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Childbirth at CPMS


Aug 2009: SF Midwives and Giving Birth @ CPMC?

I'm about three months along with #2 and this is my first pregnancy in the Bay Area. I'm currently seeing an OB/GYN at Pacific Gynecology and Obstetrics Medical Group in San Francisco. Though my first delivery was intended to be a natural one, it ended up with an emergency C-section. An experience I'd like to not repeat. In searching through the archives, I found a lot of recommendations for East Bay midwives, but almost none for ones based in San Francisco. I work in the city, so it's much easier for me to see a provider there. Can anyone provide a recommendation for a midwife? Preferably one associated with Brown & Toland and supports VBACs? I also see that the reviews of giving birth at CPMC are quite outdated (2005). Can anyone give a more updated point-of-view on giving birth at CPMC? How supportive is the staff of a woman's wishes for a low/no-intervention, natural birth? Especially a VBAC? Thank you. Learned my lesson the first time


It's my understanding that CPMC will not do VBACs. I don't know if that's an official policy written down somewhere, but I have heard multiple times that the hospital will not allow VBACs at all. Unfortunately, I think you're also out of luck looking for midwives there. I heard their midwives recently left CPMC after a lot of frustration with the medical model over there. You're better off at UCSF, although I heard that they are dropping out of Brown and Toland. But if you want a natural birth that's less likely to end in c-section, that's the place to be, especially if you're trying to have a vbac. At UCSF, the faculty practice is amazing -- both MDs and midwives, so if things don't go as planned, you use their MDs. The midwives there are wonderful. We loved Suzanne Seger and Judith Bishop. It's a teaching hospital, so there are residents, but unlike many Ob/Gyn residents these days, their residents see a lot of natural deliveries and seem more comfortable than most young docs with the whole concept. Loved my UCSF midwives
Let me tell you, if you want a natural birth, CPMC is last place you want to be!! As far as I know, there are no midwives there, even doulas are very discouraged there. They have a 98% epidural rate, and one of the highest c section rates in the country! This is not a place for natural birth, though i will say I know some women have done it. UCSF is much better for natural birth, Kaiser also, though the insurance thing is a problem. Most doctors (outside of CPMC) now know that a v-bac is safer than a repeat cesarean. You may want to look into a birthing center, like Sage Femme, in SF. Again, not sure of the v-bac laws for them, but this is a midwifery run birth center, so they're obviously much more open to the idea of a natural birth. Last thing, I'd highly recommend you do your research on V-bacs, douls support, etc. Knowing is half the battle, and in the case of how your baby is born, you are your biggest advocate, because when you know what you want, you're much less likely to get pushed around. Please educate yourself, look for what you need, and stay far away from CPMC. been there, never agtain
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 delivered my son at CPMC in 11/03. we had a terrific experience there, the nurses were all very good and very helpful. i felt they did a good job of listening to what we wanted, while making recommendations on what to do next. i wanted to deliver as naturally as possible, but my labor had to be induced and then i ended up with an epidural anyway. i did hear other mothers delivering w/o drugs, though, so i know they respect that. the labor and delivery rooms were very good, most include bathrooms so you can shower or get in the tub during labor. they support your partner rooming in with you and the baby for your stay.

UCSF is also a fine hospital and i have heard they are very good at respecting your birth plan. two of my friends delievered there and there are two UCSF pediatricians in my family.

i don't know if this concerns you at all, but one difference i have heard of between UCSF and CPMC is that CPMC will ''resuscitate'' earlier. that is, if you go into labor and deliver very early, say around 22-23 weeks (? not sure of the exact number) CPMC will, if requested, put the baby on breathing machines etc. in an effort to help the baby survive. i think UCSF doesn't do this earlier than 24 weeks. if this is a concern for you i suggest you talk with your OB/GYN for more info. Chi-An


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
Hi, I had all 3 of my kids (5, 3, & 8 weeks) at CPMC, and I can't say enough good things about it. I had the first one there because we lived in SF, but even after moving to Berkeley 5 years ago, I chose to continue going in for my OB GYN care, mainly because my midwife delivers at CPMC, but also just because I love the hospital. It's a fairly small facility, in comparison to Alta Bates (I don't know the size of UCSF, but it seems bigger too...). The nurses are attentive, caring, and knowledgeable, but also just left me alone most of the time; I had uncomplicated, unmedicated deliveries, and easy recoveries. The facilities are newly renovated, relatively spacious (though there are a variety of sizes), and private. Newborn Connections is great--they offer products and services for moms to be, new moms, and babies, including breastfeeding consultations, both in the hospital and by appointment after discharge. Room Service is a good thing too--they don't automatically bring you nasty hospital food 3 times a day. You order off a menu, call in the order, and they bring it to you, free; and better quality than most hospital food. I'd be happy to answer any other questions you have--email me if you like. Heidi
I delivered at CPMC and everything was going great -- there was no pressure to have an epidural or anything. But the trouble began AFTER the delivery. My baby went missing from the nursery and no one could tell me where he was. They've since tightened nurses' procedures checking baby's IDs but it exposed a side of the hospital, the risk management department, that I hope no one ever has to deal with. Good luck! Nightmare-Plagued Mom
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
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


Definitely -- if you want a low/no intervention birth -- UCSF is prefereable to CPMC. I know many people who gave birth at CPMC, and no one had an intervention-free birth -- and several of them were really invested in trying. I understand that is their MO. On the other hand, UCSF is a teaching hospital which means they are up on the latest and greatest, but to them it also means they have more than few fantastic midwives on full- time staff with the major practice there -- which is all the faculty of the med school. I was cared for there for my first child, and loved it and my friend just VBAC'd there with twins and felt so supported and cared for and respected. Make sure you get into the care of a midwife at UCSF -- and at almost any hospital you'll need to be prepared to advocate for yourself if you need to. UCSF booster
Congratulations on your pregnancy. I would highly recommend working with one of the midwives at UCSF (Judith Bishop is the only name I remember). I had planned a homebirth but needed to transfer late in the labor to the hospital. We chose to drive all the way to UCSF from Oakland because of their great reputation with homebirth transfers. I had an incredibly supportive group of Drs., Nurses, and Midwives who helped me deliver my son without drugs, scalpels, or judgement. In my experience with hospitals (I am a paramedic who works for the San Francisco Fire Department) the so-called ''learning'' hospitals (UCSF and SF General) are the places I recommend to families and patients who want the best care they can get in SF. The quality of the treatment and the quality of the staff is (in my opinion) much greater than at the other hospitals in SF (mind you I almost exclusively deal with the Emergency Rooms) Also, I think that CPMC has the highest rate of C-section of all the SF hospitals. That said I have a few friends who delivered there and had great experiences, without having c-sections. Do as much research as possible, get as much sound advice as you can, interview the Labor and Delivery staff at both hospitals, then go to UC :) Best wishes for a wonderful and safe pregnancy and labor experience no matter where you end up. kristi
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&D 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)


See also: Childbirth at UCSF
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