Pregnant, switching from HealthNet to Kaiser?

Hello, I am 4 months pregnant and insured through HealthNet HMO via my spouse. HealthNet has been refusing to pay for tests requested by my doctor. I am very frustrated, I don't have time and energy to fight every single denial notice I receive and I am therefore thinking of switching to Kaiser Oakland (my employer).

Do you have experience with this? Has Kaiser systematically paid for all your tests? Is there a good OB/GYN who is OK with alternative approaches, even better, does Kaiser cover for midwives? If I wanted to make sure I got fully covered, which plan should I choose?

My profile is high risk and over 35.

I delivered my first in Europe and even though I had basic insurance coverage, I never saw a bill. It's the law in my country that pregnancies are fully covered, no deductible, no extra cost whatsoever. So with the health system here I am at a loss and I am finding very hard to understand what my rights are.

I really appreciate any guidance you may have. Thank you! Isabelle

all that to say: you MUST talk to your HR person about what specific kaiser plan they have and what is and isn't covered

re: prenatal and delivery. as for midwifery, they do not cover the cost of a direct entry or homebirth midwife. Kaiser Walnut Creek does have a midwife program and many people are attended by nurse midwives for their delivery. but no matter what, with Kaiser, you will do your prenatal care with a different person, or different people, than you deliver with. you deliver with whomever is on-call when you go into labor. kaiser oakland is a teaching hospital, so you will be dealing with interns too. my prenatal care was excellent with my first, and with this baby so far. they have a very consistent approach to things like recommended tests and procedures, but if you get a good prenatal provider that person will be flexible and help personalize the experience to your particular pregnancy. i did NOT like my delivery experience at Kaiser Oakland, though there was much of it that did go well. this time i am switching to a homebirth midwife and paying out of pocket for the opportunity to avoid the very assembly-line/impersonal hospital experience i had with my first. good luck to you! Ellen

The thing that I love about Kaiser is that you don't have to fight them over every bill. What you pay is what you pay. Where you do have to be savvy is making sure you know what you want and clearly communicating it to your doctor and the birthing team. One thing to be aware of is that your OB is not going to be the one who delivers your baby. The Kaiser Oakland Labor & Delivery team is staffed by residents and attending physicians (which, by the way, I loved as the doctors on staff are young, energetic, and well versed on the most up to date info related to child birth).

Good luck with everything! I hope the transition to Kaiser goes smoothly for you. Maria

I had my prenatal care at Kaiser and delivered my baby there too. During my whole pregnancy/delivery, I only paid twice (one was at my first prenatal care visit, and the other was for the medicines they prescribed to me after the delivery). All tests, including screening tests were covered. Due to Kaiser's unique system, as long as the tests are requested by the doctor, they won't deny the coverage. So if you don't want to deal with bills, Kaiser is a good choice.

The OB/GYNs at Kaiser, in my opinion, are very pro natural delivery and breastfeeding, which I think is a good thing. I did not know what ''alternatives'' you mean, but I think the doctors at Kaiser will cooperate with you if you have special requests.

However, I did not have a good delivery experience at Kaiser (Oakland). After a long hard labor and an emergency C-section, totally exhausted and feeling down (b/c I really wished I could have a natural delivery), I found myself have to share the recovery room with TWO other families. My poor husband did not even have a chair to seat and lean his back in our tiny part of the recovery room. Me and my husband could not sleep at all because of all the noises. But what really made me upset was when I saw there were actually a few private rooms UNOCCUPIED at the time. I just did not get it. I guess (hopefully I was wrong), they did not let us use the private room maybe because they did not want to clean all of those rooms? Anyway, I was very unhappy about that, especially thinking of how much money we and our employers pay to them every month.

About the midwife - We were told that, Kaiser Walnut creek has midwife service (but not sure if that is covered by insurance or not), but Kaiser Oakland does not. However, per our instructor at birth class, the midwives at Walnut creek are more like a doctor, and they will take care a few patients at a time.

Hope this helps. Feel free to ask me if you have more questions. Xun

Good OB and delivery at which Kaiser?

I have a past of complicated pregnancy,a child with special need and then a DNC, I am not happy with my current obgyn at kaiser oakland , need recommendation for a good obgyn at kaiser , who is understanding and have time to listen to me, and can suggest and guide me through my next pregancy.I don't mind to travel if the obgyn is really good. Also trying to decide on which kaiser has a better delivery facility, any recommendation please.

By the way, I've delivered at Kaiser Vallejo and Kaiser Oakland. I preferred the Vallejo birth experience but the Oakland post-partum care. Could have been just the particular nursing staff I experienced at both places, or the particular birth situations, but that's me.... three-time Mama

Switching to Kaiser during pregnancy

I am 14 weeks pregnant and I am going to be switching jobs on April 1 (when I am about 19 weeks along), and as a result will have to change my health insurance to Kaiser (will probably be going to Kaiser Oakland). My coverage will start April 1. Based on when my last appointment is with my current doctor, I will probably need to see a new ob within about 2 weeks of starting at Kaiser. I also have moderate asthma, and while my pregnancy has been uneventful thus far (and my asthma has been controlled for years), I have been regularly seeing my asthma doctor as well, and will need to pick up with that shortly after switching to Kaiser also. I may be worrying about this unnecessarily, but does it just work that if I call April 1 and tell them I need an appointment with an ob and an asthma/allergy person it will get set up very quickly? Am I likely to have any ability to control who I see given that I can't really wait for too terribly long to get appointments? I've read the archives about the regular process for selecting a doctor at Kaiser, but I am sort of more curious about whether being in the middle of my pregnancy and having a tighter time frame is likely to mean that I will have fewer options.

I am also just a bit apprehensive about switching all of my health care providers and insurer in the middle of pregnancy, and would appreciate any words of wisdom (or maybe just comfort!) from others who have had to do that. I will be getting all of my records from my current doctors and will bring them--is there anything else I should be aware of or any pitfalls others have experienced? Thanks! anon

Kaiser has a great website, kp.org, which you can access even before you become a member. On the website you can view a list of available doctors in your area. You can view a fair amount of information about them online then ask around and see if anyone has personal experience with the ones you are interested in. I have been happy with all the doctors I have used at Kaiser Oakland. I love my personal physician, my OB/GYN and my daughter's pediatrician. Only one (the pediatrician) did I request. The others I just lucked into.

I hope this has been helpful in alleviating some of your stress. Once the change is made you will be in very good hands. Good luck with the pregnancy.

Kaiser or Alta Bates for pregnancy/birth

I would like to hear from anyone who can help me compare the prenatal and birthing experience at Alta Bates and at Kaiser Oakland. My employer offers Kaiser and Anthem Blue Cross/Blue Shield, and I am trying to decide which system would work best for my husband and me as we try to get pregnant with our first. I have never had an HMO. Thank you!

Recent childbirth experiences at Kaiser

I am a first time mother-age 39-needing to give birth at a Kaiser. I have heard mixed reviews for both Oakland and Walnut Creek.I am leaning toward Kaiser WC but it seems far. My OB-GYN likes Oakland, but it seems like a zoo there. Anyone have expereince with delivering at Kaiser Vallejo? Any comments would be greatly appreciated! Anon

The cons:
- I feel like some information given on the L&D tour was a 
little misleading.  For example, they say you get fetal 
monitoring 15 min per hour; but in practice the monitor just 
stays on all the time.
- My water broke and although I was having contractions, they 
did not consider me in ''active labor'' and wanted to give me 
Pitocin.  Once the doctor realized I was not necessarily going 
to follow her recommendations, she became very angry and 
confrontational.  I know she was genuinely concerned, but she 
did not listen to me about my experience and my body.
- My partner and I hoped for a drug-free birth but were not 
opposed to medical interventions; however, once we said we did 
not want to induce labor right away, the staff (especially the 
dr.) cast us in the role of hard-core anti-medical types and 
said things like ''So you're going to refuse treatment?!?'', 
when this was NOT what I had said.

The pros:
- The nurse and doctor (also a resident) who attended the birth 
were wonderful.  The nurse took the time to go over the birth 
plan with my partner and really treated me the way I wanted to 
be treated - e.g. giving suggestions for positions to labor in, 
but not barking orders at me.  The doctor did perineal massage 
during the delivery which I believe was a large part of why I 
did not have any tearing.  They were both caring and supportive.
- We got good postpartum care.  Although I found it stressful 
being in the hospital with lots of nurses in and out all the 
time, the nurses were really caring and took good care of us.

My advice:
- Labor at home as long as possible.
- Get a doula, no matter where you give birth.  It's so hard to 
make decisions during this altered state, and a doula can 
support you so you are able to make decisions you will feel good 
about.
- You can get good care at Kaiser, just be educated and willing 
to advocate for yourself.  I learned during this birth 
experience that many things around birth are not clear-cut and 
the doctor's word is not the gospel.

Hands down, I would pick Walnut Creek over Oakland any day for a better clinical outcome and overall experience. (The facility in Walnut Creek is dramatically nicer, large private rooms and I labored in the room with the jacuzzi tub. The food is better, the parking is free for you & your guests,there is an outside courtyard to walk/labor in, the list goes on.)

I chose to have the birth at Walnut Creek, but for various reasons, started my labor accidentally at Oakland, so experienced both. The residents at Oakland can be very risk averse and cautious, and I had the unsettling experience of watching the veteran L&D nurses argue openly with the residents about my case. (The residents wanted to introduce drugs and tests that the experienced nurses told me openly were unneccessary.) We ended up leaving Oakland and making a mad dash to Walnut Creek where the midwives didn't bat an eyelash at my baby's data on the monitor and let me have my birth as I wanted it - largely hands off. The midwives ranged from their 30s to 50s, but the vibe was dramatically different from Oakland. The postpartum care was amazing, and one of my favorite nurses called me after her shift ended to say she missed holding my son the week before and wished us well on our breastfeeding journey... My entire family was amazed at the compassionate care we received in Walnut Creek.

I know other people who have had great births at Oakland, but with any training facility, you run the risk of having residents practice on you or do procedures that more skilled clinicians would rule out. I don't know about Vallejo, but San Francisco is also a training facility. Good luck! Fan of Walnut Creek Birth Experience

The staff that helped with my recovery were all wonderful at Oakland. The nurses were helpful and friendly, the lactation consultant was great, the pediatricians were all good with my daughter. They seemed to take my cues as to how much help I wanted, what my daughter and I needed, and worked hard to support my vision for my recovery. I would recommend Kaiser Oakland to other moms delivering. Just be ready to share a space after you have the baby! a new mama

Also, the nurses afterward were amazing. Simply amazing. They were very helpful working with me to get my post-surgery pain under control. One nurse even stayed after her shift was over so she could meet my older son since she heard he was coming by. They were truly caring; I'll forget one nurse who helped me with horrible post-surgery gas pains coming in the next day saying how she had come back to check on me and was so happy to see me and my husband finally sleeping peacefully. You could see she she took our well being to heart. I also liked the fact that it's not a large maternity ward, you don't feel like you're in a baby factory. Happy Oakland Kaiser Mom

Birth at Oakland vs. Walnut Creek Kaiser?

I am trying to choose between delivering my first baby at Kaiser Oakland or Walnut Creek. There is quite a bit of information on the website, but all from 2004.

I am leaning towards Walnut Creek over Oakland because I feel that having a CNM attend the birth rather than a resident would reduce my chances of an unnecessary c-section. I have read that residents tend to have higher c-section rates because they are less skilled. My instinct is that a resident would adhere to a more traditional ''medical model'' than a CNM. While I don't require a completely natural birth, I lean more towards a non-medicalized one.

Taking a look at CalHospitalCompare.org shows that Walnut Creek has higher patient satisfaction scores and Oakland's c-section rate at 18% is slightly higher than Walnut Creek's rate of 16%.

Can anyone share recent experience (past year?) who chose between the two facilities? Which did you select and why? I hear that Walnut Creek is referred by those who work for Kaiser as the ''Country Club'' facility. Feeling guilty about not wanting a resident to ''practice'' on me

That said, I had a perfectly fine experience at Walnut Creek. It wasn't like I was surrounded by nurturing mother figures singing lullabies, but on the other hand I had a vaginal delivery after prolonged/stalled labor. They gave me every encouragement to keep laboring and working at it, and not once did anyone mention C-section (although they told me afterward that it was a possibility). I don't know if the resident MD's at Oakland would have had the patience or sensitivity to let me do it at my own pace.

I stopped taking my girls to the pediatrician office there after I noticed a drug exchange going on between a couple of pre-teens who were in the waiting room the same time as me & my younger daughter.

SO...don't feel guilty about anything! You have to go where you feel most comfortable. Congratulations & good luck! Sandra

I have heard some good things about Kaiser WC, but the complaints I've heard have to do with how potentially busy they can be, due to Kaiser patients coming from all over in order to have a midwife-attended birth. I have heard things about having to share a recovering room, which you may or may not care about. I liked the privacy we had at Kaiser Oakland, though they did not have laboring tubs or birth stools, or birth balls available. I'd check with them now, as well as Kaiser WC. Also consider how far you live from each facility. Riding in a car while in labor is no fun at all. kaiser oakland fan

I was concerned about the recovery rooms. I know they have some single but a lot of double and even triples. I wasn't looking forward to sharing to be honest. But after doing a tour I actually wanted a double/triple because the singles are really small. I ended up in a triple but as the sole occupant. Very nice indeed. Good luck! brenda

However, while interviewing doulas, the different options were one of the things we talked about. All of the doulas we talked to, who had attended multiple births at both facilities, praised Kaiser Oakland's staff as excellent. All had attended natural births at both facilities, and said the level of intervention suggested depends a lot on which medical staff you get, something that is hard to control. One doula, herself a midwife-in-training, remarked that while many assume that being staffed by midwives means less medical intervention, that's not necessarily true. One tip that we got was to specifically request a nurse who is interested in working with moms wanting natural births during the intake phase. They did say that Walnut Creek is ''fancier,'' but otherwise said they're pretty equal. In the end, we've decided to go with Oakland because it's closer to home, with no risk of getting stuck on 24 during rush hour while in labor. Kaiser Oakland mom-to-be

The main thing is, I think you will find the nursing staff at Oakland very supportive of your wishes. Unless something goes very wrong, you will be dealing more with the nurses than with the residents in any case. Our experience with the residents was that they were quite progressive.

I'd encourage you to take the tour at Oakland and meet the residents and other staff. Our experience was great. Merrilee

I live in Richmond - which Kaiser for delivery?

I live in Richmond and need to choose a hospital for delivery. Would love to hear your experiences. I like the idea of a midwife at Walnut Creek, but am concerned about the drive while in labor. Anyone make that drive from Richmond/El Cerrito area?

Kaiser WC not accepting transfers - where to deliver?

Up until my 25-week appointment today, we have been planning on switching from Kaiser Oakland to Walnut Creek for the labor and delivery, so we could have a midwife at the birth. Well, lo and behold, at our appointment the doctor told us that Walnut Creek is not accepting new transfers now because they are too full. She said we could transfer to Hayward if we want a midwife.

So does anyone have any recent experience at Hayward? I know nothing about it. Advice from 2001 on the website is mostly positive but it says there are no private rooms and midwives are only there 8am-8pm M-F... has that changed at all?

Are there other, better Kaisers we could switch to? Could we transfer to San Rafael from Oakland? And what is L&D like there?

I was excited about Walnut Creek's midwives, mostly, but also about bigger rooms (we plan to have quite a support team, plus our 3-year-old and someone to watch him for part of the time) and the fact that they are installing labor tubs. I don't need to have a tub, but I want to be somewhere where it will be comfy to have my 3-5 people with me, where they will be fine with a natural, unmedicated birth with as few interventions as possible, and where I can have a private room.

Thanks in advance! Jen

The last information I have about tubs at Walnut Creek is that installation has been placed on hold due to the need to upgrade electric wiring in the location that they will be placed. San Rafael does not have a Labor and Delivery service. Locations besides Walnut Creek with CNM services include Santa Rosa, Hayward, Redwood City (currently only at night and weekends- they have CNM openings that need to be filled), Vallejo (M- F 7am-7pm), South Sac, Sac (sporatic coverage), and Santa Teresa. I believe Hayward CNMs are covering L and D 24/7. You can call L and D and ask to speak with the on-call midwife at any facility to confirm current CNM coverage. The CNM chiefs are working on a web page that will give everyone the ability to learn more about our services but that will not be ready for a while. We will also have a phone number for each service at that time. I will continue to monitor this site to answer questions as they arise. I hope this information is helpful! Thanks, Kathy Heilig, CNM. Co-chair, CNM Chiefs, Kaiser Northern CA

My next child was delivered in 2003 at Walnut Creek. My baby again went into distress, they wheeled me into the operating room, after 3 hours of pushing hard, and I was told that if the baby did not come out in the next 10 minutes they would push her back up and give me the C section. She did come out. They did not have the right needle yet she stiched me up anyway. The thread broke later. In my room nursing my beautiful daughter in recovery my husband thought she was breathing hard, nurse said she seemed fine but would check. Off to the NIC unit for a week due to breathing problems. I boarded there (if they have empty rooms you can stay on which is a huge blessing). I went in every 3 hours and was able to breastfeed her within a few days. Most of the shift care was amazing. Wonderful, considerate nurturing nurses. The 2 am shift does not seem to have a doctor on rounds. It was loud in there. The manager yelled from one end of the room to the next, a nurse put a radio really loud next to an 5 month old who kept crying, and the topper was the nurse who said ' stop crying or I will throw you in the trash'. I kid you not. I chose not to report the staff until we were out ( she was in a week).

I was told that the manager was fired, yet I heard from another manager that she was transfered. I sent a complaint to the Chief of the hospital who later forwarded it back to the head of NIC who heard my original complaint. She wanted me to come in so that she could reasure me that it was all better. She was also upset that the complaint I sent to the Chief 'passed through a lot of hands before it got to her.' So, there it is, my experience at Walnut Creek. In hindsight I think it would have been a great choice to have a doula who would have had the experience to shepard us through the experience. I do want to add that I have had a great many positive experiences with Kaiser but this was not one. Anon

My first child is due in early December, and I'm trying to decide whether to deliver at Kaiser Walnut Creek, Oakland or Hayward. I've toured Walnut Creek and Oakland, and liked Walnut Creek much better--both the physical space and the midwife, natural-birth-oriented approach. But at a check-up today my nurse told me that Walnut Creek is overcrowded and I may get turned away. She suggested that I check out Hayward, which also has midwife births and which has apparently recently been remodeled. I'm wondering if any mothers who've given birth at any of these places recently can comment on their experiences. The previous postings I've found on BPN about Kaiser Walnut Creek and Hayward are quite a few years out of date. Thanks! Erica

Kaiser midwifery coverage is 24/7 in a number of our No. Cal medical centers including Hayward and Walnut Creek. There are no midwives in medical centers with large OBGYN residencies except for Sacramento where there is part-time CNM coverage.

Walnut Creek is very busy these days but you can deliver there as long as there is an open bed when you go into labor. It is rare that a client is asked to deliver in a location other than the one she planned on. It does happen, however, so it is important to call the Labor and Delivery unit before you leave for the hospital.

Walnut Creek asks that women who receive prenatal care elsewhere transfer their care to WC around 35 weeks so they can plan and staff for your delivery. An extra midwife has been added to the WC staff through December as they anticipate a sustained baby boom there through the end of the year.

Hayward has a wonderful midwifery service. If you are uncertain where you want to deliver, I would recommend taking a tour of the facilities on your list. I hope you all find this information helpful. Thanks and take care, Kathy Heilig, CNM Kathy

Delivering at new Kaiser Oakland vs. Walnut Creek

Hello all! We are due in January and as Kaiser patients have the choice of where to deliver. I've heard that Kaiser Oakland L&D is staffed by mostly interns, whereas Kaiser Walnut Creek is primarily staffed by CNM's. We are hoping for a natural birth, and would welcome hearing about any and all experiences relating to delivery at the new Kaiser Oakland facility vs. Walnut Creek. Thank you in advance for your reply! Yvonne

I'll probably deliver there, just because I don't want to get stuck in traffic going to Walnut Creek, but I'd be very interested in hearing about more recent Oakland birth experiences. Irene

I'm a Kaiser patient and I have been in prenatal care since October. There is a lot of confusion at the moment about the question in which hospital Kaiser patients have their babies and what role Alta Bates plays in this. It took me about 20 phone calls to find out, but these seem to be the facts:

Every Kaiser patient has the right to get care at every Kaiser facility anywhere in the US. It doesn't matter where you live. For example, I live in Berkeley but I got my prenatal care at Kaiser SF because it was more convenient - the SF Kaiser hospital happens to be in a walking distance from my workplace. So if you decide to have your prenatal care and deliviery at Kaiser Walnut Creek, that's okay regardless of where you live.

Kaiser would like you to have your baby in the same place in which you have obtained your prenatal care. For SF, Walnut Creek etc. that is not a problem - you just deliver at the hospital at which you got your care before. For Kaiser patients of Richmond and Oakland, delivery is no longer possible at these hospitals and will usually happen at Alta Bates in Berkeley instead.

It is, however, possible to have your baby at a different hospital if you go through some paperwork beforehand. This is what I will do - I've stopped working now, so I no longer drive to SF regularly, and I want to have my baby at Alta Bates because that's closer to my home. This was clearly not Kaiser's "preferred method", but in the end all I had to do was to make sure that the records about my prenatal care got faxed over to the East Bay after my last prenatal appointment in SF.

This DOES work, and I think the same must be possible the other way around (a woman who got her prenatal care at Oakland Kaiser should still be able to deliver at Walnut Creek as long as she sorts out the paperwork beforehand and gets a referral from her doctor). I hope this helps. Good luck, Angela