Evidence Based Childbirth Classes in Monterey - Salinas - Santa Cruz
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Birth Options in Monterey County

2/3/2015

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One of the most important decisions you will make regarding you birth is who your provider will be and where you will have your baby. I dedicate an entire two to two and a half hour class to this decision. Many couples believe that which ever hospital is closest to their home should be where they birth. However, all hospitals are not created equal. Like any business, they provide different services, options, and amenities. If you are in Salinas, Monterey, or anywhere in between you are blessed with five hospitals to choose from within 45 minutes of you, which is more than enough time to travel to your birth place, even if you have very fast labors! Choose carefully, where ever you choose to bring your baby into this world will impact your birth immensely.

In class we are able to cover many details like induction rates, which hospitals are doula friendly, and where your decisions like to eat in labor, labor in a variety of positions, or birth in an upright position are most likely to be honored... after all... these are YOUR decisions to make, not your doctor's. If you choose a doctor or hospital that tells you upfront that these are not your decisions, I may not be able help you achieve the birth you want.

To help simplify this choice just a bit, I put together this chart. It compares Natividad Medical Center, Salinas Valley Memorial Hospital, Community Hospital of the Monterey Peninsula, Dominican Hospital, Sutter Maternity and Surgery Center, and home birth. It is available in printable PDF form here. This is something you are welcome to print and share! I hope you find it helpful.

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Learn more about local hospitals and read reviews from local women:
Community Hospital of the Monterey Peninsula
Dominican Hospital
Natividad Medical Center
Salinas Valley Memorial
Sutter Maternity and Surgery Center

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Meet the Hospital: Dominican Hospital

9/20/2013

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Dominican Hospital is located at 1555 Soquel Dr in Santa Cruz, California. Many Monterey County couples may not even consider Dominican an option because it's in Santa Cruz. Birth according to the movies is lightening fast and perilous, but in reality the first time mother will labor 14-18 hours, leaving plenty of time to travel the 30-45 minutes from Monterey/Salinas to Santa Cruz. Some couples travel much farther, even over state lines, for a birth place that will respect their desires.

From Dominican's website:

"We deliver small miracles. At Dominican Hospital, we are committed to offering a full service, state-of-the-art, individualized birth experience.

We believe every birth is special, from our tiniest 26-week preemies to our robust 12-pound full-term babies. That is why our Birth Center is designed with the latest technology and staffed with a highly specialized obstetrical team of physicians, nurses and auxiliary staff, available 24 hours a day. We are prepared for any type of birth and any situation that may arise.

At Dominican, we have high standards for both safety and patient satisfaction. Our birth rooms are well-equipped and cozy to help emphasize bonding while “rooming in” with your newborn. With patient safety as our first concern, our Birth Center includes an operating room in the Labor and Delivery area, and a Level 3 Neonatal Intensive Care Unit (NICU) equipped to care for high-risk babies who need closer observation. The Birth Center, Postpartum, and NICU areas are staffed with highly trained registered nurses. Specialized staff such as anesthesiologists, neonatologists, perinatologists, clinical nurse specialists, lactation consultants and occupational therapists are available to meet with you and your family for any routine or emergency needs that may arise."
Dominican refers to their labor and delivery unit has a "Birth Center." It's important to note that the natural birth experience offered by a freestanding birth center is not the same as the "Birth Center" in a hospital. This is just the name that they have given their labor and delivery. To learn more about freestanding birth centers visit the American Association of Birth Center's website.

Dominican is supportive of women who choose to birth vaginally after having a cesarean (VBAC). Many women travel to Dominican to from Monterey for this reason. Dominican's Jacuzzi tub, birth stools, and access to midwives for low risk deliveries may also play a role in that decision. In 2011 almost 450 women traveled to Santa Cruz to have their babies.

Out of the total of 926 births at Dominican in 2012, 26.7% of the births were by cesarean section, (www.cesareanrates.com). Though this rate is below the state average of 33.2% and lower than all of the Monterey County hospitals, it is above the World Health Organization's recommendation of 10-15%. Dominican is a non-profit hospital, "a California survey found that women were 17% more likely to have a cesarean at a for-profit hospital than a non-profit" (Optimal Care in Childbirth by Henci Goer).

Dominican is certified as Baby-Friendly, meaning they utilize evidence-based practices in the postpartum such as immediate skin to skin, support in breastfeeding, and rooming in.

I had my second child at Dominican Hospital in 2011 with certified nurse-midwife Margann Mentor. The nurses were friendly and encouraging, my nurse knew exactly what to say to me when I felt overwhelmed. I could tell they were experienced in working with women who wanted to birth naturally. You can read my birth story here.

Meet the Hospital: Dominican Hospital - Reviews from Moms in Monterey County / Cori Gentry / Natural Birth

The following is from a Monterey military mom, Esther:

"I can't recommend Dominican Hospital highly enough. They were incredibly hands off through my entire stay, from labor through postpartum. Since I was GBS negative I didn't need an IV for antibiotics and they didn't even ask if I wanted a saline lock. The only needle I ever saw was when they drew blood to bank. I was able to eat while I was in labor and when I did need to be on monitors, they used the telemetry unit so I could still be up and moving around. The telemetry unit is also waterproof so it didn't restrict me from spending time in the jacuzzi tub, which is huge and made contractions so much more bearable I didn't even realize I had hit transition until they did an internal exam.

When it was time to push, they helped me take my gown off so Aaron could be skin to skin immediately. He stayed on my chest until it was time to clean and stitch me up, at which time my husband was surprised to be told "Okay Dad, take your shirt off, it's your turn for skin to skin". They didn't even consider clamping the cord until it stopped pulsing. They helped me get him latched on to nurse right away. EVERYTHING (bath, vitamin k, assessments, etc.) was done in the room with me. Literally the only time he left the room before we were discharged was when we moved over to the mother-baby unit. When they did the heel prick for the Newborn Screening, it was with me holding him, still clothed, breastfeeding him, lights down low, and she was very gentle with him.

They have a variety of bars and equipment for pushing so that you can deliver in the position that works best for you. I had been looking forward to trying giving birth in a position other than lying down but didn't get to because he came when they were doing an internal exam and unconstipating me. I literally only pushed once. I wonder if I would have pushed at all if I'd been standing up... lol. Once we moved rooms after he was born, they left us alone for the most part, except for the necessary vitals, checking if we needed anything, etc. They didn't push us to do this that or the other. The dry-erase boards were very well-organized with sections to write requests, considerations, and preferences. They encouraged us to use the boards for that purpose. It was also nice having it on the board when I could get another dose of pain medication after the baby was born.

We loved having a mini-fridge in the room and especially loved the double bed. My husband did sleep on the pull-out bed-chair in the birth room and the rest of the night after Aaron was born in Mother-Baby and he said it was actually pretty comfortable. The chairs are wider than the ones you see in most hospitals and have an actual mattress that folds out.

The nurses were FANTASTIC. I can't remember which night it was, Aaron was extremely fussy and didn't want to sleep unless he was being held. The nurse knew we were having a rough night and when she was busy, had another nurse come in and check on us. That nurse sent me back to bed and took Aaron and rocked him to sleep, then rearranged the bassinet to incline it a little and rolled blankets on the sides. I could have kissed her. The food was amazing too. I've never had hospital food before that actually made me happy for meal times to come around. One of the juice options is Martinelli's sparkling apple cider, that was my drink of choice. I'm also not a big seafood fan but I did like the salmon. They give you a celebration meal for two one night, that was nice. The food all tasted fresh, like they actually cook FOOD instead of just sticking packaged processed food in the microwave."

The following are reviews from other Monterey County moms:

"I labored in the tub at Dominican and the nurses are AHHHHHHMAAAAZZZZZING!!!! As was that tub! I was in there for quite some time and spent a good chunk of time in the shower as well. I wasn't bothered by any of the nurses and they pretty much left me to labor. Absolutely wonderful! Unfortunately baby had a short stay in the NICU, but fortunately, everyone there was wonderful. I even requested that he receive donor milk instead of formula, as I wasn't getting a drop out of me and the doctor accommodated my wishes! This was my second birth at Dominican and I thoroughly enjoyed that full size bed :0) It was like a vacation. Especially because we were served three celebratory dinners."
"Not all OB's at Dominican are VBAC friendly. My frustration lies in the fact that the on call Dr. (Dr. Nicholson) told Dr Klikoff she used the vacuum because they were worried baby's heart rate would dip too low and not come back up and that I wouldn't be able to push him out fast enough. Yet my records say I was pushing very effectively (literally, exactly what the doctor wrote down) and they didn't use the vacuum until he was nearly crowning. Wwwwhhhyyyy?! He was nearly out and I was doing fine! Reading my records just made me even more frustrated than I already was. Another care provider in my doctor's office wasn't surprised at all by his delivery once she saw who delivered him. She said she's far more conservative than Dr. Klikoff...she stopped short of saying she's not VBAC friendly but did say I probably freaked her out, walking into L&D attempting a natural VBAC and already feeling the urge to push."
"I was REALLY impressed with Dominican's birthing center tour last night... They highly encourage using the showers during labor if you want... The beds are specifically birthing beds that are designed to have all sorts of bars so you can labor (and push) kneeling, standing, squatting, in bed or out of bed, in whatever position is most comfortable for you. They also have the birthing stools... The sleeper chairs for support staff are a lot bigger and more comfortable than most hospitals, they actually had dads at one of their tours try out a bunch of different models and pick their favorite and that's the one they went with. Of course they have the Jacuzzi tub too that they encourage women to use...

The [postpartum] bed is a traditional double bed with (gasp) more than one pillow! The postpartum rooms do not have showers in them. I was a little iffy at first until she explained their reasoning. I guess too many moms try to go to the shower by themselves and get lightheaded and have issues, so they want you to be communicating with the nurse. The nurses will go in the shower and help you if you need it. Support people are "welcome and encouraged" to use the showers too. Of course the rooms do have toilets and sinks in them and a rocking chair...

I talked to her afterwards and explained how fast things moved with [my last baby], and that we're going to be coming from Seaside and that I don't plan on sticking it out at home and risking a car birth, and said 'But what happens if I get here and I'm not 4cm, are they going to send me back home?' She said 'Absolutely not. If that happens, just explain to them where you're coming from and they'll go ahead and have you stay there, they might have you go walk around outside and in Santa Cruz some but explain the situation to them and they absolutely will not send you all the way back to Seaside.' They encourage medication free labor but support whatever decision the mom makes and have a team of anesthesiologists in LDR to administer meds if asked for/needed."
"I had a great experience at Dominican with Dr. Klikoff, but I got lucky with a nurse who is at Sutter 99% of the time, and was only covering a shift at Dominican. Her name is Carol and I'm certain she's an angel."
 "I've had clients deliver there recently and Dominican is fine with eating during labor. They pretty much leave it up to Mom and how she's feeling. You can also bring a few healthy snacks with you--just pull them out when you need/want them." - doula
"I delivered there in 2009 - The staff was wonderful, so grateful to the nurses I had!"

Reviews from Yelp and Google:

"I had both of my youngest children at Dominican - I felt like a queen there. Great, professional staff, beautiful large room, more food than I could possibly eat. I give them 5 stars!"
"The birth center has great security, the nurses were nice, the rooms were bright and clean (p/s the post-delivery rooms where you stay for 2 days had double beds, couches, fridges, etc. - way nicer than the post rooms I've been in at Marin General and California Pacific in SF). The rooms didn't feel like a hospital, more like a 2-3 star hotel. Not bad, come on, it isn't the Hyatt. Before the tour I didn't think I would want to deliver at Dominican, now I am 100% happy with the idea. I especially liked how they played 'rock a by baby' on the loudspeakers when a baby is born (it happened two times while we were there), they have a level 2 and 3 intensive care unit for at-risk newborns (which Sutter does not have), and the security is top notch... not that I am a security freak, but it appears to be pretty much impossible to steal a newborn from that ward, the babies wear a low jack type bracelet and there are locked doors with passwords and cameras, etc. That was nice for the hubby who comes from a much more security phobic."
"Since the birth of my daughter 5 years ago I have visited Dominican many times.  The first was when Dr. Hencke knew what was wrong with me (rare pregnancy complication, which a lot of doctors miss).  The whole staff is caring.  When my daughter begin having seizures at 5 months old we were in and out of ER and pediatrics till she was one.  We had to transfer to Lucile Packard children's hospital twice because, even for having such a great staff, do not specialize in infants and seizures. We had an awful time at LPCH.  If I had to pick a hospital (and really who would want to be in a hospital) I would pick Dominican for the caring, compassionate staff."
"My son was delivered at Dominican. We were in labor room for 4 shifts, and every staff member we interacted with was amazingly helpful and kind. Same experience in the postpartum section of L&D. Would recommend, 5 stars. Even the food was good."

I include every review that is sent to me, if there is helpful information that you would like me to include, please let me know.

Learn more about local hospitals and read reviews from local women:
Community Hospital of the Monterey Peninsula
Dominican Hospital
Natividad Medical Center
Salinas Valley Memorial
Sutter Maternity and Surgery Center

You can view and download a chart comparing hospital options and amenities here.

Did you give birth at Dominican Hospital? Please share your experience in the comments below!

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Meet the Hospital: Community Hospital of the Monterey Peninsula

9/11/2013

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Community Hospital of the Monterey Peninsula (CHOMP) is located at 23625 Holman Highway in Monterey, California. Like our other Monterey County Hospitals, CHOMP is certified as Baby-Friendly, meaning they utilize evidence-based practices in the postpartum such as immediate skin to skin, support in breastfeeding, and rooming in. CHOMP provides a Level 2 Neonatal Intensive Care Unit (NICU), babies that are in need of a Level 3 NICU are transferred to a Bay Area hospital like Stanford or UCSF, sometimes to Dominican in Santa Cruz or Natividad in Salinas.

CHOMP refers to their labor and delivery unit has a "Family Birth Center." It's important to note that the natural birth experience offered by a freestanding birth center is not the same as the "Birth Center" in a hospital. This is just the name that they have given their labor and delivery, it does not mean they necessarily offer a more natural approach to birth. To learn more about freestanding birth centers visit the American Association of Birth Center's 

About CHOMP's amenities from their website:

What to expect during your birth:

"Our 13 rooms are equipped for labor, delivery, recovery, and mother-baby care. As you prepare for the birth of your child, we thought you might like to know some of the things we believe at the Family Birth Center...

  • Birth is one of life's most special events.
  • Birth and parenting occur with greater ease, comfort, and joy when parents know what to expect.
  • Parents can make decisions and accept responsibility for their own healthcare.
  • Family, visitors, nurses, doctors, healthcare providers, and all hospital personnel are regarded with dignity and respect.
  • Your support person should be encouraged to stay with you and your baby throughout your hospital stay.
  • Your nurse will manage your labor according to the instructions from your doctor. Your heart rate, respiration, blood pressure, and temperature will be monitored periodically, and your urine will be checked for protein and glucose. Vaginal exams will be done to check the progress of your labor.
  • A test may be performed to determine if your water has "broken."
  • A fetal monitor will be used to assess your contractions and your baby's well-being.
  • You may eat and drink as instructed by your doctor.
  • You will be encouraged to walk and move while you are in labor.
  • If you choose to have an epidural, an anesthesiologist will be called.
  • An episiotomy occasionally is performed at delivery if needed.
  • A special suction device or forceps may be used to assist in the birth if needed.
  • If it is determined that your baby will require special care at birth or shortly after birth, a pediatrician or neonatologist will be called to attend the delivery of your baby.
  • Identification bands will be placed on the baby and on you and your partner. Your nurse will discuss your baby's security at the hospital.
  • The usual length of stay after a vaginal birth is about 1-2 days, for a cesarean birth 3-4 days.
  • In the Monterey County Weekly article, The Holistic Hole, director of CHOMP’s Family Birth Center, Catherine Powers said, "medication-free births like Ellis’s only represent about 1 percent of the hospital’s deliveries. Doulas, though rare, are allowed to attend to laboring moms... We’re all moms here at the Family Birth Center. We believe birth is a choice,” Powers says. “[But] we are a medical model, so that’s what we provide.”

    You can learn more about the medical model of care (as opposed to the physiological model of care or midwifery model of care) and your options within it here.

    Out of the total of 1045 births at CHOMP in 2012, 32.9% of the births were by cesarean section, (www.cesareanrates.com). Though this rate is below the state average of 33.2%, it is above the World Health Organization‘s recommendation of 10-15%. CHOMP is a non-profit hospital, ”a California survey found that women were 17% more likely to have a cesarean at a for-profit hospital than a non-profit” (Optimal Care in Childbirth by Henci Goer). Though, in 2012 CHOMP did have a higher cesarean rate than the only for-profit hospital in the county, Salinas Valley Memorial.

    CHOMP is one of two hospitals in Monterey County* that do not offer the option of vaginal birth after cesarean (VBAC) to women despite the American Congress of Obstetricians and Gynecologists and The National Institutes of Health‘s 2010 recommendations to do so. Unlike hospitals who support women in having a VBAC, CHOMP is not required to have an anesthesiologist or obstetrician on the floor at all times.

    In 2011 CHOMP had the highest epidural rate (79%), and the highest induction rate (37%) in Monterey County*. (Monterey County Weekly) CHOMP also has the highest episiotomy rate (11%) in the county, which is quite a bit higher than other local hospitals like Natividad (2.8%) and Dominican (2.3%). (CalQualityCare.org)

    CHOMP does not offer the option to birth with a certified nurse-midwife, which is the standard of care in most other developed countries and has shown to improve maternal and infant outcomes according to a recent study including 16,242 women published August 2013 in the Cochrane Database of Systematic Reviews.

    Meet the Hospital: Community Hospital of the Monterey Peninsula - Reviews from Monterey County Moms / Cori Gentry / Natural Birth

    The following is a Salinas mom's experience touring CHOMP:

    I toured CHOMP in spring of 2012. CHOMP seems to only allow pregnant ladies and one other adult on the tour. They also don't schedule a tour until pretty late during pregnancy. I was 6 months (I think) when I finally got to do a tour.

    CHOMP is a nice hospital. They have lovely grounds and gardens, a koi pond, and valet parking.

    The Family Birth Center has a nice waiting area with comfy furniture and awesome murals. It also looks out onto a garden. There's a place to get food and drinks just down the hall. There are no visiting hours, so family and friends are free to come whenever. You can tell the nurses if you don't want visitors.

    The rooms all have adjoining bathrooms with showers. The showers are spacious enough for laboring in. They also have hand-held shower heads and stools. The beds can be raised and lowered and the back can be raised and lowered to allow for all kinds of laboring positions. There's also a sofa that converts to a bed like a futon. It was pretty big, big enough that I thought my 6'3" husband could sleep comfortably on it. Each room has a white board so moms can leave notes about preferences and what not for the nurses. The room we toured look out on to a garden. The rooms also have TV's with DVD players and a little stereo thing for CD's or an MP3 player.

    Moms have a nurse who is their primary nurse. If mom ends up in surgery, this nurse will usually attend the surgery/recovery as well. They seem concerned about making sure moms of continuity of care through the entire labor and delivery process.

    CHOMP is known for their milkshakes. Apparently, all of their food is good. You can order food anytime. I'm sure they charge a premium for it, but its nice to know its an option if you really want that cheeseburger at 2am.

    The nurse on my tour said they encourage laboring moms to move around. They do monitoring 20-30 minutes of every hour, so mom has to be lying in bed for that time.

    CHOMP has a surgery room (or possibly 2?) in the Family Birth Center. There's a recovery room across from surgery where mom goes after surgery for a couple of hours. After that, mom returns to her room. Having all that stuff close together means dad/birth coach can stay with mom and/or baby pretty much the entire time. They really seem to have the c-section routine down. They also encourage moms to be up and moving around soon after surgery. On my tour, all of the other moms (5) were having scheduled c-sections and they all seemed very impressed with CHOMP.

    Overall, CHOMP is a nice hospital. If I were having a scheduled c-section, it would be my first choice. I decided that we wanted a lower intervention birth so we had our daughter at home with a midwife."

    More reviews from Monterey County moms:

    "They took me to my room – which was a teeny tiny room that they haven’t used in a long time but had to shove me in it since they were extremely busy. I stripped my clothes off as fast as I could, got my monitors on and hopped up on the bed.

    They checked me and I was “just a lip” – I think meaning I was about 9 cm and almost fully dilated and ready to push. I had to pant through several contractions… I don’t even know how many but way too many in my book! I was waiting for the doctor to show up so I could push. I kept asking how much longer, and they couldn’t really tell me! I kept saying how it wasn’t fair that I had to wait, and that I wanted a 15 minute break from the contractions to catch my breath. Luckily there was a nice lady there that was actually a nursery nurse, that came in to help me through my contractions. She told me to blow out birthday candles so that they would just flicker and not go out. That helped a bit, because otherwise I really wanted to push. Everything in the room was chaotic. I can’t remember how many people were in this tiny “closet” like room! One particular nurse came in to put my IV in and I yelled at her saying she can’t do it now! I couldn’t imagine I’d be able to stay still for her to poke me. It took her several tries but she did get it in. After what seemed like an ETERNITY, panting through a billion contractions (ok so it was like 20 minutes)… I was finally told that the doctor was close enough to the hospital that I could start pushing."
    "Being a first time mom, and having heard some negative stories about delivering at CHOMP, I had my concerns about being able to have a natural birth, free from interventions there. However because of my insurance, CHOMP was really my only option.

    I ended up having a fairly problem free pregnancy, and as my due date approached I wrote a birth plan, which I reviewed thoroughly with both my doctor and my doula. Labor started naturally with my water breaking in the middle of the night and contractions starting about 30 minutes later... I arrived at the hospital about an hour after labor had started and at first was a little put off by the attitude of the nurse who I was assigned to. However after my husband and doula gave the nurses my birth plan, the nurses attitude changed and I was left to labor as I wished. I labored in a few different positions including kneeling, standing, and laying on my left side towards the end. The baby was monitored occasionally, but really the only intervention I was required to have was a Hep-Lock, in case of emergency. I ended up laboring for about 6 hours total with pushing for about an hour. With the help of my husband, doula, and doctor I naturally delivered a healthy happy 10 1/2 lb. baby boy, without any medical interventions. Following the delivery I was put on a Pitocin drip to help my uterus contract and minimize blood loss because my uterus was so expanded from having carried such a large baby.

    During the remainder of my stay at CHOMP, my son stayed with us the entire time, and I was happy with the help and breastfeeding support that the nurses provided. The only downside to my stay was there were a lot of interruptions and they did the hearing test in the middle of the night. Because of this, and because we had postpartum and breastfeeding support outside of the hospital, we decided to only stay one night. The only other thing that bothered me during our stay, was that because my son was so large they tried to treat him as if he was a diabetic baby (even thought I did not have gestational diabetes). My pediatrician ended up intervening and they did only 3 of the 6 blood glucose tests that they wanted to do."
    The doctor wanted to induce me at almost 37 weeks because the non-stress test was  94% and they wanted to see 100%. The doc told me he didn't want to have to have me come in every other day for a non-stress test and said I needed to be induced. I didn't have any problems throughout the pregnancy...

    I told the doc I didn't want to be induced and that I wanted a natural birth. I felt my birth plan was a waste of time. He assured me this was the best option and I could still have a natural birth... natural meaning vaginally. So, the next morning I was induced. Having my water broke felt like the biggest violation to me with our unborn child. I will never forget that eerie moment. Within less than 1 hour, baby's heartbeat went from the being in the healthy 145 bpm range to 119 bpm and slowly decreasing. Before I knew it, the doc called and said we had to deliver via c-section. He was at home watching the monitor when he made the call. I was never asked to rotate, etc.

    After 9 painful attempts to give me a spinal anesthesia, the anesthesiologist was ready to give up and have me go under for general anesthesia. I wouldn't have that. So I told them I felt my position was wrong sitting up right on the OR table. I told them maybe I should have the back of my knees to the table and then lean over to open up the spinal column. So we tried it again. Each time more painful than the last. It felt like your sorest muscle being pulled apart. At last, 45 min later, the 10th time worked like a charm. I immediately felt a weird, cold sensation run down my legs. I remember shivering, even though I wasn't physically cold.

    Once the baby was out and they allowed me to hold her, I asked for back up hands from daddy because I couldn't stop shaking. There she was. Born 3 weeks 2 days early. An unnecessary preemie, in my book. Went against all my motherly instincts I felt as a mom. Fortunately, she was healthy. I had weird heart palpitations and flutters for 4 months (I attribute that to the chemicals put in my body) never had that happen before.

    In the end, I wasn't even in labor for more than 2 hours. My body could not birth naturally once the intervention took place. I was angry for a long time. Instead of having me rest more, whether at home or in the hospital, and be monitored, to let the baby grow and come out when ready, the interventions started, leading to a c-section. Never thought I'd have one of those. My mom had 10 babies naturally, I felt I could birth naturally too.

    I was banned from CHOMP if I wanted a VBAC for any future pregnancies, so 4 years later we had another baby, this time born at home.
    I've had my 3 kids at CHOMP: 2010, 2012 and 2013. I had gone in the first time expecting to do an all natural birth, no meds. I had an open mind though, knowing and telling myself it would be okay if I did end up getting an epidural. I did and it ended up saving my life and my babies, I truly believe that. I had to be turned on my side and my pelvis/hips slid out of socket because of the weight of the baby and my super lax tendons. If I had not had the epidural, I would have been in immense pain, and not have been able to push.

    Anyhow, after that, my next two, I knew my plan, and the hospital staff was very accommodating to my needs and wants. One birth we had to be moved out of our room because there was so many babies being born that night. They gave us a nice room overlooking the forest and had great nurses.

    My third baby, which was born this past March, was born at 36 weeks. I had gone 3 times before for pre-term labor. I ended up having to stay and extra 4 days, and they accommodated me by giving me a room for free to stay close to my son. Even though he was under lights, the nurses allowed me to go into the nursery to nurse him and see him. Excellent, nurses, every time.
    "My daughter was born at CHOMP. We hoped for a natural birth, but one thing lead to another and I got to experience the "cascade of interventions" first hand. We ended up with pitocin, my water was broken, an epidural, episiotomy, vacuum extraction and then my baby had to stay in the NICU for 5 days because of the infection we got while in labor, which I've learned can happen when nurses do many cervical checks after your water has broken."
    "I had a c-section at CHOMP 5 years ago. I was moved three times starting the day after the surgery. The second room I was in was atrocious. There was a jack hammer breaking apart the neighboring wing. It was so loud I couldn't hear my husband talking nor my baby cry. I asked the nurse if there was anywhere else they could put me and she said 'would you rather be in the hallway?' Anyway, I waited in a wheelchair in the reception/waiting area until a room became available. It took a few hours, but I was grateful, all 13 rooms were full. I went on to have a VBAC at Sutter for my next child."
    I include every review that is sent to me, if there is helpful information that you would like me to include, please let me know.

    Learn more about local hospitals and read reviews from local women:
    Community Hospital of the Monterey Peninsula
    Dominican Hospital
    Natividad Medical Center
    Salinas Valley Memorial
    Sutter Maternity and Surgery Center

    You can view and download a chart comparing hospital options and amenities here.

    If you birthed at CHOMP please share your experience in the comments below!

    *hospitals included were those with 200 beds or more

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    Meet the Hospital: Natividad Medical Center

    8/30/2013

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    Natividad Medical Center is located at 1441 Constitution Blvd, Salinas, California. Natividad is one of the few county run hospitals left in California. It is a non-profit hospital, "a California survey found that women were 17% more likely to have a cesarean at a for-profit hospital than a non-profit" (Optimal Care in Childbirth by Henci Goer). Natividad is also a teaching hospital, which is sometimes a bad thing when you have doctors eager to give residents an opportunity to practice their skills, sometimes when they aren't necessary. However, at Natividad it is a positive.

    Most of the doctors that catch babies at Natividad are up to date on the latest research and seem eager to work with their patients, I personally have felt an attitude of learning is encouraged. I chose Dr. Peter Chandler, Natividad’s Obstetrics and Gynecology Services director, as my doctor when I transferred to Natividad. In our first appointment he was referencing my favorite natural birth documentaries and had listed some topics for me to look up on PubMed, a refreshing change from doctors who seem threatened or bothered by an informed mother.

    Natividad is the only hospital in Monterey County that offers VBACs (vaginal birth after cesarean). In 2011 Natividad had a 60% successful VBAC rate (The Holistic Hole, Monterey County Weekly). Even if you are not having a VBAC, it is good to know if your hospital allows them. If they do it is a sign that they follow the American College of Obstetrics and Gynecology's guidelines and that they provide evidence-based care, care that is supported by research and science, as apposed to fear-based care, opinion-based care, or convenience-based care. Out of the 2812 total births at Natividad in 2011, 28.3% of them were cesarean section (www.cesareanrates.com), lower than the national average of 32.8%, but still higher than the World Health Organization's recommendation of 10-15%.

    In 2011 Natividad had the lowest epidural rate (45%) and lowest induction rate (15%) in Monterey County.

    Like Dominican and Sutter in Santa Cruz, Natividad now offers mothers the option of having a certified nurse-midwife deliver your baby, which no other Monterey County hospital offers. This is standard care for low risk mothers in all other developed countries and has been shown to result in better outcomes in mothers and babies (read more here).

    From Natividad's website:

    "The Maternal Infant Unit is a 26 bed unit promoting family-centered care and provides a full range of care to childbearing women, the normal newborn, and their families. Fathers and significant others are included in our family-centered care... Education and support services, including infant CPR classes, lactation support and information on women’s topics are offered. A Lactation Consultant is available 7 days a week providing individualized instruction."

    We did have our third son, Indiana, at Natividad, you can read his birth story here. We visited the hospital a few times before his birth, to tour and we were admitted a few times for various reasons, you can read about one of those visits here. Here's a picture I snapped of the beautiful light filled room we were given. Not fancy, but I loved all the windows and how big the room was. Not all rooms come equipped with bored husbands, just mine.

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    The following is from a Monterey mom, Wendy, who had her baby at Natividad, these are just some snippets from her incredible home birth turned induction at 43 weeks:

    We arrived, birth plan in hand, and got settled into a room. From the get go, I retained as much control as one can when you are checking yourself into a hospital. Knowing that they couldn't turn me away I felt empowered to assert my right to respectfully refuse anything that I wasn't comfortable with, starting with the hospital bracelet they wanted me to wear but that I promptly took off... Dom set up our room, with a sarong over the bright light, my blanket on the bed, our music on the ipod, snacks for the nurses laid out by the sink, copies of our birth plan distributed widely... We claimed the space as our own. I dressed in the special nightgown that Bestie had given me. I texted my mom and the midwives to come join us.

    I was still only barely 2cm dilated... It had been over 20 hours of really hard labor and 18 hours since my water had broken. I was exhausted and still barely dilated... They asked me what I wanted to do. If I wanted to proceed with a section. The anesthesiologist had reviewed our birth plan and was willing to accommodate all of my requests... My amazing support team believed in birth. Believed in me. Dom listened to them and it was decided to wait another hour before making any decisions. As long as the baby was tolerating the labor we would wait another hour and hope that I made some progress.

    The contractions were gaining strength, [the nurse] decided to check me one more time... Again the nurse recoiled in shock when she reported that I was fully dilated with a baby descending down the birth canal. No one could believe that I'd gone from 2 to 10 in less than an hour, with a baby ready to deliver.
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    More reviews from Monterey County moms:

    “If I had been at any other place they probably would have done a C-section. They were just so patient. They met my every need, emotionally and physically.” (The Holistic Hole)
    "The neonatologist, Dr. Bruni, was awesome. The labor room was huge and spacious, that was cool. We had some scary stuff going on, the nurses were great. The surgeon, Aguillera, was amazing. I went to visit my cousin there last week, her nurse gave me an SNS (supplemental nursing system) when I told her my baby had IUGR (intrauterine growth restriction). The way they handled my baby's transport was super great, my nurse stayed after to see her off. I would recommend them in a hot sec."
    "I loved my [labor & delivery] nurse. The after care? Not so great. They stuck me in a back room and basically ignored me."
    "They explained every step they were going to take... When it came to pushing my doctor was in the room the whole time. She as well was pleasant. We had a good relationship, she was trying to make jokes to ease some of pain. If I told her I felt like I had to push, she wanted me to push, if I felt like I couldn't anymore, she wanted me to take a break... My overall experience delivering at Natividad was positive. Would recommend any one and everyone to deliver here."

    I include every review that is sent to me, if there is helpful information that you would like me to include, please let me know.

    Learn more about local hospitals and read reviews from local women:
    Community Hospital of the Monterey Peninsula
    Dominican Hospital
    Natividad Medical Center
    Salinas Valley Memorial
    Sutter Maternity and Surgery Center

    Did you give birth at Natividad Medical Center? Please share your experience in the comments below!

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    Meet The Hospital: Sutter Maternity & Surgery Center

    8/23/2013

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    Sutter Maternity & Surgery Center is located at 2900 Chanticleer Ave in Santa Cruz, California, right across the street from Dominican Hospital. Some people (myself included) have mistaken Sutter for a freestanding birth center. We do not have any freestanding birth centers on the central coast. A freestanding birth center, like Sutter, employs both midwifes and sometimes obstetricians, but do not offer epidural or narcotic pain relief and do not do cesarean sections like Sutter does. Sutter, however, still may be a good choice for couples planning an unmedicated birth and prefer a less hospital like environment.

    From Sutter's website:

    "We have both doctors and midwives on staff, which means you have a choice in your obstetrical care. We have 12 birthing suites to accommodate you before, during and after your baby is born. Some of our suites include an in-room Jacuzzi. For suites without an in-room Jacuzzi, a private one is available."

    Sutter is supportive of women who choose to birth vaginally after having a cesarean (VBAC). Out of the total of 978 births at Sutter in 2012, 23.5% of the births were by cesarean section, (www.cesareanrates.com). Though this rate is below the state average of 33.2% and lower than all of the Monterey County hospitals, it is above the World Health Organization's recommendation of 10-15%. Sutter is a non-profit hospital, "a California survey found that women were 17% more likely to have a cesarean at a for-profit hospital than a non-profit" (Optimal Care in Childbirth by Henci Goer).

    Sutter is certified as Baby-Friendly, meaning they utilize evidence-based practices in the postpartum such as immediate skin to skin, support in breastfeeding, and rooming in.

    An expecting Monterey mom shared her thoughts and a couple pictures from her tour:

    "The rooms are huge, bright and sunny, with a balcony you can walk out on (Dominican has patios but they don't let you out on them for security reasons)."
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    "And half of their rooms have the jacuzzi tub in them. The other half have only the shower, but there's a separate tub room those rooms can share. My pic doesn't show it, but they even have fake candles to make a soothing environment.
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    "They have a nutrition closet where you can grab drinks and snacks any time, plus you can order food from their cafe 24/7.

    They said most babies never leave your room. And they do chest-to-chest contact immediately and recommend that mom and baby bond for at least the first two hours before even handing baby over to dad because this helps with baby latching on for breastfeeding. They have lactation specialists on staff, and all the nurses have gone lots of hours of training on breastfeeding in order for them to get the "baby friendly" designation from the World Health Organization.

    They don't have any visiting hours, so friends/family can come whenever you want them to, but they discouraged passing around baby too much because it's more important for mom and baby to bond.


    They don't even bathe baby until 6 hours later, although they said they could do it earlier or not at all depending on what you prefer.

    That place is amazing! I liked it way better than Dominican. I didn't even have any of the hospital anxiety that I usually have. I'm 95% sure I want to go there and have Dr. Klikoff as my doctor. I'm still going to tour Natividad tomorrow and maybe look at CHOMP, not because I want to go there, but just for the contrast so I can understand how great Sutter is and reinforce that it's worth the farther drive!"


    And another Monterey County mom shares her birth experience:

    Hands down Sutter Maternity was amazing. We toured CHOMP, Dominican, and Sutter and immediately knew where we were going.

    We had planned on an au-natural birth laboring at home as long as we could with a doula in Monterey before going in. My water broke in the middle of the night on a Thursday without any contractions. Waited a while and called our doctor(Klikoff/Joanne, AH-MAZING!) went in that morning to check to make sure my water had broken. Was given the option to either go in for an induction (it had already been several hours) or to wait it out until that evening when I would have to be induced to lessen our risk of infection. Waited it out in beautiful Santa Cruz all day, went into Sutter around 5pm.

    Immediately the nurses were so wonderful, the food was amazing and we had it set up so my husband would call down and order with me and it would come up when we requested. Started cervadil that evening/night with a plan to start pitocin the next morning. No monitoring that I can remember that night, maybe blood pressure once or twice.

    Started Pitocin the next morning and still had intermittent monitoring but nothing constant for a while, then the waterproof belly/baby monitor. Spent HOURS in our tub. When the monitor would be a little iffy the nurse (Christine) would either have my husband hold the monitor on or she spent at least an hour elbow deep in the bathwater to make sure it was reading.

    Fifteen or sixteen hours later, after starting the Pitocin I was mentally exhausted and I was the one who mentioned getting an epidural, not one person had even brought it up until this point. Joanne(my midwife) came to make sure I really wanted to and encouraged me that either decision would be totally fine. Decided on the epidural and the anesthesiologist came quick. Listen to exactly what I wanted and decided on a very very slow low drip. I was checked and was 5 cm (this is after 16 hours.) Within 45 minutes I was feeling pushy and let our nurse know, it was a temporary nurse as our original was on break. She checked I was completely dilated and she let me know I could push if I wanted a few times to see how effective it was going to be. After watching she said the baby wasn't really descending but would go back and forth or turtle as she would call it, and wanted to call Joanne to see if she wanted to come in and maybe need to rotate the baby a bit.

    She left the room to call and get a squat bar (at my request) and told me I could continue pushing if I wanted. Within 2 contractions I knew the baby was coming now and she came back to the room, the baby was crowing and the midwife was not going to make it. I can just remember her hitting a button on the wall and about 4 nurses coming in because nothing had been prepared yet because I was laboring so slow. There was a little panic because my daughter had shoulder dystocia and was very stuck. Christine immediately knew apply pressure on my abdomen and avoided any injury to my daughter or the need for an episiotomy.

    She was placed tummy to tummy and they left her there as long as they could, but it became evident that she had developed an infection due to my extended time of broken water. They immediately had a pediatrician called in and took her to their rarely ever used nursery where my husband was allowed to accompany. After she stabilized she was brought to stay in our room with her IV antibiotics and all. We ended up staying an additional 5 days, so 7 total and we were allowed to stay in our room the whole time even though I had been discharged after the third day. We were even encouraged to co-sleep and taught how to nurse laying down.

    Rachel, Ann, and Christine were by far the best nurses ever, enough that its been 9 months and I still remember their names. I think at any other hospital in the area I would have ended up with a c-section, certainly at CHOMP, or my baby would have been in the NICU at Dominican. I loved that Sutter put my husband and I in charge of taking care of our little one and treating us as knowledgeable adults.

    You can read more reviews of Sutter on yelp, here are a few excerpts:

    "If you want to have a low-intervention or non-medicated childbirth, this is the place.  It's the best of both worlds.  Although I had a natural childbirth, I was glad the technology was there when we needed it, because my son had some heart rate issues during delivery."
    "I do not care where you live....if you are pregnant...and you want an amazing birth experience.... GO TO SUTTER MATERNITY!"
    "Giving birth here was like being a VIP, staying in a 5-star resort hotel. The nurses were so amazing and the chef downstairs whipped up gourmet meals daily."
    "Staff was AMAZING.  With my first child, I had a nurse by my side for 24 hours, literally.  One nurse spent the night by my bedside (Due to some complications, but where else can you say you get your own private nurse?)"

    Learn more about local hospitals and read reviews from local women:
    Community Hospital of the Monterey Peninsula
    Dominican Hospital
    Natividad Medical Center
    Salinas Valley Memorial
    Sutter Maternity and Surgery Center

    You can view and download a chart comparing hospital options and amenities here.

    Did you give birth at Sutter Maternity & Surgery Center? Please share your experience in the comments below!

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      PictureI'm a childbirth educator, birth doula, and birth activist with 4 little boys and occasionally enough time to write.



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