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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&D 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&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)


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
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