Bay Area Hospital Comparison
Note: Last updated February 2021 (Stats are for the period of July 2019 - June 2020).
I provide this as a free resource to the birthing community. If you’d like additional information or help deciding on the right place given your circumstances and preferences, you can reach out to schedule a consultation with me.
These are most of the Bay Area hospitals where my clients have birthed or planned to birth. The statistics are from calhospitalcompare.org. Many of these numbers speak for themselves, and I share some thoughts below.
NTSV: Nulliparous, Term, Singleton, Vertex, which means: first baby born at term (37-42 weeks), positioned head down at the beginning of labor. So NTSV Cesarean numbers exclude breech and transverse babies, twins, triplets, etc., and labors that begin before term.
VBAC: Vaginal Birth After Cesarean.
SF General has the best outcomes, but unless you’re uninsured or have Medi-Cal or Healthy San Francisco insurance, it’s a bit tricky to get care there (though not impossible :) ). I think there are a few reasons why the outcomes here are so good: a long-standing culture of respecting birth as a healthy physiological process, high quality clinicians, and an overall younger patient population. Younger people tend to have an easier time birthing (on average; I have seen gloriously smooth labors in 40+ year-olds).
CPMC Van Ness has relatively poor outcomes despite being the newest SF hospital. Its episiotomy and VBAC rates are especially egregious, and its cesarean and breastfeeding numbers aren’t great either. If your insurance works there, it would also work at UCSF, which is a better alternative in terms of care and facilities (and great bathtubs!)
CPMC Mission-Bernal has an excellent hospital-based team of midwives; their doctors are a bit hit or miss, though. (*The ratings above include several months during which this team moved to CPMC Van Ness—because of the pandemic—where they still remain, and the numbers may be affected by that and/or may be inaccurate; in any case, their episiotomy rate has increased quite a bit since the previous rating, which is unfortunate.)
Conversely, UCSF has some of the best doctors; the midwives are a bit hit or miss. (UCSF has improved in the most recent ratings: their cesarean rate has decreased.)
Alta Bates is doing quite well. Some of the rooms have bathtubs; ask for one of these rooms when you’re being admitted. It’s part of Sutter Health, so there are occasional misguided quirks: some of their nurses and doctors tell women not to eat if they get Pitocin. Best available current evidence does not support this policy, and lack of food in labor is detrimental to a woman’s energy levels.
Many private hospitals (CPMC, for example) tend to have higher rates of episiotomy. Current research-based medical guidelines recommend against episiotomies except in cases of rare emergency because these surgical cuts tend to lead to worse tearing and worse long-term pelvic health without improving outcomes.
If you’re with Kaiser, and can get to Redwood City, go for it — it has a great birth-friendly culture, one of the lowest cesarean rates in the Bay Area, and is doing pretty well by other metrics, too. For the other two Kaisers on the list: Kaiser Oakland facilities are more pleasant than those of Kaiser SF, but it’s mostly a coin toss between these two and a lot depends on the specific people who will be on your care team that day—luck matters—and there are some good medical professionals in both locations.
Marin General is doing quite well by all measures, and has nice views :)
No matter where you are, remember that if you are unhappy with one of your nurses, doctors, or midwives, it’s your right as a patient to request and receive a different clinician. I don’t know anyone who has changed clinicians in pregnancy or in labor and regretted it, but I know quite a few people who regretted not changing. Some people worry they’ll be labeled as “difficult,” but my experience suggests that when you’re assertive about your clinicians, you end up surrounded by the best people and the best care. This is especially important during such a pivotal time in life!
If you are happy with a specific nurse, doctor, or midwife, let them know that you appreciate them! There’s quite a bit of burnout in the medical field, and acknowledging competence and compassion in medical professionals improves matters for everyone.
Happy Birthing! :)