UCSF Labor & Delivery

San Francisco

Parent Q&A

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  • UCSF or Alta Bates for planned c-section?

    (11 replies)

    Hi - I am pregnant with my second. My first was delivered outside of California via c-section after 28 hours of induced, unproductive labor. I have no interest in attempting a v-bac; I would like to schedule a c-section for my second (and believe I have that option since I am 35+). I am trying to figure out where to deliver - UCSF or Alta Bates. 

    I have had a great patient experience (for other matters) at UCSF, but the positive reviews UCSF delivery reviews all seem to speak to the birthing experience, great birthing suites, etc.

    Alta Bates is more convenient, but I've also heard more horror stories - though fewer about c-sections. 

    I would love to hear experiences of scheduled c-sections at UCSF and Alta Bates to help inform my decision of where to deliver. If you've had a positive Alta Bates or UCSF c-section experience, I'd also love to hear who your doctor was, as I'm flying blind. 

    Thanks!

    Hi if you are planning a c section i would go to where is most convenient. The surgery will be faster in a non teaching institution and it will be closer to your home.

    Im with UCSF and can't speak highly enough of them. I just had a planned c section 3 weeks ago and the whole experience was a great as it could be. Amazing staff, lovely facilities. UCSF is also where other hospitals send their trickiest cases so you'll be in the right place if anything goes wrong.  My obgyn was Dr Lester who I love but another doctor, Dr Tushani Dimantha Illangasekare did my c section due to scheduling requirements, and she was also lovely. 

    Go for UCSF is my advice :) Mission bay is not so long a drive from east bay. 

    I had a good scheduled c section experience with dr. Lilia Lizano at Alta bates,

    I had a planned c section with Dr. Redwood at Alta Bates in early 2020, and my experience was VERY positive. Everyone was very professional and friendly, and I healed much more quickly than I expected to. 

    Other details - 

    -I slept more or less through the night the night before my c section. Such a nice part of having a planned c section. Went in around 6am, and didn't have to wait around long. Processes were smooth. Once I was in surgery, baby was born in 7 mins. 

    -Personally, I did not feel the need to take any opioids after the surgery itself - was able to stick to (prescription-strength) Advil and Tylenol. This was important to me, because I hate the groggy feeling of being drugged up, but I didn't feel like I was being "brave" and suffering through unnecessary pain either. I think it really speaks to how well the c section was executed and the team of nurses who trusted my instincts around pain management. 

    -I was able to take short walks by the end of the week, and I was able to go on short runs 6 weeks after my c section. 

    -My scar healed beautifully - no scar tissue that I'm aware of. 

    Good luck! 

    Hi-

    I had a scheduled c-section at Alta Bates this past march; my experience was fine. I think the most important component (b/c it's scheduled) is who will perform your surgery. My OB that I saw throughout my (complicated) pregnancy performed mine and that was made a huge difference to me. 

    I will note that UCSF is a nicer, newer building. Alta Bates is older & in need of a face-lift. Their food is also atrocious (I haven't tried UCSF's) - but there is a Whole Foods a few blocks away, so your partner can hopefully supplement pretty easily.

    Finally, regarding nursing staff and experience - some are fantastic, others are meh - as I would expect at most other hospitals as well. I delivered my first in the city at Mission Bernal and had to be transferred post-delivery to the new Sutter facility - and had some truly awful care there. I would not recommend them.

    All taken, if who delivers you is important, I would definitely consider figuring out where that OB / office has admitting privileges and go from there. As consistent with most practices, my dr's office always rounded on me and was the deciding factor in my care. I also found this comforting - while my actual OB never saw me, her team did and they were at least knowledgeable about my case (note I had a very complicated twin pregnancy, and developed severe pre-e). This is in contrast to being at a hospital where you're under the care of their OB staff (as I found myself when I was transferred from Mission Bernal to Sutter after delivering my first). However, if your OB team is not an important consideration or has dual admitting privileges, all things being equal - UCSF is probably a lot nicer, newer, and if you're lucky- has better food. 

    Best of luck-

    Kate

    I had a scheduled c-section at UCSF and a VBAC at Alta Bates. Both great but UCSF is far superior in terms of the general facilities which makes the whole experience much more comfortable. Alta Bates was fine though and they are truly a "baby factory" so the nurses are very experienced and excellent. Typically you'd have to see an OB affiliated with UCSF to birth there which means prenatal appointments in SF which would probably be a deal breaker for me. For Alta Bates, my OB was through Sutter on Milvia in Berkeley and they were all great. Almost zero chance you'll see your actual doctor at delivery but all the ones I met during pregnancy and then delivery were great. 

    I noticed you also asked about physician - I saw Pantea Pahlavan at Sutter East Bay OB/Gyn. Couldn't have asked for a better dr or practice. Note that they're big, and while that was initially intimidating at first, it also means that anytime you end up in the hospital (I was in L&D triage a lot), they come see you - which is great, and someone from their practice will likely also deliver you (or do your c-section). All of the other doctors at her practice ranged from good to stellar. I've also have a number of friends go there for their care and have similarly shared positive experiences. 

    Feel free to reach out with any questions-

    Kate

    I had a C-section at Alta Bates, unplanned but non-emergency, with Dr. Lizano in end of 2017. She is no-nonsense and wants you and your baby to be healthy and safe, so we were philosophically well aligned. She had another surgeon along with her and it was extremely uneventful. She also reminded me that you are allowed 4 days to recover in hospital with a C section (not sure if the pandemic has changed that), and that it was my job to heal and take my time. She practices alone which is good (you know your doc) and bad (I'm sure it's exhausting for her)-- she has a backup relationship with another doctor when she is out of town, but otherwise it's her that attends your birth. The nurses and lactation support were also fantastic. The only drawback was the food, but hey, you can't win them all. Congrats and good luck!

    Had a c-section at ucsf and was happy with the experience. Facilities seem far more modern and food options during your stay were way better (pre covid though so not sure if it’s changed). Alta Bates, I cycled through several obs and hands down Dr Nseyo is top. Competent and great bedside manner. Preference will always be a personality thing but sounds like lots of people like her a lot. 

    Birth and surgery

    I intended on giving birth at the wonderful Pacifica Family Maternity Center, but after 57 hours of hard labor and no progress, I made the decision to go to Alta Bates. After getting meds to ease the pain, get me to sleep, and allow labor to advance, I woke up several hours later. When I saw the surgeon walk in I knew. She and the rest of the nurses gathered around me to explain their reasons to recommend a c-section and the surgeon sat next to me and saw how scared I was. She said,"This is all I do. You are in good hands," and continued to reassure me that everything was gonna be fine. The rest of her team were supportive to the degree they allowed my midwife in addition to my husband to be with me during the surgery (they usually only allow one person). They played the music of my choice during the operation, and were very professional. I was very happy with my experience and truly felt I was taken care of by one of their best surgeons. I can barely even see the scar from the surgery now and the midwives were also impressed with how little it showed after surgery. 

    As much as I didn't want a c-section, we found out during the surgery that the umbilical cord was wrapped around both baby's arms like suspenders, so there was no way she was coming out naturally, and it also explains why the pain was so intense, but yet, no progress was made. So I was thankful that there was an option for c-section in this case.

    Nurses and postpartum care

    I also have to mention the amazing care I got from several nurses during my recovery. I had very good treatment, care and support from a lot of them, but in particular Cheka. When I was going through the hormonal peaks right after birth, she sat with me, holding me and encouraging me in the middle of her night shift - she had a great sense of humor and often filled our room with laughter. She continued to check in me even when it wasn't her round. I really appreciated her so much. There were others that were really kind too. They come in a lot (every couple hours) to check in, but you can put up a sign so they don't disturb you if you're trying to sleep.

    Recovery room

    It's worth mentioning that we were put in a remodeled room that was very nice, but you can tell it was designed by someone who didn't quite know what women go through after birth. The nurses also made comments on how far the sink was from the toilet and such and that they had offered feedback to the designers, but it wasn't taken. Hopefully, they've made some improvements by now - it was fairly new when we stayed there from what I gathered. The extra bed for your partner or other family to sleep was a plus (although COVID protocols might affect this).

    I know different people have different experiences, so I'm sure at any place there's a spectrum, but this was mine. It occurred in the fall of 2019, so I can't speak to how it is now. I hope this helps though. I've also heard great things about UCSF, we just happen to live in Berkeley and went through Pacifica Maternity. Best of luck and congratulations :)

    Delivery surgeon: Dr. Bonagura

    I delivered twins by planned c section in August. Our experience was extremely positive. I felt that the staff in surgery was extremely competent, the recovery nurse was amazing, and the nurses that looked after us during our stay were, for the most part very respectful, professional, helpful and kind. The lactation consultant’s at Alta Bates are amazing too. We had our own private room with two beds so my boyfriend could stay overnight and sleep. The doctor I had was Samantha Varner. But I think your surgeon depends on who your primary care provider is. I only had access to the doctors that work in the clinic that I go to. There is lots of hospital protocol that you have to go through which is kind of a pain but I think that’s the case at all hospitals. Alta Bates is very pro breast-feeding so if you don’t want to breast-feed you might encounter a little pushback, but in my experience the nurses were very open to letting me do what I want. I felt very supported at Alta Bates. 

  • UCSF birthing center - can I use a midwife?

    (3 replies)

    Hi everyone! I'm a FTM and I will be moving to the bay area when I'm 28 weeks. I'm considering prenatal care / delivery at UCSF birthing center. After speaking with the clinic at Mt Zion they explained to me that their model of care is whoever is on call. What are the chances my prenatal care and delivery will be handled by a midwife? Is there an opportunity to meet all the providers at some kind of meet/greet night (my current provider does this)? Is there anyone who has delivered at UCSF and felt their care would have been different if they had gotten the OB/GYN on call rather than the midwife on call? New to the pregnancy thing and the bay area thing so any advice is much appreciated!

    Hello, and mazel tov on your upcoming birth! 

    I gave birth at UCSF twice, and they seem to have midwives on call along with the doctors and they work in tandem. You might be able to meet the folks who will be delivering your baby, but UCSF is a teaching hospital, so you have the option to have students in there, too. For me, I was just like, "the more the merrier, let's get this baby out," but I would imagine you are experiencing some anxiety about being trans and managing expectations. I can't speak to that personally, but I can tell you that UCSF is at the forefront of medical knowledge, and my perception is that they would be both sensitive and proactive in handling any concerns you might have. I know you won't be the first trans man to give birth there. 

    That being said, I'm going to make an unusual statement (for the Bay Area) now: I would always choose a doctor over a midwife. Why? Because at both births, the midwife repeatedly told me I was not in pain, I should not need an epidural, I was not in labor, I should listen to her instead of my body, and both times I was apologized to by that midwife after the fact. My miscarriage in between -- the less said about that, the better. The doctors at UCSF are really, really on board with the control being in the hands of the person giving birth. It is not a medicalized experience. Similarly, the L&D nurses are 100% on top of the situation -- I remember looking past the angry face of that crappy midwife at my second birth, and seeing the nurse laying out everything for the epidural that I was begging for. She was taking care of business while the other lady was just scolding me. Oh! And the way they do epidurals there is apparently very different from most other places, because my friends reported that their epidurals made them totally numb, but I felt EVERYTHING - just not in as much pain. So I was able, with the epidural, to flip from one side to the other, to get on my knees, to pull up using a birthing bar -- I was like a circus performer trying to get my baby to agree to exit the premises. It was freakin' so cool, and I could not have done any of that if I hadn't had pain management. Me, personally. I know there's hella ladies who are like "BAM!" and that baby shoots out like a T-shirt from a cannon at a basketball game, but not this vagina. 

    Bottom line: Don't put all your faith in one sort of provider. I encourage you to tour UCSF when you get here and talk to them about your needs. I know you don't want to hear this, but it's really unlikely that you'll be able to control which provider you get. But the really important thing is that there's a baby in you and there's a pretty predictable set of routes out of you, and the doctors at UCSF are familiar with all of them. Your baby will be spectacular, and YOU are spectacular. If you want to contact me directly, I can put you in touch with other trans parents in the area. I'm so happy for you! 

     

    I delivered both my children at UCSF (old hospital and new hospital) and had incredibly positive experiences with the teams.  Both my deliveries were handled by residents, an attending, and nurses.  One time a pediatrician was also present.  I'd say there were about 5-6 hospital staff (MDs, RNs, etc.) in the room for the actual delivery, but usually it was just me and the nurse.  I met everyone after being admitted, and it was no problem.  The on-calls were never present for my deliveries (as far as I can remember) but we did see them around the floor.  

    If you want a midwife to be present at your delivery just ask at your next appointment if there is a midwife on-site in labor and delivery.  I assume the answer will be yes.  If you want her in the room, just ask when you are admitted and make sure your partner (or whomever) reminds the nurses as you progress if you forget or are unable.  I'm sure they will do their best to accommodate your wishes if you state your preference.  I can't say whether my delivery would have been different with a midwife (probably not) but know that sometimes you don't have a choice (whether because of staffing or because of the specifics of your pregnancy/delivery).  Have a general idea of what you want, but be ready to go with the flow.    

    I do not believe UCSF has a meet and greet for its team but I know they are more than happy to have you see different providers during your wellness checkups leading up to delivery.  That way you can get to know more of the staff.    

    Congratulations!

    I delivered there. You don't get to choose who will deliver your baby and I don't think it would be easy to "meet and greet" beforehand. UCSF is one of the very best hospitals in the world and it feels like the big research hospital that it is. You are in good hands, they are leading edge with their capabilities, and if anything goes wrong with the delivery, you are in the right place. Other hospitals in the area send their complicated cases to UCSF for expert care. But it is not going to feel small and personal in any way. You feel a bit like a cog in a wheel. I don't think there would be any difference in the care if it was an OB/GYN vs a midwife. They have their process and change shifts and doctors come and go and whoever is there when the baby is ready delivers it. 

  • Childbirth at UCSF Mission Bay?

    (3 replies)

    Hi, have any of you delivered your child at UCSF Mission Bay? If so, how was your experience, and would you recommend it? I can't find much info on it since it's still relatively new. Most of my friends delivered at Kaiser (and had great experiences), and the hospital with the most reviews online is CPMC. However, I'm looking at UCSF Mission Bay because of my insurance. We're expecting in late March 2017! Many thanks!

    We had our daughter there in June and loved it. The nurses and doctor's were great, the rooms were huge, private, and really nice, I even liked the food! (Though maybe this was just because I was starving after the labor.) They were also not pushy about interventions and very receptive to your birth plan (in case you were worried about that.) Overall highly recommend. Feel free to contact me if you have specific questions. 

    Yes!  I delivered at UCSF Mission Bay.  (We were living in SF and my OB was at UCSF.  We moved when I was about 8 months pregnant to Albany but I didn't want to find a new OB so we crossed the bridge to deliver at UCSF).  The labor rooms are huge, each room has a tub so you can labor in water (with colored lights to relax you!), solid food.  Great staff and responsive.  Nice outdoor patio so if you want to walk the hallways before or after, you can go outside and get some fresh air too.  The only cons - even though UCSF is a new hospital, they are having a hard time finding enough permanent L/D nurses so all my nurses were travelers. It's not a big deal but some were new to the area/procedures.  (This was in Nov 2015 so maybe things have changed).  I had a midwife deliver my daughter, who was fantastic (the resident was bouncing in and out but honestly, I am happy that the midwife did it.  She was so patient and gave great directions.).  Happy to answer any other specific questions if you have them as well.  

    I delivered at UCSF Mission Bay in early June, and really appreciated the hospital. I was a high-risk pregnancy/birth (required induction, no epidural allowed), and was glad that I had other pain management options available there that weren't available in other hospitals (nitrious oxide and others). I also really appreciated the evidence-based approach to labor and delivery - they're fine with you eating food and drinking whatever, moving around a lot, getting in the tub, etc. throughout labor. They have exercise balls, a mirror for pushing, etc.The room was huge (my husband joked that he could play basketball in there), the tub was wonderful (every room has them!), and all of the nurses and doctors I came into contact with were great (with a special shout out to my main delivery nurse, who coached me through the pushing stage wonderfully). The postpartum rooms are also great - not quite as big, but plenty big, with a small sofa that converts into a bed as well as a rocking chair. Oh, and all of the rooms get some natural light during the day. The outdoor patio space was a great place to walk around the day after delivery. Food is decent enough (I recommend the chicken dim sum), although portions are on the small size.

    I had the same experience as steannmom with a high percentage of traveling nurses, but didn't find it a problem at all

Parent Reviews

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Hi!

Congrats! I had all my babies at UCSF. Not sure if you want to drive to the city or will be working in the city, but I found it totally worth it, especially because I was a high risk pregnancy (type 1 diabetes) with all 3 of my kids. UCSF is the best but if you want to stay closer to rockridge, I’ll let other parents chime in! :) Good luck!

I don't have experience with Kaiser Oakland specifically, but do with Centering. Definitely recommend it as a central (no pun intended) and positive experience of our pregnancy, birth, and childhood so far.

My wife, 37 years old, and I participated in the Centering program organized by UCSF before the birth our now-four-month-old son. The Centering sessions were great at covering a wide range of topics in a group setting that's much more engaging and interactive than a doctor's visit. A greater time investment, for sure, but if you can manage that with work, we found it worthwhile. We were lucky that the OB and Midwife that ran the group we're also amazing! We formed some lasting bonds with the other parents in our group and all still hang out with our babies even now that the structured Centering program has ended.

Happy to answer specific questions you might have, just reach out. For us, I can't imagine a first pregnancy without Centering, and we're very happy we went that route.

We did the centering pregnancy program at UCSF at it was the best experience! I have a group of 10 moms I regularly speak to and have play dates with as a result of the group, it is a wonderful program.

I live in Berkeley and still delivered at UCSF Mission Bay. If you really like your doctors, I wouldn't let the bridge scare you. I absolutely loved UCSF hospital, and am so glad I chose it.

Archived Q&A and Reviews


UCSF Birth Center or Alta Bates

Sept 2014

I am a clueless Brit and am 27 weeks pregnant now (having survived a rather rocky
introduction to US healthcare so far!) I am supposed to be giving birth at Alta Bates, but
I really want to have gas and air (nitrous oxide) and a water birth. This is what I did
last time around and it did the trick as I was relaxed, serene and most importantly, as
high as a kite. I had a long but straightforward 48 hr labor (including pre-labor) last
time and although I am hoping it will happen a bit faster second time around I really
don't fancy doing it with no pain relief on offer other than hardcore drugs/epidurals.

I found out that UCSF offers nitrous oxide, but I'm not sure about water births. My health
insurance covers both Alta Bates and UCSF. I live in Alameda. In your experience where do
you think would be my best bet, Alta Bates or UCSF?

Thanks so much for helping out a hapless foreigner. Clueless Brit 


I'd go with UCSF if you can. I did not have a good experience at Alta Bates. I used to work at UCSF, and the level of nursing care far surpassed what I experienced at AB. anon


Dear Clueless, I am laughing, and not because of nitrous oxide. Have you been in the Bay Area long enough to notice the traffic? Second baby will probably come much faster. We lived 2 miles from Alta Bates and after a perfect slowly progressing labor made it along a small stretch of highway 13 to Alta Bates with only13 minutes to spare in the Labor Ward before giving birth. Never plan to give birth anywhere where you will be stuck on a bridge/ferry/anywhere without traffic exits etc. en route. I barely got a bed to deliver in. Not a clueless Brit any more.


I delivered at UCSF in March and had a fantastic experience -- absolutely top notch doctors and nurses. I didn't use it, but I know that gas is available. As for water births, there are bathtubs in the delivery room bathrooms that you can use to labor in but my understanding is that you must get out of the tub to deliver. I'm also not sure whether they would allow you to be in the tub while you are hooked up to gas. You may end up having to decide which you prefer, gas or a water birth, as I think you may have a hard time finding a place that does both. Good luck to you! Happy UCSF Mom


I had both my kids at UCSF and would recommend them, though I had a terrible midwife the second time around. I didn't know they offered nitrous! I know there is a jacuzzi in the birthing room, and I was encouraged to use it, but I don't know if you can give birth in it. You know, you've just got to tour both facilities. You can call both: Alta Bates - (510) 204-4444 http://www.altabatessummit.org/clinical/women_infants.html UCSF http://whrc.ucsf.edu/whrc/gex/tour.html

I'd be scared to have to get my butt into the city while in labor, though. Oh my gosh. I went SO FAST the second time, if I had been stuck in the least bit traffic, I'd have a baby named Sutter or Folsom right now.


So I'm also a newish Brit immigrant living in the East Bay and had our daughter at UCSF last year. Similar to you, I wanted gas and air and ideally, a water birth. I also wanted a midwife-led model. I'm really glad I went with UCSF but there are a couple of things to think about. If we had a second I might consider giving birth in the east bay were in not that it would be a high risk pregnancy (UCSF is indisputably the place to go for high risk, multiples etc).

- UCSF are one of only a handful of hospitals in the US that do nitrous. I had a whole tank to myself and sometimes wish I still had it when my toddler goes all banshee on me.

- The birthing suites have tubs but while you can labor in them, you have to get out to deliver. TBH they're a bit clinical - hospital toilet, fluoro lighting.. not what I had in mind really. I didn't stay in it for long. Besides, they couldn't fit the massive tank of nitrous through the door

- they absolutely respected my birth plan and didn't raise an eyebrow about the whale music, LED candles, chanting.. shaman etc... Seriously, they were really good about NOT immobilizing me and letting me labor in my own way. I gave birth on all fours and did not even see a stirrup. - a nice young man did pass by soon after I checked in to offer a dazzling array of Class As and was very nice when I declined and didn't pressure me or make me feel silly

- the midwives are fantastic, most of all Judith Bishop who is a bit of a midwife celebrity. She is wise and reassuring. I adored her. But in the end I didn't see any midwives when I gave birth because they're not there 24/7 and I of course delivered my baby during the rare times they aren't about. - they let me go right up to 42weeks without trying to freak me out. They were just very vigilant. I went in for nonstress testing every day at the end. Luckily my insurance covered the astronomical cost.

- my only gripe is that I think they cranked the pitocin too much. I accept I did need 'a whiff of pit' as they put it, but I don't think I needed so much so fast. So if you deliver there (or anywhere) I'd suggest you put it in your birth plan that they should tell you every time they want to 'crank the pit' rather than sneaking in and twisting the dial quietly while you're eating chocolates and watching your shaman do the booty clap.

The main reason I'd consider the east bay if there were another time is that I now know what active labor is like and have the fear of being stuck on the bridge in heavy traffic. There is a way around this though - some small hotels around UCSF do let heavily pregnant women rent rooms to labor in, so you can go over before things seriously kick in.

Welcome to SF and good luck with your pregnancy! Kelly


Alta Bates vs. UCSF delivery

Feb 2012

So, at Alta Bates I have to go with a ''mega'' doctor clinic where I get the ''on-call'' doc...which they all seem fine. Or I can travel over the bridge and deliver at UCSF with a midwife. Can you please give advice as to which was a good (or bad) experience?? I have had a previous natural birth and that is my plans for the next. Thank you PJ 


Although this is an unlikely scenario for you, I personally had a premature delivery and hence we had a 2 and a half week stay at the NICU before finally going home. (Well, they discharged ME after 3 days, but I spent almost all of my time at the hospital). Thus I was really, really glad that we were at Alta Bates and not having to make our way across the Bay into San Francisco and back every single day. For what it's worth, I was at one of those huge practices-- I had a very long delivery and hence saw a number of the doctors during my time-- I loved almost all, disliked one. But, really, it was the nurses who seemed to have so much more impact on my experience in labor than the doctor's per se, who generally just pop in, and then make their appearance for the big moment. So, despite how it seems on the outside, I didn't find it to be a bad system. --fan of alta bates


I had a natural birth at Alta Bates, and can't say enough positive about the nursing staff. We'd hired a doula to try to help keep the medical stuff to a minimum, but really, the nurses there were so much more helpful and knowledgeable and respectful. The birth was straight forward, so I did not need any medical intervention, and no one insisted on IVs or drugs or anything. It is important to have a good doctor or midwife, but really the doctor is there for the crowing and birth. All of the labor of a natural birth is overseen by nurses. At Alta Bates, they were truly wonderful. Happy Mama


I delivered at Alta Bates with a midwife and doula. Nurses were great too! Couldn't even imagine being stuck in bridge traffic during labor. Alta Bates Mama


PJ, I think you need to have a better understanding of what you're asking before you will find the right information. Alta Bates is not a ''mega doctor'' clinic that determines who you're going to see for your delivery. Alta Bates is a hospital, and they have a Women and Infants Center where you can deliver your baby http://www.altabatessummit.org/clinical/women_infants.html. That is probably determined by your insurance carrier and their medical group (if you're on an HMO) under which you're subscribed.

Your OB-Gyn and doctor's group (if part of one) is who determines who you will see at your delivery. You need to communicate with your caregiver find out if she/he will be there for your delivery, or if a different (on-call) doctor from the group might be there because of timing. Furthermore, if you do a little bit of research, you will find that Alta Bates does have midwives who they work with and can help connect you with who deliver at the hospital. I suggest you visit the website and gather information http://www.altabatessummit.org/clinical/birthpref.html

I'm due with my first child in 7 weeks and will be giving birth at Alta Bates. So far I've had nothing but excellent responses to all of my questions and concerns from people there when I call for information. I am working with my doctor to clarify my personal birth plan and how she (and her group) and I will work to make final decisions when our big day comes. Your concerns sound to me like they're mostly a result of either misinformation or no information, and I think your entire birth experience is going to improve when you are better informed. Good luck in a safe, healthy and happy birth for your baby. -EM


I have to compare the two hospitals from two different experiences. I delivered both of my kids at UCSF, while I supported two different friends delivering at Alta Bates. So my experience with UCSF is much more personal. I should also say that I am a former L&D nurse.

I can certainly say that my experiences at UCSF were amazing and I highly recommend UCSF to women in the Bay Area seeking a natural delivery in a hospital setting. I absolutely love Judith Bishop and Suzanne Seger (both midwives), but saw all of the midwives at one point or another during my pregnancies. The Faculty Ob/Gyn Group is a unique combo of maternal-fetal medicine docs (read: high-risk OB) and midwives. They hit on this formula years ago and it seems to work really well, both for caring for patients along a wide risk spectrum, as well as for teaching residents. If you prefer midwifery care, you will have the option of scheduling all of your appointments with a midwife. You are also very likely (though not guaranteed) to be able to deliver with a midwife when you go into labor. Should you experience any complications during the pregnancy or labor, you can be reassured that you are in excellent hands, but if you have a normal pregnancy, you can also be reassured that the UCSF midwives and (even more importantly, IMHO) the nurses are going to support you in going through the process as naturally as possible. I delivered my first after 24 hours of pitocin-augmented all-natural labor with the support of an AMAZING nurse (without whom I would not have been able to do it) and my second after a breezy 4-hour all-natural labor. The two deliveries were night and day, but both wonderful.

Another bonus at UCSF: you can get nitrous during the pushing stage, which I found took the edge off during my first delivery, though I didn't need it the second time around. UCSF is a teaching hospital, so you will work with residents during your delivery and post-partum stay. I found the UCSF Ob/Gyn and pediatrics residents to be uniformly excellent; I think the model of having midwives included as teachers of medical residents means that UCSF residents are more familiar with and supportive of natural labor than many.

The only downside of UCSF is that it may be a bit far for you: I am assuming you live in the East Bay. Your second baby will likely come a lot faster than your first, and you may not like having a bridge in between you and the hospital. You or your partner may also find it inconvenient in the post-partum period.

My experience supporting friends at Alta Bates was not a great one. Both times my friends ended up with on-call MDs whom they'd never met (may be a bad coincidence) and one of them ended up with a horrendous episiotomy that I think was totally old-fashioned and uncalled for. However, neither of my friends would characterize their experience as negative; this was just my perception as an outsider. Also, neither of them were working with midwives. The midwife experience at Alta bates may be totally different. Love UCSF midwives


I don't have any firsthand experience with either (I'm a Kaiser patient), but I believe UCSF is the only Bay Area hospital that will let you deliver a singleton baby who is breech vaginally (most hospitals here will let you deliver twins vaginally as long as the first baby is vertex). I have a couple friends who have had to have c-sections because their babies didn't turn, so it's something to consider even though you'll have to decide before you know if this will help you or not.


Hello, sorry for the late response but I just saw your note re: UCSF vs. Alta Bates delivery. I had both my kids (now 6 & 9) at UCSF when I lived in SF and I absolutely loved it. I actually switched to UCSF at 35 weeks pregnant with my son, mostly because I felt that UCSF would be more supportive of a natural childbirth than CPMC (my previous hospital) was. I also switched in part because I was very interested in nitrous oxide as an approach to pain.

When I was there, the midwives pretty much ruled the show from 9-5 each day, then OBs took over at night. Since my labors were long I got a bit of everything. Each individual personality varied, of course, but all in all I was very impressed by the calibre of the medical staff. Some details, such as the skill with which a midwife or OB supports the perineum during crowning, can make a huge difference in pain & tearing. No episiotomy or other unwanted interventions were pushed on me throughout the process.

I personally love and adore the teaching hospital environment but you do need to accept that there will be a lot of people around - med students etc. - and certain procedures may be done more thoroughly than necessary in order to give students a chance to learn. For example I think I got more of that post-partum stomach ''massage'' than I needed! And at times it felt like a parade of people were putting their hands in my ying-yang! Lastly, the hospital is on a hill and the labor rooms are on the top floor, from which you can see the Pacific Ocean. For me there was nothing more comforting than having a look at my beloved ocean during labor. Good Luck!


I delivered at UCSF in 2009 and it was not a great experience. In fact, I think I had PTSD for a while afterwards. It is a good place in a high-risk situation but NOT for routine care and the resident on call and the nurse were pretty uninvolved until minutes before the delivery. I highly recommend a doula no matter where you deliver because no matter who is on staff, you have a support person and advocate that speaks up for you and helps to keep you on your desired birth plan. The midwives at UCSF only work during business hours during weekdays. During my hospital stay, student nurses seemed overwhelmed, were not helpful in lactation guidance and several were rude. One threatened to not discharge my son and contact CPS if my son lost any weight (he was almost 9 lbs!) since it would be considered ''child endangerment'' when that was not true (a pediatrician told me the next day). She advised me to stay up all night to force him to eat so he would not lose any weight. In short, the experience was very stressful and scary and took away from my joy. I have heard the nurses at Alta Bates are great but the doctors seem to do many episitomies and C-sections. You have to do your own reasearch beforehand to avoid as many issues as possible. Good luck! anon


I delivered my first daughter at UCSF, and my second at Alta Bates. They were two very different birth experiences because of what happened in my labor, but I still have some good info for you. I chose UCSF because they offer (or they did in 2002) self-administered nitrous oxide for pain relief. It is terrific, because at the very height of your contraction you can inhale it, and it wears off in seconds without affecting the baby. And you can still push. That said, I was pushing for three hours, and they would have given me a C-section if my doula hadn't made them give me a ''last chance'' and then yelled and coached me into pushing her out. They are respectful of your birth plan up to a point, I guess is what I'd say. A minus at UCSF is that since it's a teaching hospital, there are lots of extra people who pop in and out of the room. Which might not matter much if you aren't in labor for 18 hours. A big plus at UCSF is that the labor and delivery rooms are spacious, and have beautiful views. We were in the corner room and got to sleep in there with our new baby because all the recovery rooms were full. We woke up at sunrise to see a panorama including both bridges. I only spent 15 minutes in labor at Alta Bates (!), but I still learned a lot. I really appreciated that they didn't make me fill out the clipboard when it was clear I was ready to push. Afterwards I had some difficulty expelling the placenta, and my nurse was that perfect mixture of forceful and kind when she kneaded my abdomen painfully and kept me on task when I really just wanted to get to know my new baby. Hope this helps! Good luck! heidipie


NICUs - Alta Bates versus UCSF

April 2010

We are 24 weeks pregnant with twins and there is a very strong likelihood that our children will be born early. While we hope neither of them will need to stay at the NICU, we want to be prepared in case they do. We are trying to decide whether Alta Bates or UCSF would be the better choice for us. Alta Bates is closer to home, which is a plus, however we are told that they won't guarantee that we can stay overnight with our babies. Also, if there is a situation that is beyond their care level, the default is to transfer babies to Children's Hospital (which we know we don't want) and we are concerned that there would be difficulties in getting one or both of our children to UCSF. These are our primary concerns: (1) we want to be able to stay with our babies as much as possible; (2) we want to be at the place which does the most to encourage and support kangaroo care; (3) we want to be at the place which does the most to assist us in feeding our children breast milk and ultimately breast feeding; and (4) we want to be at the place that provides more private or semi- private space for us. If anyone has had experiences at either or both NICUs, I would love to hear about them. Many thanks. Debra 


My son had a 5-day NICU stay at Alta Bates 4 years ago, when he was born with vacuum extraction, resulting in a nasty wound on his head and softs signs of infection. So, our NICU stay wasn't long, and it wasn't real recent, but I can offer our experience. In short, save one terrible nurse, we had a really wonderful experience with the Alta Bates NICU.

In terms of your specific questions: (1) staying with babies: you are right. there is no guarantee you can stay over night. there are a few rooms, like hotel rooms, that they do daily lotteries for. for whatever it is worth, on the days we were there, we never had a problem getting the room. (2) kangaroo care: no problem there. it was highly encouraged with my boy. (3) breast milk & feeding: one of the highlights for us. my son got banked milk for the first 2 days until my milk came in and I had continual access to a lactation consultant. She was a huge help, and probably watched my son latch on for at least 10 separate times during our 5 days there. (4) private/semi-private space: to be honest, i can't remember. having just delivered my first kid, being in pretty bad shape, and having a baby in the NICU eclipsed any concerns I had about privacy. I don't ever remember even thinking about this.

Best of luck to you, your family, and your babies. I hope all goes well and you are bringing home healthy, strong babies in no time:). genevieve


Unfortunately I can't give you specific advice on the two hospitals in question, but having had a baby who spent two months in the NICU at UCSF, here are a couple of thoughts that might help you prepare.

Although we were at a hospital that has a terrific reputation, it was enormously frustrating and stressful to be at a teaching hospital, as is UCSF, constantly being shuttled between residents who didn't know our baby's case very well or honestly weren't yet well-versed in neonatology, and having to fight for the attention of the senior staff, who also rotated every few weeks.

Also, being in the NICU can be so draining that I would advocate for the closer hospital, so long as you are comfortable that the level of care will still be high. Is it at Alta Bates that they can't guarantee you can stay overnight based on the babies' condition? Because most NICU's have regularly scheduled hours for parents to be present along with only couple of hours of no visits/downtown for nurses to trade shifts and focus on this without interruption. Is there any chance you can visit the NICUs briefly beforehand? I'm sure you'll get lots of other hospital-specific tips, so just hoping this helps a bit and wishing you all the best with your babies-to-be.


We just spent three months in the Alta Bates NICU with our twins who were born at 25 weeks (they shared a placenta and amniotic sac). (DOB 12/30/2009 -- they came home 3/30/2010, & 4/2/2010)

I have nothing but the most amazing things to say about the NICU experience at Alta Bates. It is a very nurturing environment and our twins were actually able to co-bed with each other once they were stable enough. You can visit 24/7 (even through nurse shift changes) and kangaroo care and breast feeding are strongly encouraged. And since you have twins, most likely they will share a room and you'll have that room to yourself. (If the babies are really stable, there might be as many as 4 babies to a room, but that's like, when you have 24 hours until discharge). The support for parents is just amazing, even going as far as giving parents 3 parking passes each week. (They bend over backwards to make sure you can be with your child as much as possible).

My experience with NICU moms is that everybody loves the hospital where their babies stayed. It seems that NICU nurses are just a special breed of people. So I would guess that UCSF and Alta Bates are pretty similar, but I can't speak for UCSF. I can say that the NICU experience is pretty harrowing, so you'll want the one that is closest to you. You do not want to cross a bridge to see your babies, trust me. janine


Midwife at UCSF

June 2006

Hi - We're moving to SF (from the east coast) in July and I am due in October. From what I've read on the BPN and elsewhere, UCSF seems like a good place to deliver - top notch hospital, but relatively supportive of natural birth and not overly interventionist. I'm looking for recommendations for providers or practices who deliver there, preferably midwives, and preferably a smaller practice so that we would have the opportunity to meet the person who would be there for the delivery even though we will only be in town for 2 months before. I don't know if there is such a practice - from the little research I've done it seems like they are all pretty big and there are no guarantees about who will be at the delivery. Also is it true that the midwives are only there during the day? Any any advice would be helpful. I'd also be interested to hear about people's birth experiences at UCSF. Heading West


UCSF works a bit differently from other hospital set-ups in that to deliver at UCSF, you'll need to see a doctor or midwife through UCSF specifically. Because it is a teaching hospital, the ob-gyn doctors are also faculty of the medical school. Non- UCSF doctors do not deliver at UCSF. You can find a listing of all of them here: http://obgyn-nw.ucsf.edu/list_faculty.cfm I delivered at UCSF 2 years ago, and was seen by Marya Zlatnik (OB) and Judith Bishop (midwife) during my pregnancy. I was very happy with both of them, as well as the care at the hospital itself. Judith Bishop ended up delivering my baby. Throughout the process, I felt respected with regard to my choices, and supported re: issues that I didn't have opinions about. I'm now pregnant again and planning to deliver in the East Bay (we moved), and I actually miss the whole UCSF setup as I deal separately with the private-practice doc, the lab she outsources to, and the hospital. Even though it's a big UC bureaucracy, everything seemed to be a lot more streamlined, since it's all under one umbrella.

Unfortunately, short of a scheduled birth there's no way to guarantee which practioner you will have. I don't know what the call hours are for each practioner (you had asked about whether midwives only work during the day), but I went in to the L center late one night (not to deliver but early on in the pregnancy), and was seen by a midwife.

As you indicated in your message, the good thing about UCSF is that they are absolutely a top-notch center, and you will not meet more knowledgeable practicioners, both with respect to high-risk issues and complications, and with ''everyday'' issues as well. The potential downside is that you may well be seen by ob-gyn residents (doctors who are 1-3 years out of medical school, doing their ob-gyn training) when you deliver, but they are always supervised by the doctors and midwives (who are literally looking over the resident's shoulder) Good luck!


You are correct that at UCSF, there are no guarantees about who will be at the delivery. I also believe that your understanding that the midwives are there only during the day is correct, but am not certain about that. That said, I had a wonderful birth experience at UCSF in January 2005. My son arrived at 3 in the afternoon - delivered by a midwife, with the assistance/company of a nurse, resident, and an intern (with my husband there as well); the OB/GYN who I saw for most of my visits (Dr. Mari- Paule Thiet) and another who I saw for some appointments when I couldn't see Dr. Thiet (sorry, forget his name) both came by during my labor and after my son was born. All of the labor and delivery folks were absolutely wonderful, and I was happy to be somewhere with such a great reputation, etc. in case there had been any problems (which, thankfully, there weren't). It's not something I considered, but maybe you could bring a doula with you to get the best of all worlds? Best of luck in your decision and birth Jen


I am not an expert on midwives but I LOVE mine, John Fassett 415-668-1010. He is warm and funny and kept me feeling safe and happy through a tricky pregnancy that had some scary moments. He practices right across the street from CPMC, where both my daughters were born (one was pre-term). I have heard only good things about births at both these hospitals, so since you are coming from out of town, perhaps you might also be interested in CPMC. My OB practices in a group of MDs so there is always someone to back him up if needed. For example, my first child was born before 36 weeks so one of the MDs had to deliver, so it's nice to have that built in just in case. You will probably get lots of great recommendations, but if you want someone really plugged into an excellent hospital, John might be perfect for you. If you are intent on having him there to deliver, I can't say for sure but he came to the hosp. for me on a vacation day. The deliv. was super fast but he was there 2 minutes after the baby was born. If you already know there are special circumstances with the baby, I believe UCSF is where some of the more specialized NICU surgeries and things like that are performed, so that is something to consider. Best of luck to you! rund


Childbirth at UCSF

Feb 2005

For a variety of reasons, I need to plan on delivering my first child at a hospital in San Francisco. As such, I'm trying to decide between CPMC and UCSF. I'd like to labor and deliver with minimum intervention and, hopefully, no drugs -- and therefore would like to be at a hospital where the nurses are supportive without intervening medically unless absolutely necessary. I'm leaning towards CPMC simply because UCSF is a teaching hospital (I think) but any and all advice and experiences would be much appreciated!!! A. Deg


I have delivered at both. I sought medication during each birth. I had to be induced at both after many hours of labor. I found UCSF a little more ready and willing to ride things out (slow to induce, long long pushing) and a little more tentative on asking about desire for drugs. But only slightly. I went to CPMC for the second baby because I wanted a more ''private practice'' clinic experience (easier to schedule appointments, better staffed office, less hectic crowded office atmosphere). For me the lead up to birth was better for CPMC but the birthing experience was fairly similar with slight differences mentioned above. Anon


I am a Doula and have worked at both CPMC and UCSF and would reccomend UCSF with the midwife option for a birthwith as few interventions as possible. It is a teaching hospital so it has its limits but my experience there has been more supportive of natural birth, you may want a Doula as well. anon


I would HIGHLY recommend having your child at UCSF. They are wonderful. The labor rooms are huge, and have a great view of the city. I did opt for pain medication myself, but it wasn't pushed on me. The nurses were very attentive, and very nice. We didn't hire a doula, but my husband was right there, holding my other leg while I pushed, and they talked him through it. They had a lactation consultant and arranged for a visiting nurse to visit me at home the day after I was discharged.

I think they have this cool looking optional program where they will match you with a medical student who is interested in OBGYN, who goes to all your appointments with you and is there as a support person while you are in labor. The student gets exposed to pregnant women, the mother gets another support person. I found out about this after my baby was born, unfortunately, or I totally would have participated.

Also, if you want minimum intervention, this is the place to do it. They have the lowest C-section rate around. The reason is that they are always set up to do an emergency C-section quickly if the need arises, so they feel more comfortable waiting longer for you to have a chance to have a natural childbirth than most other places. If you have any more questions, write me! Erica UCSF is definately a teaching hospital for OB so residents would surely be involved there. CPMC is also a teaching hospital but I'm not sure if they have OB trainees or not.

I'm a doc myself and I had the choice of the 2 and opted for CPMC. Why? Because the front desk staff for the UCSF OB/GYN clinic were absolutely impossible to work with. They were rigid, unpleasant and unhelpful. They were also hard to reach. I didn't ever ask for anything out of line that would merrit this treatment. Once I did ask them to run an appt date past the doc ( would she think it was too late) and they acted like I was a big pain in the a** and didn't do it (I think). So I opted for a CPMC doc who's front desk staff were wonderful, warm and very helpful. Believe me, I was VERY happy about my decision. Her name is Rebecca Yee M.D. She's tops.

I can't compare the 2 hospitals along the lines you asked, but these are issues that you might want to think about. JM


I've attended births at all of the SF hospitals. To answer your specific question: UCSF! If you are seeking low intervention, woman/ family centered care, definitely UCSF over CPMC. If you really want it, then go to SFGH, I'm serious. UCSF has some midwives (the FOGG practice) and SFGH has a whole team of them (who train the residents who work at both UCSF and SFGH). That means the OBs and nurses are much more in line with natural birth (at both UCSF and SFGH). Just because SFGH is a public hospital, don't knock it. You will get excellent care there and the L area is really nice looking too (with tubs in all rooms).

Many docs who use CPMC discourage doulas-- if that gives you some idea of the place. Of course, it all depends on your OB or midwife and which nurse you get that day- in ANY location.

As an aside, St Lukes has midwives also and is ramping up to be a great place to give birth, but the facilities aren't quite there yet. Kim (a nurse-midwife)


I had my son at UCSF 4 years ago next month. We had a wonderful birthing experience and found the labor nurses absolutely fantastic. You're right that UCSF *is* a teaching hospital, but we believe that's why they were willing to let me labor without intervention, eat during labor (which CPMC forbids), and be very flexible and accomodating of my needs. We had also heard that CPMC was more rigid than UCSF and performed more c-sections (but I have no stats to back that up). That said, they're both excellent institutions. I would definitely go back to UCSF if/when I ever have a second child. Susan


I delivered my first child at UCSF (granted is was more than five years ago) ... I like the fact that it was small (they deliver considerably fewer babies at UCSF than at CPMC). Since I was there for four days, I ended up getting to be quite familiar with the nursing staff -- who were universally excellent and really were able to spend one-on-one time with me. Nurses have 12-hour shifts so you only have to deal with two shift changes a day instead of three. Yes, it is a teaching hospital so it seemed like there were a lot of extra people in the delivery room. But, when you're in the middle of labor, you don't really pay much attention to who is in the room. In fact, one of the first year residents went and got me some ice water when I was thirsty -- don't know many full-fledged MDs who would do that! Some other advantages to UCSF: it is the only hospital in the Bay Area that offers nitrous oxide as an options for pain relief. At the time (perhaps, because it is a teaching hospital), they did a newborn hearing test on my baby -- something that I did not get with my next child who was born three years later at Alta Bates. My doula, who had coached births all over the Bay Area told us that UCSF was her favorite hospital to work in. Having said all that, many of my friends who delivered at CPMC had satisfying and happy births there. Margaret


See also: Childbirth at CPMS