Local Birthing Options: A Guide for Expectant Parents

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There was a time—say, 50 years ago—when labor and delivery were not unlike a Looney Tunes episode. The mother was hit over the head with a mallet (anesthesia) and came to hours later to learn her new infant was cleaned up, drinking a big bottle of formula down the hall in the nursery.

But by the late ’60s/early ’70s, running parallel to the women’s movement, mothers began to openly suggest that having a baby is way different from having your appendix out. They—and their partners—wanted to be more actively involved in the birth experience, and in their newborns’ care.

The medical community eventually responded, and as a result, there now are almost limitless options for where and how babies can come into the world. This is especially so in the Sacramento area, where four large health care institutions have gone out of their way to create state-of-the-art, family-friendly birth centers. There are also dedicated professionals here who will help you have your baby in a homelike setting—or even in your own home.

University of California, Davis, Medical Center

As the area’s only teaching hospital—and a nationally recognized one, at that—UC Davis delivers 2,400 babies a year and offers a range of services. “We can handle [both] ends of the spectrum,” says Laurel Finta, M.D., Sacramento’s only dedicated “laborist,” who spends her entire day on the maternity ward, overseeing patients in labor. By that she means both low-risk and high-risk pregnancies can be accommodated here.

UC Davis Children’s Hospital, located at this same site, has a new 51-bed, Level III Neonatal Intensive Care Unit. The Level III designation means it cares for the most complex cases and most seriously ill newborns. The award-winning NICU is staffed with eight full-time neonatologists and six neonatology fellows.

Other specialized infant programs include the fetal cardiology program and the fetal diagnosis center. UC Davis also has the only pediatric cardiothoracic surgery service in the region.

The maternity unit has 15 spacious birthing suites and 24 postpartum beds. It is staffed by nurses (including seven full-time OB/GYN nurse practitioners), 28 OB/GYN physicians, 28 obstetrical specialty residents and, of course, Finta, whose presence provides “continuity” for everyone on the ward. UC Davis also provides a full range of anesthesia services, including epidurals, available 24 hours a day, seven days a week; and two OB operating rooms.

The Caesarean section rate at UC Davis is 30 percent, which is relatively low for a high-risk referral center, says Finta, given that nationwide averages are approximately 25 percent. During the past year, UC Davis had 100 successful vaginal births after Caesarean (or VBAC) deliveries. 

UC Davis has a full-time lactation consultant to help with breast-feeding and a dedicated medical social services department, which can help families obtain other assistance when they go home. “We offer the entire experience here,” says Finta.

Kaiser Permanente

Kaiser’s big news in the baby world is the opening of its $150 million Women’s and Children’s Center in Roseville this coming January. “It’s the first time Kaiser will offer labor and delivery services in Placer County,” says Chris Palkowski, M.D., physician-in-chief for Kaiser’s Roseville Medical Center. It will serve all Sacramento-area Kaiser members, and Palkowski predicts it will handle 5,000 births a year.

The maternity unit will include private suites, each with its own shower, bathroom, rocking chair and foldout bed where the father or other family member can spend the night. Babies can also stay in the suite from birth until the trip home, and visiting hours will be unlimited. “This is obviously one of the most memorable events in any family,” says Palkowski, “and we’ve tried to make the whole experience really wonderful.” He notes the unit is being decorated in a soothing water/seashore theme, and all rooms will have views of a rooftop garden.

VBACs and C-sections will be available at the new site, as they are at Kaiser’s existing maternity facilities. (Kaiser’s current C-section rate is 18 percent for its South Sacramento campus, 29.5 percent for its Sacramento facility, which sees more high-risk cases, 29.5 percent.) Anesthesiology services, including epidurals, are available 24/7, an option that will also be offered at the new Roseville facility.

The Women’s and Children’s Center will include a 48-bed Level III NICU—the largest in Placer County—that will be staffed by neonatologists, respiratory therapists, specially trained nurses and other clinical specialists. The 32-bed pediatric unit has been designed to “make it easy for parents to stay,” according to Palkowski, with foldout sleeper chairs in the private rooms, as well as guest rooms in the hospital.

Mercy Hospitals/Catholic Healthcare West

“Mercy Family Birth Centers are in the communities where women are,” says Gail Maduri, R.N.M.S., vice president for women’s and children’s services for Catholic Healthcare West/Mercy Sacramento. “And so you have Methodist Hospital in the [Elk Grove/South Sacramento] area, Mercy Folsom in [the east], Mercy San Juan in the north area and Mercy General downtown.” The Mercy system also includes Woodland Memorial Hospital in Yolo County and Sierra Nevada Memorial Hospital in Grass Valley (Nevada County).

“Having a baby is not primarily a medical event,” Maduri adds, “but a family event.” With that in mind, the Mercy facilities offer comfortable surroundings, with private suites for mother, father and baby; Jacuzzi tubs; scenic views; TVs and VCRs. Midwives and doulas are welcome, as well as an unlimited number of extended family members, provided the safety of the patient is put first. “We need to make sure we can get everyone into that room that might be needed,” Maduri says.

And if you need medical help, it is always available, whether that is anesthesiology—in the form of epidurals or, at some Mercy Hospitals, intrathecals—or C-sections. All of Mercy’s hospitals are at or near the national C-section average, with the highest rates at Mercy San Juan (28 percent), Mercy General (27.8 percent) and Methodist (27.7 percent), all large facilities that see many high-risk patients, and the lowest rate at Mercy Folsom (25 percent). Mercy does VBACs, so long as medical criteria is met, according to Maduri. All in all, the local Mercy system delivers thousands of babies every year: For example, Mercy San Juan delivered 3,500 last year, and Mercy Folsom 1,100.

State-of-the-art care is also available for your newborn, with an NICU located at both Methodist and Mercy San Juan. “But neonatology—the doctor and the team—can also respond to all four (Sacramento County) hospitals and can care for your baby there,” says Maduri. And the Family Birth Center at Woodland Memorial Hospital has the only Level II intermediate care nursery in Yolo County.

Sutter Health

“Sutter has many different options,” says William M. Gilbert, M.D., regional medical director for women’s services for Sutter Health. “From the high-tech services at Sutter Memorial in Sacramento, where high-risk pregnancies are cared for by pregnancy specialists and OB anesthesiologists 24/7 and we have the largest NICU with a neonatolgist in-house, to the low-tech, midwife-assisted service in Davis, which has the lowest c-section rate in the state.” In fact, Sutter Health encompasses both these hospitals, as well as Sutter Auburn Faith in Auburn and Sutter Roseville, which has a newly expanded family birth center that Gilbert calls “a beautiful facility.” Together, the Sutter Health system delivers 8,000 local babies every year.

And indeed, Sutter offers a lot of diversity for women. Take the Sutter Davis facility, where midwives deliver most of the babies, and women can use birthing balls or birthing tubs. (Sutter Davis is the only local hospital that offers water births.)  “Some women love this idea—others don’t,” says Gilbert, who says the level of choice Sutter provides is a wide one, and so women should investigate all their options. “You want to have as good an experience as you can,” he says. “So be as informed as you can early on. Research where you want to be and make sure your health care provider knows what you want.”

C-section rates for Sutter hospitals in the Sacramento area average 28 percent, with the lowest rate at Sutter Davis (17.3 percent), the at Sutter Memorial (31 percent), its high-risk site. And in addition to the NICU in Sacramento, Sutter is scheduled to open a 16-bed Level III NICU at its Roseville campus later this fall.

The Birth Center

If you have a low-risk pregnancy, your options include giving birth outside a hospital. Located in Fair Oaks, for example, is the only licensed free-standing birth center in the Sacramento area. It is run by Ruth Cummings, a Certified Nurse Midwife, who says: “I like to tell people . . . this care is really a home birth—you just come to my house instead of me coming to yours.” And indeed, the environment at The Birth Center is meant to be homelike, with women free to move about, eat, drink, shower or use the birth tub. They can also have family members—including their children—present at the birth.

Technological interventions, including pain relief, are minimized here. As a result, delivering at The Birth Center is often less expensive than a hospital birth, particularly important if you are under- or uninsured. A typical vaginal delivery with no complications in a hospital costs about $7,000, compared to $1,600 for a birth center delivery. Costs for a Caesarean, of course, are much higher—between $10,000 and $20,000—but national C-section rates at birth centers are under 5 percent, and the most recent C-section rate at The Birth Center is essentially zero. (Bear in mind The Birth Center only accepts low-risk patients and will not treat women who’ve had a previous C-section or have medical complications.)

The Birth Center also runs the area’s only human milk donation center: Any lactating woman who passes the screening process may donate her frozen breast milk for use by premature babies in NICUs.

Home Births

Some women choose the most low-tech option of all: staying home. Other facilities strive to make you feel like you’re home; with this option, you can truly have the comfort and familiarity of your own surroundings. About 2 percent of American births take place at home, with women attended by a midwife. Experts say home birth should not be considered by women with previous C-sections, diabetes, high blood pressure, preterm labor or other medical complications. But if you are not in these categories, it is a viable option, with several midwife practices located here. These include One Heart Midwifery, run by Kaleem Joy, R.N., CPM, and Marlene Smith, LM, CPM; Birthstream Midwifery, run by Tosi Marceline, LM, CPM, and Rachel Fox-Tierney, LM, CPM; and In Home Birth Center, run by Vanita Lott, R.N., B.S., CNM.

Other Resources
There are several ways to investigate local birth options in more detail. One is a new website: BetterBirthSacramento.com. All four Sacramento hospital systems also offer childbirth classes and tours of their birthing facilities for expectant parents, as well as events for planning a baby, such as Mercy’s recent “Baby on the Brain” last May.  Finally, you can talk to your current health care provider about obstetric options and services within your medical group, and change groups if you want access to other facilities.

Taking the First Step

If you have “baby on the brain,” but need some help making it a reality, Sacramento is home to several state-of-the-art infertility centers. These include:

1. UC Davis Fertility Center, 2521 Stockton Blvd., Sacramento; (916) 734-6106
   Three infertility specialists and two embryo specialists provide a broad spectrum of fertility services, including in vitro fertilization.
2. Kaiser Permanente Center for Reproductive Health, Point West Medical Office Building, 1650 Response Road, Suite 1A, Sacramento; (916) 614-5200
   This newly opened Kaiser facility is staffed by two infertility specialists and one IVF specialist. 
    
3. Northern California Fertility Medical Center, 1130 Conroy Lane, Suite 100, Roseville; (866) 714-2492
   This fertility center offers a full range of infertility services, including IVF, donor eggs and surrogates. It is staffed by five board-certified infertility specialists and one board-certified urologist, and many of these physicians are also Sutter Roseville medical staff.