UCSF birthing center - can I use a midwife?

Hello, and mazel tov on your upcoming birth! 

I gave birth at UCSF twice, and they seem to have midwives on call along with the doctors and they work in tandem. You might be able to meet the folks who will be delivering your baby, but UCSF is a teaching hospital, so you have the option to have students in there, too. For me, I was just like, "the more the merrier, let's get this baby out," but I would imagine you are experiencing some anxiety about being trans and managing expectations. I can't speak to that personally, but I can tell you that UCSF is at the forefront of medical knowledge, and my perception is that they would be both sensitive and proactive in handling any concerns you might have. I know you won't be the first trans man to give birth there. 

That being said, I'm going to make an unusual statement (for the Bay Area) now: I would always choose a doctor over a midwife. Why? Because at both births, the midwife repeatedly told me I was not in pain, I should not need an epidural, I was not in labor, I should listen to her instead of my body, and both times I was apologized to by that midwife after the fact. My miscarriage in between -- the less said about that, the better. The doctors at UCSF are really, really on board with the control being in the hands of the person giving birth. It is not a medicalized experience. Similarly, the L&D nurses are 100% on top of the situation -- I remember looking past the angry face of that crappy midwife at my second birth, and seeing the nurse laying out everything for the epidural that I was begging for. She was taking care of business while the other lady was just scolding me. Oh! And the way they do epidurals there is apparently very different from most other places, because my friends reported that their epidurals made them totally numb, but I felt EVERYTHING - just not in as much pain. So I was able, with the epidural, to flip from one side to the other, to get on my knees, to pull up using a birthing bar -- I was like a circus performer trying to get my baby to agree to exit the premises. It was freakin' so cool, and I could not have done any of that if I hadn't had pain management. Me, personally. I know there's hella ladies who are like "BAM!" and that baby shoots out like a T-shirt from a cannon at a basketball game, but not this vagina. 

Bottom line: Don't put all your faith in one sort of provider. I encourage you to tour UCSF when you get here and talk to them about your needs. I know you don't want to hear this, but it's really unlikely that you'll be able to control which provider you get. But the really important thing is that there's a baby in you and there's a pretty predictable set of routes out of you, and the doctors at UCSF are familiar with all of them. Your baby will be spectacular, and YOU are spectacular. If you want to contact me directly, I can put you in touch with other trans parents in the area. I'm so happy for you! 

 

I delivered both my children at UCSF (old hospital and new hospital) and had incredibly positive experiences with the teams.  Both my deliveries were handled by residents, an attending, and nurses.  One time a pediatrician was also present.  I'd say there were about 5-6 hospital staff (MDs, RNs, etc.) in the room for the actual delivery, but usually it was just me and the nurse.  I met everyone after being admitted, and it was no problem.  The on-calls were never present for my deliveries (as far as I can remember) but we did see them around the floor.  

If you want a midwife to be present at your delivery just ask at your next appointment if there is a midwife on-site in labor and delivery.  I assume the answer will be yes.  If you want her in the room, just ask when you are admitted and make sure your partner (or whomever) reminds the nurses as you progress if you forget or are unable.  I'm sure they will do their best to accommodate your wishes if you state your preference.  I can't say whether my delivery would have been different with a midwife (probably not) but know that sometimes you don't have a choice (whether because of staffing or because of the specifics of your pregnancy/delivery).  Have a general idea of what you want, but be ready to go with the flow.    

I do not believe UCSF has a meet and greet for its team but I know they are more than happy to have you see different providers during your wellness checkups leading up to delivery.  That way you can get to know more of the staff.    

Congratulations!

I delivered there. You don't get to choose who will deliver your baby and I don't think it would be easy to "meet and greet" beforehand. UCSF is one of the very best hospitals in the world and it feels like the big research hospital that it is. You are in good hands, they are leading edge with their capabilities, and if anything goes wrong with the delivery, you are in the right place. Other hospitals in the area send their complicated cases to UCSF for expert care. But it is not going to feel small and personal in any way. You feel a bit like a cog in a wheel. I don't think there would be any difference in the care if it was an OB/GYN vs a midwife. They have their process and change shifts and doctors come and go and whoever is there when the baby is ready delivers it.