Berkeley Parents Network: Disappointed with Kaiser birth experience

Berkeley Parents Network

Disappointed with Kaiser birth experience

The Parents Network > Reviews > Health & Medical > Kaiser Doctors > Disappointed with Kaiser birth experience

Jan 2005

Ok, so what's the real deal with Kaiser? Is it truly a progressive HMO as they claim it to be, or second rate health care for the poor as I hear it described so often? Here's my concern, specifically: I delivered a baby by c-section, 3 (yes, THREE) weeks late, at Kaiser Walnut Creek about 18 months ago after receiving care at their Pleasanton medical offices. Things were just OK through my prenatal care- there seemed to be a lack of communication between health care providers (rarely saw the same NP or dr twice), contradictory medical advice given, no real plan for moms 42weeks+, very chaotic labor&delivery unit (they claim to have been very busy, but I hear that they are just always ''very busy''), and way, way too much medication pushed after surgery among many other things. Anyway, anytime I read things about Kaiser Walnut Creek from other BPN members, it seems like they have nothing but great things to say- and I wonder, did I really deliver in the same place? How could my experience be so far off from other people's wonderful experiences? Granted, I did like most of the nurses I met and the dr who did my c-section seemed very competent (though I was never given a real medical reason for the c-section), but it's unlikely I'd see any of them again. Now, I am pregnant again and about to start the whole thing over- should I give Kaiser another try or should I go with a private practice/different hospital? Am I really the only disappointed Kaiser WC patient?

I have a suggestion: ask to see your chart. Call ahead and make an appointment so you don't wait while they fish it out. Even with medical mumbo-jumbo, it should explain what the medical folks were thinking at the time but were too busy to communicate. Then feel free to discuss your concerns with your doctor.

I've been a Kaiser member for 15 years and had 2 kids with them. Like any other large, bureaucratic system, a lot depends on the individuals you come in contact with. There have been times when procedures seemed capricious and burdensome and other time where the bureaucracy has actually meant better communication and timely intervention. But even in my most frustrated moments, I've stayed because I'm not convinced that the other HMOs or PPPs are any better. In fact, with other plans, the communication between doctors is often worse because other HMOs aren't as centralized. To sum up, Kaiser works best if you have a pleasant, non-confrontational, but persistent advocate with you (I say with you because in labor you or your partner are unlikely to be any of those things!). Good luck. Brenda

I am wondering if you can contact me offline. I work for Kaiser and want to direct your concern to the Medical Group Administrator of the Walnut Creek facility. I work closely with him and I think this is something that he would want to know. Please let me try to address your concern. If anyone else has issues, please call me. That is after you have went through the facility's member services and have seen no change in your services. lena

I noticed in your message that you are pregnant now. You should know that you won't be able to get insurance anywhere else right now since you're already pregnant. You might want to work on finding out how to get the best prenatal care you can at Kaiser. I'm a health insurance broker and would be happy to answer any questions you have on the topic. Denise

I can only speak with regards to Kaiser Oakland, but our family's experience has been great for the entire five years that we've been members. I, too, am pregnant with my second. I have had the same OB/GYN Doc & NP since we signed up, the same family doctor and pediatrician all along, and a good birth experience - in the Kaiser Oakland Alta Bates days. I look forward to excellect care at the new Labor & Delivery in the Kaiser Oakland Hospital, and, in fact, have heard only good things from doulas, etc about the new unit. When I struggled with depression due to miscarriages, the therapist selected for me was great and caring - and even recommended a Meditation and Mindfulness class offered there, which was beyond any expectations I would have of a ''normal'' HMO. I will use things learned in that course throughout life's tough times, and even in labor.

So, my advice, give Kaiser Oakland a try this time. Ask to see if Rebecca Avery, NP OB/GYN, is available. Roberta Cunningham is a fabulous pediatrician. And, I'd recommend Dr. Lawrence Sirott for a primary care doc.

And, no, I don't work for Kaiser, though it sounds like it, huh? signed, A happy Kaiser family

I'm so sorry you had such a horrid experience. (Interestingly, my experience with post-CS pain meds was the opposite--I practically had to beg for them with one nurse, at Summit Hosp!)

I've had a very, very good experience with Kaiser Oakland. My physician and pediatrician have been top-notch, as have been the specialists. But don't take my word for it: there are surveys every year of health providers by Consumer Reports and others, and of the ones available in California, Kaiser No Cal & So Cal always come out WAY above anything else, including HealthNet, which I left after my son was born. I mean, like on a different page, the others are so much farther down in terms of satisfaction rating.

I don't discount your experience, and have heard of others who have been dissatisfied (sometimes deeply dissatisfied) with Kaiser, but that doesn't seem to be the norm. If Kaiser Oakland is convenient for you, drop me a note and I'd be happy to supply the names of my doctors. Hope this helps. Jennie

I'm sorry to hear that you had such a negative birth experience at Kaiser Walnut Creek. I too delivered at Walnut Creek and went to the Pleasanton Medical Offices. I truly had a great experience and was really impressed with the whole prenatal care and delivery (also a c-section)process.

I say give it another try but you need some consistancy. Pick a doctor as your primary OB and see only her/him. You can also pick a secondary Doc or NP, in case your primary is on vacation or sick. I only saw my doctor and loved her. In fact, she did my c-section as well.

I'm not one to whole heartedly endorse Kaiser, as I have not always had the best experience with them but after my pregnancy/birth experience, I really hope I have Kaiser with the next child.

Hope this helps, Karen

Hi There. Kaiser Walnut Creek is a little dirfferent in the fact of having midwives staffed there. As a doula, I have witnessed a variety of situations good and bad. Of all the Kaisers, Walnut Creek and Hayward have been the most outstanding when circumstances have arose. I do validated the fact that they tend to be chaotic in their commincations and their protocols. I think that since you are pregnant again, check into giving Walnut Creek another chance. Maybe you could have a personal support team that would allow you to labor, and leave all the business affairs to your support team. Walnut Creek has responded positive in having family/friends/doulas present for the birthing mom. Last note- KWC does stay busy, its a populare site because they are more relaxed than other Kaisers. Niccole

I've been a Kaiser member for over 20 years, and have been a patient at WC, SF and now Oakland.

Overall, I really like Kaiser, but I notice now that I have Primary Care Physicians for both me and my kids, the Kaiser system is even better. Do you have a PCP? For years and years I didn't have one, and when I was pregnant with my kids I saw whomever they gave me.

Now I just call my personal physicians, and I have had nothing but excellent customer service and care.

It's true, different doctors will sometimes give you conflicting information, but I think that is true of any practice, not just Kaiser.

I also had c-sections, but I know for a fact that Kaiser is pro-natural. They tried to talk me into a VBAC, and they also let me go 2 weeks and one day the first time around. Their policy is not to induce until you are 42 weeks. They also won't give you an epidural until you are 4 cm.

I think just like any other organization, some years they give better service than others, and some branches might be better than other branches. Maybe WC is having a bad year. Kaiser fan

I had my first child at Kaiser and was very disappointed with the chaotic care I received. Although my daughter is seven years old, I remember seeing a different doctor throughout the entire pregnancy and did not even know the doctor that delivered my baby. The only thing good was there were no medical bills. I switched after being a member since I was a kid because they wanted to perform surgery on my six month old daughter for constant ear infections. Now my second pregnancy was high risk and my doctor was wonderful and proactive throughout the ENTIRE pregnancy. His name is Dr. Kevin Smith and he has an office in Oakland (Chinatown) and Oakland(Montclair). I too had a c-section at Kaiser & was able to give birth to a boy vaginally. I also had gestational diabetes, early onset depression (due 2 post-partum blues with the first, spotting and a host of other things. It was like when one thing got repaired something else happened. But I was confident throughout the entire process and didn't worry. Kimberly

I have delivered at Kaiser WC twice in the last 2 years. I had both bad and good experiences respectively. My first labor was 36 hours long. I went into labor with the birth plan to have the least amount of intervention as possible, but not totally closed to pain meds if I truly felt I couldn't handle it. I ended up with every intervention - okay not EVERY, but plenty, including water droplets to help stop back labor pain (which it didn't), narcotics (which made me hallucinate), and an epidural at about hour 24. I was there for so long I went through plenty of nurses, and ended up with a real loser for the actual pushing and delivery. I was threatened that I was going to have a C-section for the last 11 hours of my labor. I was dilating REALLY slow, but I WAS dilating, and the baby was not in distress. I begged and cried for them to let me keep trying to have a vaginal birth. Reluctantly they let me go. The nurses were rude to me when I was contemplating the epidural, asking ''what are you afraid of'' in a condescending manner. They didn't encourage me by telling me what a good job I was doing, or that I was strong and could do. When I was finally pushing no one was telling me what was going on, and when I asked the nurse replied ''it's going to be a while'' in this bored tone. The Midwife came in at the very last second to catch the baby. After the baby was born, my after care wasn't great either. I had very bad tearing and a hematoma (a big pocket of blood protruding from the perinium - VERY painful). Yet I constantly had to get out of bed to get myself juice or call for a nurse as they weren't answering my pages.

Labor number 2 which was this last April was totally different. I had a GREAT experience, but my labor was also totally different. This time I was only in labor for 2 hours (and I mean from the very first contraction). I got to the hospital at 9cm, let out a wail like only a woman in labor can do, and was literally swept off my feet to a delivery room. I begged for the epidural, was told it was too late, that the baby was coming, and was ENCOURAGED that I could do it. The nurses helped me breath through the contractions, and in general were there for me in the intensity of the moment. Right away the baby went into distress, and they called for the doctor. I was told they couldn't find the heartbeat, and I needed to push the baby out right that moment or they were going to do an emergency c-section. I opted for bearing down and pushing with everything in me, and the baby was born in about 3 minutes. My after care was also great. The nurses were friendly and helpful, and seemed to have my best interest at heart. My only complaint this time was that ALL NIGHT LONG people were in and out of my room, and I got very little sleep. Nurses came in to do vitals on me and baby, came in to check serial numbers on the beds (or something like that), they came in to empty the trash, the circumcision doctor came in at 2am to discuss the circumcision with me, then a half later (just as I was getting back to sleep) the nurse came in with the cicumcision paperwork, they came and took the baby to do the hearing test, and Lord only knows what else. It was INSANE. I had to stay another night (because I fainted for some unknown reason), and my doctor left a note to leave out room alone. There were still a couple interruptions, but nothing like the night before.

So, I would have to say that you just don't know what you are going to get. Do I think they improved that much over the 21 months since I had been there. Not really. I think it's the luck of the draw. But I also think it's that way anywhere you go. The only predctable thing about labor and delivery is that it is unpredictable. There are no guarantees no matter where ou go. Good Luck in your decision! Done with L & D

hello, after reading your posting, as a healthcare professional, i got a sense from some of your comments that you need to take more control of your health care. for example, thoroughly research your kaiser's prenatal practitioners, and by all means understand why your c-section was performed (i assume you signed a consent form and had the risks and benefits of your c-section explained to you). surgical procedures are NOT performed without reason. i would encourage you to even follow up on this and ask your ob precisely why your c-section was performed, aren't you curious? i am a very pleased kaiser patient, and i thoroughly researched the obstetricians in our office prior to committing to one for the delivery of my daughter. and i continue to see him for my routine well ob care as well. in order to see your chosen practitioner as often as possbile, you should book your next appt whenever you are at an ob well baby appotintment. yet at the same time, as in many multi-physician offices, you need to accept that you will see different practitioners occassionally.

you'll feel better about your care if you connect with your ob on SOME level (who you see quite often during pregnancy!). read about the birthing process and convey how you would like your delivery to go to your delivery team. i guarantee that you too can be a happy kaiser patient if you do your research and voice your concerns and needs. PARTNERS in health = patient and caregivers working together! good luck!

I was a Kaiser member for over 20 years. I even paid for the plan for several years even though my employer offered a fantastic indemnity plan that let me choose any dr. I wanted to and had no co-pays. I chose to have my baby at Kaiser WC even though I could have gone anywhere (and did tour Alta Bates and other are hospitals). I happened to tour KWC on a night it was pretty empty and not chaotic. I happened to go into labor on a day when apparently everyone in the Easy Bay did too. It was very busy the entire 3 days I was there and a nurse was yelling for a dr. while my daughter was coming out on her own. That said, I loved my experience at Kaiser in every way. In my 20+ years as a member, there were many things that I didn't like and many doctors I was unhappy with. So I would switch doctors until I found one I liked. Now that I have an outside plan, I may see ''the best'' docs out there but I still wait months for appointments and have yet to impressed by any of them. I also don't like having to go to so many different offices and feel a big lack of continuity in care. While at Kaiser, I felt that there was good communication between all the doctors and staff about my care vs now where i feel like i have to wade through a huge system on my own. That was all taken care of at Kaiser. It is not perfect, but I do believe it is good. My family has had Kaiser for minor and major medical issues and we never felt like we had low quality care. We only stopped with Kaiser because it seemed ridiculous not to take advantage of my company's free coverage. If I had a choice, I would happily stay with Kaiser. Nic

I have had great experiences with Kaiser Walnut Creek-both with my care and delivery in 2003 and my care in my next pregnancy, due in April. I think Kaiser can be a wonderful resource if you are willing and able to be a strong personal advocate for yourself. During the course of my care, I found a few things to really help the quality and continuity of care:

1. If possible, see a MD. Now I know they want you to see a NP, and a lot of them are very good. If the pregnancy is complication free, seeing the same NP is fine. However, I found that if there was ever a worry or complication, I'd have to first see the NP and then come back to see a MD--a waste of my time to do both. Finally I saw a doctor that said I could just continue seeing him over the course of my pregnancy instead of switching. His name is Francis Wright, and he can be brusque and a little by-the-book Western in his approach, but he is a kind, caring man that is pleasant to see and he lets me e-mail him questions and is always very responsive to anything I need. Once I settled on him, it was a much more personal experience. Even if you do see an NP, you must insist on seeing the same one (see below).

2. Don't let them switch providers on you. The nurses that schedule the follow up appointments have tried, several times over the course of this pregnancy, to schedule me with someone totally random. I just give a big smile and very sweetly say ''Oh, I'm sorry, I only see Dr. Wright, what are his available times?''. You shouldn't be expected to see more than one person, unless its a vacation or something unusual.

3. Talk to the doctor about all of your concerns, if they are good they will help with this scheduling business.

4. Having a single provider helps when you are in labor, too. Dr. Wright would call up to my room and come in to check in. He wasen't there to deliver, but I did feel like I had an outside resource.

5. Have a friend or doula at delivery. I think their delivery ward is great, but I also think its somewhat typical that you need someone other than yourself to help ask questions/make the big decisions. If you feel that you didn't have a real reason for the C-section, you needed someone advocating for you (no, it can't be you in labor!) and getting those questions answered. Also, if things are not living up to your expectations, talk to the doctor on duty. We had one nurse we didn't feel comfortable with, we talked with the attending, and we never saw that nurse again. We found that when we communicated our needs, they were willing to go the extra mile to make us happy.

In answer to your question, I love Kaiser WC and will continue to use it (even though I drive from Livermore, I have worked to establish myself with one doc in one place and I'm sticking with it). I do think you have to be a firm advocate for the quality of your own care. If you are willing to do that, Kaiser can be a great resource. Good luck! Rebecca

I can't comment on whether or not Kaiser is ''progressive'', nor can I comment on the Walnut Creek facilities (I use the Oakland facilities). However, I can say that I have been overall happy with my care with Kaiser. I've been with them for nearly three years now, and had a few medical issues that were, for the most part, dealt with well. The same medical issues that were brushed off by previous doctors were quickly referred to specialists with Kaiser. The problems that did arise were not Kaiser-specific. I'm now pregnant and expect to deliver at the Oakland hospital in a few weeks.

All that said I am also the type of person to take a very active role in my healthcare in general. I make sure that I see the same doctor/nurse for my visits, ask lots and lots of questions, and research things independently. I also have hired a doula to be with me at birth, because, yes, hospitals are busy, chaotic places. The last time I was in a (non-Kaiser) hospital I was forgotten about in the recovery room!

From reading your post it sounds like it is possible that you may be happier in a small private practice. I have little experience with such practices, so I couldn't compare. Either way, it is important that you make your concerns known to your practitioner and take the time to develop a relationship with them. Best luck with your pregnancy and healthcare decisions! Kaiser patient

A dear friend of mine is due in March, and I will be with her during the birth. She has been going to Kaiser S.F., and I have had some opportunities to check it out. We are very impressed with their birthing center, their staff, and how informative they are. they also really stress how willing they are to work with her needs and wants during the birth, and claim they are supportive of doing as little intervention as they can. They also claim a very low C-section rate, and were able to cite statistics, as well. Since we haven't gone through the delivery yet, we don't know how true this all is, but we're hoping it's as good as it seems. Anon

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