OBGYN Recommendations Kaiser Oakland - 1st Time Holistic Mom

Hi BPN Fam,

I am in early pregnancy with my first and am also new to Kaiser Oakland. I was wondering if you all had recommendations for OBs at Kaiser Oakland who respect, or even encourage, more holistic approaches to prenatal care and birth, for example minimal ultrasounds (if any), avoiding pharmaceutical medications (not forcing them and being open to more natural/herbal approaches), water birthing and pain relief that also doesn't involve drugs, etc. I do not want to feel pressured or made to feel I am doing harm to my baby if I don't want to get a flu shot, for example (I've heard terrible stories from multiple friends/family members what have experienced this - I've never had a flu shot in my life, nor has anyone else in my family including my parents, and we are just fine - so I would rather not be made to feel like I'm endangering my child or am a bad mom if I don't/my mom is a great mom and made these same choices).

I am also interested in learning more about midwives if there are any recommendations and am considering the Centering Pregnancy program, which is a group program between the OBGYN and Family Medicine departments. Has anyone done this? I think I will probably go this route, but either way, I need to choose an OB asap regardless for my 1st check up and would like for it to be someone I can stick with in all cases for obgyn needs. Welcoming any and all recommendations for OBs at Kaiser Oakland who have a more holistic approach and are also culturally/socially conscious/competent and respectful (toward POC/immigrants/low-income). MANY THANKS!!

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I'm not sure what you've heard, but most of the stuff you're talking about is pretty standard with all OBs and midwives in the area. Unless you have a high risk pregnancy, you really only are eligible to have 1-4 ultrasounds (dating scan to confirm pregnancy is viable, NT [definitely optional], anatomy scan [could also be optional], position check at 36w [could also be optional]). It's not typical to prescribe any medication if you're not having any problems, and everything from the flu shot to getting an updated TDAP to cervical checks is always optional. I believe Kaiser Oakland has options for water birth as well as med-free births. This is all pretty common around here, and you'll likely be fine with whomever you end up with (I don't think you can choose who will do your delivery with Kaiser).

I can only speak to the Centering Pregnancy option...and this is just my own experience.

I wasn't sure about it and we went to the first two sessions and ultimately decided it wasn't for us. This was simply because we have a lot of outside resources (a doula, a prenatal psychotherapist, I have been reading books since early on, hypnobirthing classes, etc.) and it felt like a lot of time to invest to be learning the same things we already knew. What we were hoping for was to connect with other new parents and maybe form relationships outside of the group but the particular group we were in didn't seem interested in community building (though maybe we jumped shipped too soon). I would say try it and thankfully they give you the option of going back to your previous OB/Gyn. When you do the CP program the two doctors who run it (and you don't get to choose I don't think) become your OB/Gyn for your pregnancy and the group meetings take the place of your other checkups so that's something for you consider. 

Hope this was helpful. Happy to answer other questions if you have them. 

Hi, I don’t have recommendations for Oakland but if you are looking for a  more holistic approach you may prefer a midwife. If you don’t mind travelling a little further out, Walnut Creek has midwives who are great. I delivered there and had epidural free birth, but did use nitrous which was a great alternate to help take the edge off and avoid epidural. As for flu shot, everything is optional  and you can advocate for yourself and let your provider where you stand/prefer and they will respect that.  I only had one ultrasound at 20 weeks through Kaiser, which i believe was standard. 

Wishing you a happy and healthy pregnancy!

M

Dr. Kristen Miranda is wonderful, and she runs a centering group. https://mydoctor.kaiserpermanente.org/ncal/provider/kristenmiranda

I'm with Kaiser Oakland, with Dr. Sarah Wilson as my OB. She is fantastic and I highly recommend her. I also did the prenatal group program during my pregnancy (my son is now 1 year old), which I believe has evolved into the "Centering Pregnancy" program as you've described, and I would highly recommend that as well. We ended up choosing one of the Family Medicine doctors who led our group as our son's pediatrician. We still keep in touch with the other couples who were in our same group, and have become good friends with one couple and their baby in particular.

I can't speak to the "holistic" approach as you've described, but I will say that Kaiser did very few ultrasounds during my pregnancy. I think I may have gotten one per trimester. Otherwise, they just used a doppler to listen to the baby's heartbeat at the checkups. 

As for a water birth, I doubt that the Kaiser Oakland hospital facility could support that. Another couple in our Kaiser prenatal group did a home birth with a water birth, however. Kaiser Oakland hospital has all the drugs, including nitrous oxide, for pain relief during labor, but I've heard of plenty of women who did not opt to use any when giving birth at Kaiser. The Labor & Delivery rooms at Kaiser Oakland are spacious (so there's lots of room to walk around, use a yoga ball, etc.), and they come with a shower. Kaiser Oakland L&D is also run by midwives - a midwife on duty supervises the OB residents, who take care of the laboring mothers. All the residents that we interacted with during our stay were excellent.

Also, my understanding is that you can also opt to give birth at Kaiser Walnut Creek, where it's all midwives (no OB residents). 

I had my "baby" several years ago so my info might not be current on most of your points, but I want to note that I had never had a flu shot in my life either. When my daughter was about 1.5 years old, I brought home the flu and gave it to her. It was so incredibly scary to see her so sick for so long. Really, this was the type of flu from which some people die. Ever since we have gotten flu shots and have never gotten the flu at all.

My son is 10 months old and I gave birth at Kaiser Oakland, after being cared for by two Kaiser OBs during pregnancy (one transferred to SF halfway through my pregnancy). With the exception of a waterbirth, which is not available at Kaiser Oakland, everything else you're describing is available and will be respected. I also wanted to have a more natural pregnancy and birth experience and had no issues with this. Just keep in mind that they have a lot of patients who have all kinds of ideas about what they want out of pregnancy and delivery, so you need to be vocal and clear about your desires. But once you are, those desires will be respected. I made it very clear to my OB before labor and to everyone on staff once I got to the hospital that I did not want an epidural, and no one ever mentioned it to me again, despite my 36-hour painful labor. At Kaiser your OB will not be the doctor delivering your baby (unless by coincidence!), and you will not get to choose the staff who delivers your baby, which in my experience were the more important players! However, there is a midwife who oversees and attends every birth at Kaiser Oakland -- while you will have minimal contact with her (it's really mostly the nurses that take care of you during labor), she is there and available if needed (and she's there as labor gets more intense and during the actual delivery). In my experience Kaiser is pretty up-to-date on progressive and holistic ideas about pregnancy and childbirth, and their policies are very respectful of different choices. Because you won't necessarily have consistency of care between your pregnancy and delivery, it's up to you to be clear about what kind of birthing experience you want to have -- you can't expect them to know that going in -- but they will respect whatever choices you make. And Kaiser has and encourages you to use whatever drugs or non-drug forms of pain relief you can think of (other than water birth :( ) 

Good luck!

This is a bit tangential, and while I'm glad someone on this list had a positive experience with Sarah Wilson, my experience with her when she was at UCSF was not positive. Happy to provide the original poster with more details (feel free to email me on BPN), but I would not recommend Sarah Wilson for any patient-centric care. I was planning a home birth, but we discovered my child was a breech baby, whom I tried to deliver as a vaginal-breech delivery (with UCSF's support and encouragement) but ended up with a c-section. Sarah Wilson's interactions with me were minimal and she never checked on me or interacted with me again after the c-section was done. Our conversation was limited to about 8 sentences, most of which I remember verbatim. I am a medical anthropologist, so I have some insights into medical care and institutions. I realize you don't have a choice about who delivers your child, but at the very least, I would advise against her for any "care" as you go through this important life process. 

If you can afford to do so, I highly recommend non-hospital-based midwives, either those at the birthing centers or ones who can support you in a home birth. At the very least, I highly encourage you to find a doula to support you in the hospital, should you decide to use a hospital. It's very easy in the throes of labor to be pressured into unnecessary interventions, even if you feel prepared to anticipate the kinds of things that may come up during your birth process.