VBAC friendly OB's that take Kaiser insurance? (Portland area)

i see that a bunch of people have viewed your thread but no replies yet, so i wanted to share. my friend was pregnant with her fourth baby last year and had kaiser insurance. she is also a vbac mama (classical vertical incision, too, from her first child over 11 years ago being a preemie due to her severe pre-eclampsia). since then, she vaginally birthed both her daughter and a son who then died a few weeks after birth, both pre term. she was unhappy with her vbac options with kaiser, especially knowing that they likely wouldn't even "let" her labor because of her classical incision, so she sought out a homebirth midwife who would work with her. her baby girl is 5 months old today, was born at 40+ weeks (this mama's first born at term baby) and was nearly twice as big at birth as any of her previous vaginally birthed children. oh, and did i mention she was born breech?

sorry i don't know of any vbac friendly obs with kaiser. will the midwives with kaiser take you on or are you needing an ob for some reason? my friends have had really good experiences with the midwives at kaiser sunnyside.

~claudia

it's a combination of the hospitals they practice in and the group.

you know if you show up at the hospital, they cannot demand that you have a cesarean. it's your right (see vbac.com) to refuse a cesarean. however, there are a bunch of things they can "call" to scare you into it ("fetal distress", etc.).

Really, if you don't want a cesarean and want a hospital birth with Kaiser, it will take some serious fighting on your part. I'd push the issue, but it seems like there's always some "dangerous risk" that suddenly appears in the last month or in labor that somehow demands a cesaeran.

Most OBs are not doing VBACs any longer. It's not evidence-based, but fear based. They created their own tragedies with this issue, IMHO. Induction of women with uncontrollable meds (prostaglandin gel and cytotec) who were attempting VBACs created a high rate of uterine rupture and subsequent lawsuits. Just like one OB said, "the only cesarean I've ever been sued for doing is the one I didn't do".

It's a nationwide problem, but Kaiser as its own HMO/business has taken a stand in this area. I have so many clients that transfer from Kaiser and pay out of pocket to avoid the (s)care they provide. Here in Salem it's much worse than in Portland, but the cesarean rates are not better.

I have no experience with VBAC but I have lots of experience with Kaiser. At the beginning of my pregnancy DP and I were "okay" with a hospital birth but not excited about it. The only reason I was even considering a hospital birth was that was all Kaiser would pay for. I was excited that they had midwives at the Sunnyside location but then found out there were only three and that it was next to impossible to actually get one at your birth, not to mention that you probably would not have all of your prenatals with the same person who would deliver your baby. Due to lots of circumstances we chose to do a homebirth with a midwife. That was the best thing we could have ever done. It cost more than we had to pay but we borrowed and made it work. If I had it to do all over again I would do the same thing except I would start with a midwife earlier instead of waiting until 28 weeks

Seriously though, Kaiser is going to say anything they can to get you to birth in the hospital and have another c-section. Good luck with your decision; I know there are a ton of great midwives in Portland.

-Susannah