Re: Natural Birth Dr Thomas @ Alta Bates (May 2004)
If you want a low or no intervention birth, I would recommend Summit vs Alta Bates. You will have to have some interventions when you come into the hospital, such as some monitoring and basic nursing care but you are more likely to get those at Summit than at Alta Bates. An experienced doula

I am preparing to deliver my first baby at Summit, with midwife Hsiu-Li Cheng. I have read the archived postings about Summit, and I'm now hoping for your comments on more recent experiences. I am planning to have a natural birth, and I would love any ideas about how to best work with the facilities and the staff to have the support I need. I have my husband and two other (sensitive but inexperienced) helpers, but no doula. Thanks for your suggestions!

* Don't go to the hospital too early. Follow Hsiu-Li's instructions.

* When you check in, request a nurse who enjoys attending natural births. My first nurse was not sensitive to my needs at all. She left me on the fetal monitor and forgot about me, knowing that it caused me a lot of pain (I was particularly sensitive to touch during contractions). Luckily, I only had her for a few hours before the next nurse came on. My second nurse was sympathetic and laid back. She read my birth plan, helped me ease the discomfort caused by the fetal monitor, and left me alone for most of my labor, which is exactly what I wanted.

* Try every position in the book. I spent most of active labor kneeling with my elbows resting on furniture. It was the only position that made the pain tolerable (of course, it's different for everyone). During the pushing stage, I lay on my side and rest in between contractions. I asked my husband to lift up my top leg to allow the baby to move down the birth canal during contractions.

* Use the shower or bath tub as much as possible. I rented a deep water tub (for about $250) and spent several hours in it at home. In warm water, I didn't feel the pain as much because my muscled were relaxed. Staying in the bathroom at the hospital will also help you avoid interventions such as vaginal exams and fetal monitoring.

* Know the rules of the hospital. It's helpful to know, for instance, that a certain amount of fetal monitoring is mandatory. However, if the strap bothers you, you don't have to use it. Someone can hold the device against your belly. While you're on the monitor, you don't have to lie on your back. You can assume any position you wish. If the cold gel bothers you, ask someone to squirt a small amount into a paper cup and warm it up in the microwave.

* Remember to drink plenty of liquids during labor. They will have juice at the hospital, but bring your own broth. Homemade chicken broth worked for me. Bring about 6 servings.

* Keep your voice low when you moan. It will help you relax and regain a sense of control over your body.

* Take a Bradley class and watch videos of births with your partner. Birth is gory, but also empowering. It helps to be emotionally prepared.

Feel free to contact me if you have any questions. Bonnie

My labor was stalled a few times, and my dilation was anything but progressing, let alone linearly. Hsui Li didn't know why it was not progressing, but she gave me time and she had confidence. She tried various things and none worked, but then one approach had surprisingly sudden success. I doubt I'd have had a vaginal birth with a typical OB/GYN, let alone one without epidural, episiotonomy, vacuum, forecepts...

Hsui Li is not particularly involved into emotially support, though. That's not meant to be a critique, I think she simply cannot function as both the boss (bearing all the responsibility for the correctness and the decision of the medical part of the process) and the laboring woman's motherly friend at the same time. There are, unless you go for a home birth, unsurmountable contradiction between these two roles. That's why having other people playing this part is very beneficial for the whole birth process.

I had a truly amazing doula, but I would not necessarily say other people cannot do this sort of support. Her presence, mindfulness, and some practical help insured my labor to unfold gently, both at home and later in the hospital. I needed her most desparetely during the transition (which would have been easier to deal with if we had known I was already in transition... ). During this period, I was truly convinced that anyone in the world can give birth, but not me. Sounds strange, but is very normal. Labor brings you in a very particular mental state. Extreme sensations, awareness, changed sense of time, very existential thoughts, doubts, feeling distant from anyone else etc. I acted entirely normal, but was in a very intense state of mind. It was crucial that my doula was with me in this moment and in this spirit. She listened to my fears, acknowledged my very hard work, and encouraged me to keep facing the process. She did not try to comfort me or make predictions about the process - I would not have believed her any of this at this point.

Your helpers need to be able to support you in an extreme situation, respond to you in this unknown state, and being practical and very reliable. While birth experience is a plus, I would not say that it cannot be replaced by other life experiences or qualities of your helpers. It must be clear to them, that they are there to *help you*, not to watch a baby being born. It would be good, if they prepare themselves for this and talk to you about it during pregnancy. The book ''Birthing from within'' helped me to understand the emotional part of labor and birth. I also like the books by Sheila Kitzinger.

The rooms in Summit are okay. The most useful thing I brought was some sort of sport bottle I could drink from in any postion. Juice was helpful for energy for the pushing (honey might have been better). If I were to do it again, I would bring a big and thick blanket to spread over the floor. I didn't feel comfortable on the narrow and unusually high hospital bed. Instead, I moved around the room. It would have been good to take short spontaneous breaks on a blanket.

Get in touch with me by email if you would like to ask more questions. All my best wishes for your birth and for your life with your new baby, Julia

The birth was fine, all things considered (I had no drugs but did have interventions because the cord was around his neck), and I don't feel particularly bad about how it went. He was born healthy with loving family and friends around, and I feel very lucky to have had a non-medicated birth experience.

BUT... it was much less natural than I wanted, and I have a suspicion that it would have gone smoother if Hsiu-Li were there. I have tons of confidence in her - she's wonderful. My suggestion to you would be to get a doula, and make sure that your support system (doula and family and friends) know what your birth plan says and are willing to ask for a change of nurse, or remind the hospital staff about the contents of your birth plan. For me, the hospital staff didn't even look at it. My one regret is that he wasn't brought to me to nurse right away, and they didn't delay the bath, etc. (as stipulated in my birth plan). We had lots of trouble learning to nurse for the next month or so, and I suspect it would have been much easier if he had nursed right after birth instead of falling asleep before he was able to.

I also had, for the first few hours, a nurse that was not to my liking (she had me in uncomfortable positions, refused to let me get into better positions, insisted on an IV, and seemed unsympathetic to my hopes for a non-intervention birth), but I felt weird asking for a different nurse to be assigned. Next time, I'll ask for another nurse without any qualms. After the shift change, my labor went infinitely more smoothly and the baby was in less distress because they let me get up, squat, etc.

Feel free to contact me if you have more questions... Jen

You may be pleasantly surprised to find many of the nurses and other staff at Summit to be very supportive of natural birth. We adored our main nurse from the first birth so much she was our doula for the second. Let them know you want a natural birth from the start and ask them for suggestions if things get rough (walking around, the birthing balls, the shower or tub, etc). If the nurse you get doesn't click have your helpers ask sweetly for another.

My older son's birth was very long and difficult, with many hours of pushing. Hsiu-Li told me later that she only let me push that long (no c-section) because I wasn't complaining - she said that she has no way to know what a mother is experiencing other than what we tell her and so her decisions are very much influenced by how we seem. This is not to say I didn't get discouraged, weepy, feel very tired, make lots of noise, etc.

I had been inspired by reading Ina May Gaskin's ''Spiritual Midwifery'' (highly recommended) to try to keep a loving and light spirit even in the midst of hardship and went into the birth with that in mind. Based on conversations with Hsiu-Li, in my particular birth that made all the difference (along with baby's heart rate, luck, support, etc.). This is not to say that all you have to do is have a nice attitude and you'll get the birth you wanted - I feel lucky it worked out this way for me and there were no adverse circumstances requiring serious intervention. - Charis

Hello, I checked the archives for experiences delivering at Summit Hospital, but the most recent posting is from 1999. Any more recent experiences that folks would be willing to share? I'm especially interested in hearing about the level of openness to natural childbirth. Thanks very much! L. Mitchell

The staff was wonderful, and the nurse who tended to me was a doula. My only advice is that you speak with your doctor beforehand about rest. The nurses are overworked, so they insist that you keep the baby in your room with you during your entire stay. You will be EXHAUSTED. You should make sure that your doctor PRESCRIBES rest for you, and s/he must INSIST that the nurses keep your baby for one night so that you can rest. That is what Dr. Girgis did for me.

I also chose to stay as long as my insurance allowed (4 days) to make sure I knew how to breastfeed (not easy for me to learn). Make sure you ask to see the lactation consultant if you have trouble - she's excellent. This was my first baby, so I wasn't sure that my daughter was getting any colestrum because I didn't know how to help her latch properly. The nurses worked hard at teaching me, but the lactation consultant had specific techniques that made the whole process much easier. Best wishes for a pleasant delivery! Christina

My daughter was delivered at Summit this past February. I thought it was a wonderful experience. The midwife who delivered me was Debbie Coleman and I have only the highest praise for her, too. When I visited Summit prior to delivering there, I was a little concerned that it seemed a little too much like the old, antiseptic hospitals of the past. But when I actually arrived in labor, I found that I didn't notice any of those things, and instead was very impressed by the warm care provided by the nursing staff. All of the nurses with whom I interacted throughout my stay there were kind and accommodating. And my doula, who had helped with a delivery at UCSF in the fall, was also impressed by the staff. Piper

Fortunately, everything went smoothly and my labor was not a long one. I love my doctor and Summit was/is the only hospital where she delivers, so I didn't have much choice. Also, this was 7 1/2 years ago, so I'd pay attention to the comments of people who have had more recent experiences there. Ann

After all the reports on deliveries at Alta Bates, I thought I should mention that Summit in Oakland is a good nearby alternative. We had our delivery there. We didn't have a choice: my wife's obstetrician only delivered at Summit or somewhere in Walnut Creek. The delivery room was large and pleasant. We had a private recovery room, with an armchair that folded out into a bed, which I used. I don't think they had any non-private recovery rooms.

The nurses were all fine and accomodating. We didn't have to insist too much for an epidural. The only complaint is that too many nurses came in and out of the recovery room for all sorts of reasons, even when we were trying to sleep.

The delivery was by unplanned (but non-emergency) C section, and we had to leave the hospital less than 48 hours after that. But that was a problem with the insurance, not the hospital. In any case, we probably slept better at home. Luigi

We just had our first baby (a girl) 2 weeks ago at Summit, and overall had a very positive experience there. We got one of the "good rooms" for L&D--a huge room with a jacuzzi tub and a great view. The L&D nurse was very good, checking on us frequently but unobtrusively. We wanted to go without meds if possible, and although she offered them several times, she never tried to push them on us. The key for us was our wonderful midwife, Hsiu-Li Cheng, whom we cannot recommend highly enough. We love her, she is a genius. The moment she walked into the room, the atmosphere changed--she immediately took charge, and we all felt better and more focussed, and the delivery went spendidly from there. She visited us several times in postpartum as well. Our postpartum experience was pretty good also. The rooms are almost all private, so my husband and our baby and I all roomed in together. The nurses were a mixed bag, but I think that is probably true of any hospital. We got mixed advice regarding breastfeeding--one nurse insisting we wake up baby every 2 hours to nurse regardless, another telling us it was OK to let baby tell us when to nurse, as long as 4 or more hours didn't pass by, etc. We just listened to all of it, then followed our instincts (which is what Hsiu-Li encouraged us to do). All of the nurses were very supportive of our efforts to nurse, though they all had different methods of doing it. One nurse in particular (her name is Mary Jo) was wonderful--she stayed with us for half an hour at a time, and made sure to stop by every few hours to check on our progress. There were a lot of people coming in and out, but they were usually respectful about it--knocking first, and postponing routine procedures if we were in the middle of nursing. Even though the ward was full, we were encouraged to stay for more than one day if we wanted, which we did.

In summary, we had a very good experience at Summit. I think it's a great place to have a baby, particularly if you have a good support team of your own. I also feel that having a fantastic midwife made the difference for us. We didn't have a doula, but I think they are a great idea as well. And in response to the woman asking about twin deliveries, Hsiu-Li is probably the most experienced practicing midwife around, having delivered something like 4000 babies, several of which must have been twins. She also has OB back-up through East Bay Perinatal Medical Associates. Karin