Ultimately, the OB team (residents included!) made a vaginal delivery possible for me. My daughter and I were healthy and we're doing great. I am dead-on certain that if I'd delivered anywhere else, I'd have had a c-section. I can't say enough good things about the team at Kaiser Oakland, residents (even interns!) included. They're closely supervised, especially early on, and the OB group there is really good. If you are worried your care would suffer with involvement of the residents, I actually think it's the opposite. Of note, the brand-new intern who did the estimated fetal weight on my daughter was MUCH more accurate than the sonographer was!

That said, if you are firm in your desire not to have residents involved in your care, that is your right. You may request MD care, you may request midwife care, you may request no med students or residents, or any combination of the above. You may put it in your birth plan, or just tell your OB (she'll put it in your chart) and the nurse when you sign in to L&D (she'll advise the team). Best of luck for a smooth delivery!

I will also be delivering at Kaiser Oakland in about a month. A midwife, L&D nurse, obgyn and resident are all included as part of your care team (not including the post-partum care team as well). My friend is a labor&delivery nurse at Kaiser Oakland and told me that I could refuse a resident without a problem if I wanted to. I think you can do that in your birth preference. Residents are included because Kaiser Oakland is a teaching hospital, but you still have the choice :)

I felt compelled to respond to your post because I birthed my kids at both Kaiser WC and Oakland, albeit a decade ago. I had midwife care at WC and an OB with residents at Oakland. I think you are overthinking things. Whether or not residents are present there will be a midwife (and supervisory OB) helping you. YOU are doing the work of bearing your child, they are just along to help you as needed. Have you toured both facilities yet? Have you thought about the length of time to get to either? Believe me, laboring in traffic to Walnut Creek may not be your best option (been there, done that!). BY FAR the thing that helped me most in both births, besides my doula (and honestly more so) was the INCREDIBLE care I received from the L&D nurses - honestly, those women are ANGELS and much more involved in your labor than any doctor, resident or midwife, and I was lucky to have amazing nurses for both births. I'm guessing most women who have labored would echo this sentiment. Good luck to you!!

Hello,

I am a Midwife at Kaiser San Leandro. Congratulations on your first pregnancy! It's true that at Kp Oakland the Midwives supervise residents, in their role as teachers of normal birth. The Medical model is predominant over the Midwifery model there. 
At both the San Leandro and Walnut Creek practices the Midwifery teams offer 24/7 labor and delivery care and provide Midwifery Management in a collaborative and patient centered approach.  Our 18 midwives work alongside the OBs who support us and step in when invited/needed. Otherwise they trust us to care for our patients which we do with a high level of respect and integrity for the birthing family.
we have no residents. Everyone is fully trained. We occasionally have Midwifery or medical students and you may decline their involvement.

everyone who is low risk will be offered and may choose to have either a Midwife or Ob-Gyn care for them.

 Midwives also offer prenatal care either in office or through Centering Pregnancy which is wonderful. I recommend Sara Flores, Kate Harris, Qui Tang and Doris Untalan, CNMs.

At San Leandro we also offer a class called "Meet the Midwives" the first Saturday of the month 12:30-1:30 to welcome and introduce you to our Midwifery team. You can register via the health education department.

I hope  that your enjoy a healthy and pregnancy and empowering birth.

best wishes,

a KP SLN Midwife