In Good Hands: Labor and Delivery at UCSF Medical Center

Contact: Obstetrics & Perinatal Specialties at Mission Bay – Fourth Street: (415) 353-2566 or visit the clinic's website.

Contact: UCSF Obstetrics & Gynecology at Mission Bay – Owens Street: (415) 353-4600 or visit the clinic's website.

Women who choose UCSF Medical Center for their prenatal visits and delivery will find themselves in a supportive environment, where doctors, midwives and nurses collaborate, respecting each mother's birthing wishes and encouraging a vaginal delivery whenever possible.

UCSF patients also have access to the latest medical procedures, top researchers and the highest level of neonatal intensive care in the rare case that complications arise. Our move to Mission Bay allows us to continue providing first-class care for moms and their newborns, but in a single, state-of-the-art facility.

"At UCSF we're focused on making birth the best it can be, whether you come in completely 100 percent without problems or in a high-risk situation," said Judith Bishop, a certified nurse midwife and professor in the Division of Maternal-Fetal Medicine. "We're a one-stop shop: You get tubs, birth balls, we're welcoming of doulas and other support people and you're never going to get transferred somewhere else for lack of expertise.

"There is the security of knowing you are in a place that has everything you ever need."

Innovative Prenatal Care

Our popular Centering Pregnancy Program lets expecting mothers with similar due dates receive some of their prenatal care together, under the supervision of a doctor or midwife. During these sessions, patients discuss pregnancy, labor, breast-feeding and parenting in a group setting and get physical exams and ultrasounds in private.

Many participants form strong friendships that last well beyond their due date.

Your Own Dream Team

At UCSF expecting mothers can receive prenatal care from a midwife, obstetrician or both, and our providers work together in a collaborative team environment.

"Our midwives are so good at focusing on the whole patient," said Dr. Kirsten Salmeen, a perinatologist specializing in medically complicated pregnancies and deliveries and an assistant professor at UCSF. "And they are so comfortable with complicated obstetric patients that it really normalizes pregnancies that would otherwise be viewed as dangerous, high-risk and complicated."

Our doctors, midwives and nurses are committed to respecting each family's birthing wishes and work with mothers to make joint decisions about the delivery. For laboring women who want pain relief, dedicated anesthesiologists are available 24/7, and we're the only California hospital to offer nitrous oxide — commonly known as laughing gas — for labor pain. We also understand the value doulas and support people provide laboring women and welcome them in our delivery rooms.

"(Our) depth of expertise ... makes us comfortable allowing women to labor their way because we know we can handle anything that comes up," said Dr. Elena Gates, chief of general gynecology in the Department of Obstetrics, Gynecology and Reproductive Sciences. "Labor is not a disease, and while things can happen to complicate the matter, most of the time it is a perfectly natural process."

Cutting C-section Rates

Our view of labor and childbirth as a natural process has helped keep our overall Cesarean rate at 20 percent, among the lowest rates in California. By contrast, the state average was 30 percent in 2012, the last year California Office of Statewide Health Planning and Development data was available. And for first-time moms who carry their baby to term, our C-section rate is just 15.6 percent.

Women come to UCSF from around California because of our commitment to vaginal birth after Cesarean, or VBAC. Between July 2013 and July 2014, our VBAC rate was almost 38 percent for women carrying non-breech (head-first) babies, compared with a state average of 9 percent in 2012.

"Our threshold for making the decision to recommend a C-section is a lot higher than in other places," Salmeen said. "If someone wants to labor a while longer, that's something we're comfortable with and able to offer if mom and baby are doing well."

In addition, our providers are experienced in vaginal delivery of twins and breech "singleton" babies.

"We're really comfortable vaginally delivering second twins even when they're not head-first," Salmeen said.

First-Class Amenities

All labor and delivery rooms at Mission Bay feature family areas with fold-out sleepers, whirlpool tubs and rocking chairs in a lovely, calming setting. Natural light, garden views and noise-softening floors bring a further sense of peace to the environment.

Highest-Level Intensive Care Nursery

UCSF's intensive care nursery is a "Level IV" Regional Intensive Care Nursery, meaning it is state-certified to provide the highest level of care to critically ill newborns and infants. The ICN also is home to a Neuro-Intensive Care Nursery, which treats babies at risk for neurological injuries and was the first such program in the U.S. at its 2008 founding.

Many of the babies in our ICN come to us from throughout Northern California and are premature, some born at just 24 weeks gestation, or require surgery. At Mission Bay these young patients will have individual rooms, allowing a parent to sleep at the hospital alongside them. The extra privacy also means fragile babies will get the chance to spend their days in a quieter, more peaceful environment, away from numerous beeping machines, noisy visitors and bright lights.

"Preemies are delicate — they get really bothered by alarms, crying, visiting families and physicians," said Dr. Sonia Lomeli Bonifacio, director of the Neuro-Intensive Care Nursery and an assistant professor of pediatrics. "The individual rooms will also really help the family feel more comfortable. Parents will spend more time at the baby's bed."

The new hospitals also will be home to San Francisco's only medical helicopter, which will transport critically ill newborns, children and expecting mothers to the Fetal Treatment Center, labor and delivery floor and intensive care nursery.

Ground-Breaking Fetal Surgery

In the rare cases when major defects require surgery in utero, UCSF patients are in the birthplace of fetal surgery. The UCSF Fetal Treatment Center performed the first surgery on a baby in the womb in 1981 and remains at the forefront of the field, thanks to its dedication to research and innovation.

"We've done more fetal surgery clinical trials than any other place in the world," said Jody Farrell, the center's director. "The majority of people who run fetal treatment centers in the U.S. trained here.

"There's a collaborative, multidisciplinary approach to care that is really unparalleled," she added, noting that a team of radiologists, cardiologists, surgeons, obstetricians, neonatologists, social workers and nurses meets weekly to discuss each patient.

Homes Away from Home

At Mission Bay there will be more options for families who live far away to stay near the hospital. The Ronald McDonald House of San Francisco is opening a new location with 11 bedrooms on the first floor of the children's hospital, and Family House will launch a new facility with 80 bedrooms nearby.

In addition, each medical unit has a family lounge with showers and a kitchen, and laundry facilities are available throughout the hospital.