Breech Birth: No Cesarean Needed

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Breech birth is one of the most misunderstood and controversial subjects when it comes to women’s pregnancy and delivery. A breech birth occurs when the baby has its head positioned up instead of down in the uterus. Therefore, coming into the world butt or feet first. Most women will never have the option to decide what they want to do when faced with a breech baby. A planned cesarean section is performed for 94% of all breech babies.

If your provider is an OB, DO, or hospital CNM, you most likely will not be given a choice. Breech births can be successfully carried out without a cesarean. In this blog, we will be discussing the different methods used to deliver these babies without a forced cesarian section. 

How Breech Birth Can Be Fixed Internally 

You may be given the option to try to turn your baby in a procedure called ‘external cephalic version’, or ECV. (This is a procedure where the provider attempts to shift the baby from head up to head down using a deep massage technique.) It can be quite painful, or not, depending on the provider’s technique and how difficult it is.

This procedure is about 74% successful and most people who have a successful ECV will go on to have a vaginal birth. For those whose baby doesn’t turn, the majority (88%) will have a cesarean birth – either by choice or because they are forced as they cannot find a provider willing or able to help them birth their breech baby vaginally.

Most hospital providers have not been trained in physiologic breech birth. Rather, they may have been trained in a procedure called “vaginal breech extraction”. This is where the pregnant person is on their back and the baby is pulled out using various maneuvers and ending with a forceps delivery of the head. This is dangerous and often results in damage to the baby, mother, or both. No wonder most providers are unwilling to provide vaginal birth as an option for clients with a breech baby.

How Breech Birth Can Be Done by Changing Position 

In contrast, there is a technique that uses the gravity of the baby moving naturally through the mother’s pelvis. Called “physiologic upright breech birth”. As the name implies, the client is either standing, kneeling, squatting, or on hands and knees. The baby births itself most of the time. A skilled provider will know if the baby needs any help and when to apply which maneuver.

There have been multiple studies that have found no differences in the long-term outcomes between planned CS or planned VBB. Some studies have found a slightly higher risk for the baby between pVBB and pCS. Although, some studies found no difference. The unknown factor is the skill level of the provider

Why Breech Birth is Usually Solved by a Cesarean 

There is almost no option for having a pVBB in the hospital, in the United States. Many people seek alternative options for the birth of their breech baby. Even though this is not their first choice. Home breech birth has been shown to have poorer short-term neonatal outcomes compared to hospital breech birth. But, we don’t know what really causes these poorer outcomes. Anything from an inexperienced provider, possible congenital anomalies, delays, or miscommunication during transfers are all potentially at fault. It’s very possible that home pVBB outcomes could be significantly improved by improving provider training for breech birth.

By eliminating the option for a hospital birth for pVBB, lawmakers, hospital administrators, and Obstetricians are effectively forcing people to have cesareans. This goes against state and federal rulings that protect a person’s right to refuse surgery, as well as moral and ethical mandates to respect bodily autonomy.

Breech Without Borders 

At Midwife360, Fadwah has been trained in the art of VBB and has attended a handful of pVBB in and out of the hospital setting, as well as several breech births in the hospital during twin births where the second baby is coming breech. She has attended and is working with Breech Without Borders Breech Pro Workshop to add to her skill level and to bring this valuable training to other providers in our community. All birth providers – CPM, CNM, OB, DO – are welcome to attend.

As a birth worker, there is always a risk of a person showing up in advanced labor with a breech baby. Rather than trying to rush into the OR for a cesarean that carries its own set of risks (not only for this birth but for the next birth and baby) why not learn the art of physiologic vaginal breech birth to assist the process safely? Go to midwife360.com to learn more about the upcoming Breech Without Borders workshop.

National Midwifery Week 2021: Meet the Midwives

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National Midwifery Week 2021 is here! In the United States, midwives have been serving communities for more than a century. National Midwifery Week was created by ACNM to celebrate the work and dedication of midwives and midwife-led care. From community education to prenatal visits to deliveries, ACNM’s national week of celebration is a time to show your support for all that you do.

This year’s theme, “Midwives for Every Community,” acknowledges the unique skills and abilities of all midwives across the country. The ACNM aims to celebrate midwives in all areas of the country that work in diverse environments to care for women and families. The week will focus on how midwives help address health disparities in underserved communities, provide culturally competent care, and improve health outcomes overall.

Meet the Midwives at Midwife360

P. Fadwah Halaby

Founder of Midwife360 in West Palm Beach, P. Fadwah Halaby was born on March 17 in Washington DC. Fadwah is an Advanced Practice Registered Nurse, as well as a Certified Nurse Midwife. She holds a Bachelor of Science degree with a concentration in nutrition from The Evergreen State College in Olympia, WA. Fadwah studied both childbirth education and home-birth training in Colorado. She is a Certified Nurse Midwife by the Frontier School of Midwifery and Family Nursing.

When taking a deeper look into Fadwah and the reason behind her passion for midwifery, these were her answers to some of our questions.

Why Did You Choose Your Career?

“I was moved by Spiritual Midwifery– an iconic book written by Ina May Gaskin- the mother of modern midwifery. I read this book while in college at the age of 19, and knew I had found my calling.”

How Long Have You Been Working in Midwifery?

“I gave birth to my first child in 1985 as a ‘free birth’- confident in my ability to birth through my self-study in midwifery over the previous 5 years. I went on to assist another woman in free birth with a breech baby in 1986. In the early 90s, I trained as a lay midwife, completed my nurse-midwife training in 2005, and started my first job as a CNM in 2006.”

What is Your Favorite Part of Your Job?

“Knowing that I had a part in empowering a woman and family through the birthing process. Also, being able to assist women that no one else will help, for example, high order VBACs, twins, and breeches.

What Do You Think is Most Important About What You Do?

“Educating families about the normalcy of birth, as well as protecting the spiritual experience for mama and baby.”

What are 3 Facts About You That Patients Should Know?

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  • I live a plant-based lifestyle
  • I practice Native American spirituality
  • I am Palestinian

What Motto Do You Live By?

“Live and let live.”

What is Your Favorite Book and Why?

The Presence Process, this book has changed my life for the better. It has made me a better and happier person by enabling me to exist in the present moment.”

What is Your Favorite Quote and Why?

” A quote by Octavia Butler says, ‘All that you touch you change. All that you change, changes you. The only lasting truth is change. God is change.’ This quote for me means nothing is permanent, time marches on, and flowing with it is the only way to stay sane!”

What are Some of Your Goals for 2022?

“Continue to organize Midwife360 so that all of our employees feel supported. Create a space where everyone who enters feels like they have come home. Achieve a sustainable work/life balance, including time with my kids and grandkids.”

Joanna Bronkema

Another midwife at Midwife360 is Joanna Bronkema who was born on November 21 in Grand Rapids, MI. Joanna is a Certified Nurse Midwife and Nurse Practitioner, however, she first began her career as an environmental biologist. She went back to school and attended the University of California San Francisco where she received her RN, CNM, and NP degrees.

Below are the answers to our questions to get a better understanding of why Joanna chose the midwifery path.

Why Did You Choose Your Career?

“I love science and I love supporting women’s rights. Bringing a midwife approach, who uses science and compassion to empower women around their health.”

How Long Have You Been Working in Midwifery?

“I started teaching reproductive health in developing countries in 2010. I then became a doula, a nurse, and finished by receiving my NP and midwife license in 2016.”

What is Your Favorite Part of Your Job?

“Watching families find out that they can take back their own power surrounding their health and birth.”

What Do You Think is Most Important About What You Do?

“Health and patient autonomy are the most important objectives of my work.”

What are Facts About You That Patients Should Know?

“I see myself as a lifeguard at birth, letting the family take the lead while quietly monitoring for safety.”

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What Motto Do You Live By?

I am love, I am energy, I am peace.”

What is Your Favorite Book and Why?

Real Food for Pregnancy by Lily Nichols. Nourishing the self nourishes the baby and sets into motion lifelong healthy habits.”

What is Your Favorite Quote and Why?

“The quote by Gandhi that says, ‘Be the change you want to see in the world.’ This is because we all need some inspiration, and living with integrity gives my life purpose.”

What are Some of Your Goals for 2022?

“I joined Midwife360 in 2021 and we moved to a bigger, and nicer office a few months later. So, in 2022 I’d like to continue to see us grow and develop as a cohesive team.”

Lauren Marie Danella

Our final midwife at Midwife360 is Lauren Marie Danella who was born on June 5 in Philadelphia, Pennsylvania. Lauren is a Certified Nurse Midwife as well as Women’s Health Nurse Practitioner with a dual master’s degree from the University of Pennsylvania. Lauren worked as a  Neonatal Intensive Care Nurse, and as a Pediatric Nurse for orphaned children with complicated medical conditions. She also studies the art of natural childbirth with the midwives of Bali, Indonesia.

Below are the answers to the questions we asked Lauren to learn why she chose midwifery.

Why Did You Choose Your Career?

After working in an orphanage for 8 years in Mexico, I was looking for the next step in life. I know I’m happiest when helping others and wanted to find a career I could be passionate about by knowing I was helping others in a loving way. In the orphanage, I saw children healing from their trauma just by connecting with a staff member and feeling loved. 

Midwifery seemed to be a way to help mothers bond with their babies from the very beginning, so they are loved from the very beginning and grow up with the strength they need to face the world.”

How Long Have You Been Working in Midwifery?

I started working in the birth world as a doula in 2009. Then as a nurse in the NICU and pediatrics. I graduated from my midwifery program in 2016.”  

What is Your Favorite Part of Your Job?

“Seeing our peaceful, smiling babies who were born gently at home. When parents who have had previous children in the hospital sometimes ask, “Is she okay? she never cries.”

What Do You Think is Most Important About What You Do?

Creating an environment where our mothers feel safe and supported. When there is no fear and doubt, this makes for a faster, more comfortable labor, and babies take their first

breath coming into the world where they feel the love surrounding them from the beginning. This is when babies are born gently.” 

What are important Facts About You That Patients Should Know?

  • Multiple trainings with Debra Pascali-Bonari, creator of Orgasmic Birth
  • Lived in Bali, Indonesia for over a year, working at Bumi Sehat Birthing Center and trained by Ibu Robin Lim and Lianne Shwartz
  • Graduated from The University of Pennsylvania, one of the top midwifery schools in the country. It is also recognized as the top nursing school in the world.
  • Before midwifery, I helped to open an orphanage and elementary school in Mexico, where I taught yoga, meditation, and nutrition.  

What Motto Do You Live By?

“Keep Life Simple.”

What is Your Favorite Quote and Why?

“My favorite quote is by Liza Rossi and she says, ‘Love is the Answer to Everything,’ which I find to be so true.

What are Some of Your Goals for 2022?

“To continue learning and learning new practices and techniques to have the ability to give each mother and baby the care and love they deserve.”

Visit Midwife360 and Meet the Midwives

Midwife360 began in 2014 and is now a staple to women’s care in South Florida. At Midwife360, they offer holistic gynecology as well as midwifery services such as routine women’s care, family planning, and pregnancy care and birthing.

Along with their three midwives, their team also includes Sandra Alandete (Admin), Vanessa Scoz (MA/Admin), and Dawn Downs (Office Manager). This team of beautiful and intelligent women all share the same passion for combing traditional care methods with modern medicine. Furthermore, they bring together a practice based on a deep connection between provider and patient, individual needs, and true healing.

5 Natural Remedies for Morning Sickness

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Nausea and morning sickness during pregnancy are some of the most common symptoms that women experience. You’re not alone if morning sickness has you feeling a little under the weather. In fact, about 70% of pregnant women get morning sickness.

This article discusses five natural remedies for morning sickness during pregnancy that have been shown to be safe and effective.

Ginger

Firstly, ginger has been used in a medicinal capacity for many many years. It is used to ease morning sickness, motion sickness, as well as cancer-related nausea. Research suggests that ginger may help settle an upset stomach in pregnant women experiencing morning sickness.

Ginger comes in many forms such as:

  • Ginger tea
  • Ginger chews
  • Ginger lollipops
  • Ginger ale
  • Natural form
  • Supplements

Moms to be can take ginger supplements three to four times daily after consulting with their health care provider.

Eat Smaller and More Frequent Meals

Eating smaller, more frequent meals can help reduce morning sickness. It’s important to make sure that you’re not eating too little during the day and making up for it by overeating in one sitting later on. This will only further upset your stomach allowing your blood sugar to drop.

Eat slowly and mindfully, adding nutrients into the body. Although you may feel the temptation to skip meals because of the nausea, remember you are eating for two. Try eating foods without additives and that are easy on the stomach

Some ideas are:

  • Fruit
  • cooked sweet potatoes
  • smoothies
  • rice
  • non-processed carbohydrates

Peppermint Aromatherapy

Another natural remedy for morning sickness is peppermint aromatherapy. Studies show that it can help reduce not only nausea during pregnancy but in women who have just given birth via C-section as well. Moreover, peppermint oil is thought to help ease morning sickness by stimulating the digestive system and calming the nervous system.

Try dotting your peppermint essential oil onto these parts of the body:

  • Wrist
  • Temples
  • Under the nose
  • Neck
  • Back
  • Upper chest area

Vitamin B6 & Magnesium

Additionally, some healthy vitamins and supplements that are known to help with morning sickness and nausea are vitamin B6 and magnesium. Vitamin B, as well as magnesium, can be found in many prenatal vitamins or supplements.

Eating more protein-rich foods like:

  • Meats
  • Fish
  • Poultry
  • Avocado
  • Bananas
  • Pistachios
  • Sunflower seeds

Magnesium can be taken in supplements, topically with magnesium spray, as well as mixed in a bath with Epsom salts.

Avoid Strong Smells

Lastly, and maybe a bit obvious, is avoiding strong smells that may trigger nausea. Many pregnant women experience heightened senses like smell, which you can blame on your pregnancy hormones. Due to our estrogen levels being so high, any small scent that passes our nostrils can seem like an all-out assault on our noses.

Try avoiding these items:

  • Cigarette smoke
  • Perfumes
  • Chemicals in cleaners 
  • Strongly scented foods
  • Candles

If You are Experiencing Morning Sickness

If morning sickness and nausea are a problem for you during pregnancy, there are many natural and at-home remedies that can help. Many women experience it and in most cases, it goes away by week 14.  However, if the nausea is severe, you may want to consult with your health care provider.

If you are looking for or have any questions about pregnancy, birth, and family planning contact Midwife 360. We not only provide holistic gynecology but pregnancy services, which include home birth and water birth to women throughout South Florida. We are here to assist you as well as educate you every step of the way.

Postpartum Hair Loss

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Hair loss is a natural process that many people experience. However, hair loss or thinning during postpartum can be especially challenging, since it’s often accompanied by breakage, and scalp irritation. The good news is that hair grows back.

The hair loss that many new moms experience a few months after having a baby is called postpartum hair shedding. This hair loss happens because the levels of estrogen and progesterone in your body are decreasing or going back to normal after spiking during pregnancy. This often causes your hair to grow slower and less full. It’s not true hair loss during postpartum because it will grow back. Dermatologists refer to hair loss as excessive hair shedding.

What Causes Postpartum Hair Loss

The hair loss most often associated with pregnancy is due to the hormonal changes during and after pregnancy. During pregnancy women notice their hair growing thicker and looking more full. The hormones during pregnancy keep your hair from falling out. However, following pregnancy, these hormones drop and the hair begins falling out and thinning.

The condition, which is also referred to as postpartum alopecia, is relatively common, affecting between 40-50% of women in the months following childbirth.

How Hormones Affect Hair Loss/ Growth

Estrogen is the leading hormone that affects hair growth during pregnancy, postpartum, as well as in menopausal women. Many women during their pregnancy experience fuller and thicker hair growth. This is due to the increase of the estrogen hormone in the body. Thus, producing more hair follicles during the growing phase of the growth cycle.

However, following the birth of your new baby, your estrogen levels drop and return back to the level pre-pregnancy. This causes the new follicles to enter the resting phase of the growth cycle. During this phase, the hair grows slower and produces fewer strands, and begins to shed. Postpartum Thyroiditis can also result in an imbalance of thyroid hormones, which can also affect hair growth.

How Long Does Postpartum Hair Loss Last?

In most cases hair loss after postpartum is temporary. Hair will start to grow back within a few months. Excessive hair loss usually starts eight weeks after giving birth and will last for six to 12 months. If your hair does not begin growing back by your baby’s first birthday, you may consult with your dermatologist or healthcare provider. Month 15 is the lucky number where most women feel their hair is back to normal.

How To Help with Hair Loss/ Growth

There are natural and home remedies that a new mom can implement into her daily routine to help with postpartum hair loss. Some of these can include all-natural shampoos that are specifically for hair loss and helping with new growth. Fenugreek seeds are also helpful when soaked and used as a scalp/hair mask. This herb is also helpful for the production of breast milk.

Adding “hair-healthy” foods into your diet can also promote healthier and quicker hair growth. Including things like:

  • Leafy greens
  • Eggs
  • Healthy fats (avocado, nuts)
  • Vitamin B12
  • Berries
  • Sweet Potatoes

Before the consumption or use of any of these listed always check with your healthcare provider to ensure the safety of you and your baby.

If You Have Any Other Questions

For all pregnancy and women’s care needs contact the professionals at Midwife360. We provide holistic gynecology and pregnancy services, including home birth and water birth to women throughout South Florida. We support and educate women every step of the way through family planning, healthcare options, and birthing. Contact us today to schedule an appointment or speak with one of our midwives.

Medicinal Herbs for a Safe Holistic Pregnancy

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The midwives at MidWife360 in West Palm Beach, Florida have gathered our collective knowledge and experience in order to provide you with an introduction to using herbs during pregnancy.

Initial Thoughts on Modern Medicine

As a certified nurse midwife, I’m forever grateful for the medical advancements in obstetric gynecology. Thanks to these technologies, the outcomes of high-risk pregnancies and complications in birth and pregnancy have vastly improved. This has saved countless lives. 

There are two sides to every coin, and unfortunately some of these advancements have been, and are continuing to be overused. For example, about 1 in 3 women in the United States gives birth via cesarean delivery. Many experts agree that this is far too high.

Furthermore, the use of pharmaceutical medications for pregnant women is also excessive, and carries risks like cesarean deliver. Many medications that were thought to be safe, like Tylenol and common yeast infection medications, have been found to carry significant risks. 

Are Herbs Safe?

In comparison, the usage of herbs during pregnancy appears mild and safe. Just like anything, it’s important to be extra informed and safe when using any herbs or medications during pregnancy. The desire toward more natural and holistic solutions has been growing. At MidWife360 we aim to incorporate more gentle and herbal solutions whenever necessary. 

Using herbs for common pregnancy symptoms and discomforts is very commonplace. Using herbs for medicinal purposes dates back to the ancient Egyptians.  In all fairness, scientific research and formal evaluations of many herbs are not available or priority. 

However, pharmaceutical medications are often in the same boat. In the U.S. almost 90% of all pregnant women will be prescribed some kind of medication during their pregnancy. 

As far as herbal and botanical medicine, most of what we know is based on historical, empirical, and observational evidence. There have been some formal and animal studies. Generally, most herbs have no evidence of harm and natural remedies may be safer than typical prescription medications. 

Adverse effects are few and far between, and when they do happen it is often because the individual is uninformed. Some herbs can be toxic or are only appropriate in small doses. Keep in mind, many experts have different opinions on the use of herbs. Just because something does not have proven adverse effects, does not mean it is proven to be safe. 

Some symptoms or illnesses should always call for prompt medical care, and should not be treated at home with herbs. They are as follows:

  • Continuous bleeding
  • Initial herpes blisters or outbreak 
  • Serious pelvic or abdominal pain
  • Continuous serious mid-back pain
  • Hand and face edema
  • Membranes rupture before 37 weeks
  • Regular contractions before 37 weeks
  • Serious headaches, blurred vision, and epigastric pain
  • Fetal movement stopping

Commonly Used Herbs in Pregnancy

There are different lists and opinions among medical professionals. Some of the most common herbs used for pregnancy concerns are: raspberry leaf, evening primrose, garlic, aloe, chamomile, peppermint, ginger, echinacea, St. John’s wort, fennel, wild yam, meadowsweet, pumpkin seeds and ginseng. 

Common ailments pregnant women seek complimentary or natural remedies for are anxiety, nausea or vomiting, urinary tract problems, or lower GI problems. 

This chart is a helpful tool but always work with your doctor or midwife to be safe. The midwives at MidWife360 are well-versed in the safety and use of herbal remedies. 

Herbs for Birth Preparation

Red raspberry leaf tea and red dates are common for birth preparation. Two cups of red raspberry tea daily is safe in pregnancy. 

Additionally, studies have shown the tea causes labor to be more comfortable and reduces need for medical interventions. There are even benefits for babies! Newborns are less likely to require resuscitation. 

Red dates consumed regularly in the last trimester are safe, and also cause labor to be more comfortable. 

The good news is, both the tea and dates are delicious. Making it easy to incorporate into your daily diet and routine. This vegan red raspberry tea latte is a great way to enjoy the tea. Snacking on dates by themselves or adding a few in a smoothie is an easy way to eat them. 

Final Thoughts

Herbal remedies can offer significant relief and benefits for some common discomforts and symptoms of pregnancy and childbirth. Just like anything during pregnancy, use herbs with caution and under the supervision of your midwife or doctor. 

At MidWife360 in West Palm Beach, Florida we offer herbal recommendations for our patients when needed. Though nothing can replace a healthy diet, exercise, positive mindset, and support system. 

Pieces of a Woman – Commentary by Fadwah Halaby

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On Friday this week, I had the privilege to watch this trending Netflix movie with Jen Kamel of VBACFacts and a few other birth workers. I enjoyed the movie as it invoked many emotions while watching this family unravel around the loss of their baby at a home birth. Pieces of a Woman.

I don’t typically pay attention to trending movies on Netflix, but my daughter – who is soon to graduate Medical School and enter her OB residency – alerted me to the movie with concern that it could harm my practice since it was a ‘home birth gone bad’.

At first I was worried as I thought the same thing, but after watching it, I don’t feel the same way. Yes, it depicts a scenario of a baby in trouble and ultimately dying that was born at home. It also is not very true to reality in regards to the amount of monitoring that we do at a home birth, so that part could be harmful as folks don’t know what we do and might assume that the amount of monitoring is just like the movie. But I also know that no amount of monitoring would have changed the outcome. And the outcome would have been the same if the baby had been born in the hospital. Bad outcomes happen in the hospital, but folks don’t typically say “if the parents hadn’t chosen to go to the hospital this never would have happened”. Yet they say that if there is a bad outcome at home without knowing the details of the case. The parents are blamed for their unconventional choice.

But this movie wasn’t a statement about home birth as unsafe. This movie was a poignant and powerful statement about the isolation and grief that parents suffer when faced with the loss of a baby. We watch the relationship between the couple completely break down as neither one is able to deal with their grief and it drives a wedge between them. We watch the mothers family grapple with their grief and their attempts to “do something” to obtain justice as some sort of compensation for their loss. We see relationships break down and we see relationships heal.

I recommend watching and hope that it highlights the need for more resources for postpartum people and families who are dealing with grief from birth trauma – which can happen even when there is no loss of life.

Midwife360 Partners with Care Credit

Care Credit for Maternity Services Palm Beach

Introducing Care Credit at Midwife360!

Having a natural birth at home is becoming more and more appealing as the COVID numbers grow and healthy pregnant people begin to question the automatic choice to give birth in the hospital.

However, home birth is not always covered 100% by insurance (think deductible and co-insurance) and even with Medicaid, there are some out of pocket expenses that Medicaid does not cover. With Midwife360, the lowest out of pocket amount is currently $1200 and many folks with private insurance may have to pay around $5000 when the numbers are crunched for their particular benefit plan. Our self pay rate is $6700. While even that is a small price to pay for one of the most beautiful and memorable days of your life, not everyone has that kind of cash available or even that much credit.

Enter Care Credit. Care Credit is easy to apply for and most people are approved and the staff at Midwife360 will help. It allows for a 4th option (other than cash, debit, or traditional credit card) to pay for your care without breaking the bank. Depending on the program chosen, there is an option for 6 or 12 months credit with no interest, or a low interest 24 month credit card.

Midwife360 pays a small percentage and we get paid for our services while the client gets to pay over more time for no extra cost (when choosing the no interest option).

We are happy to be able to help our clients be able to pay for their care without causing undue financial stress. Contact us today to find out more!

Natural Sacred ChildBirth

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Sacred Natural Childbirth

Natural childbirth for healthy, low-risk women is the only natural function of the human body that typically occurs in the hospital. “Why is that?”, you may ask. Because our culture has co-opted natural birth, babies, and women’s bodies for the benefit of capitalism – Big Pharma, Insurance companies, and Hospitals – the Trifecta of the medical-industrial complex. That is the only reasonable explanation as Women’s bodies have been successfully birthing live babies for literally millennia – else how would we be here? Birth has only been happening inside hospitals for about one hundred years and studies have shown that it’s safer to natural birth outside the hospital to avoid the unnecessary interventions that lead to worse outcomes. 1,2

Doctors are taught to fear birth

Medical schools have also contributed to the situation by instilling a climate of fear surrounding Birth mostly related to potential litigation. They believe that if the doctor is taught how to control birth, then they have control over being sued. In addition, natural birth is not taught to OBs because their focus is surgery. They are surgeons; the interventions they advocate frequently lead to surgery, and this is where they shine. Obstetricians are surgeons and if you are seeking the care of a surgeon, you are likely to have surgery. Very simple.

Birth cannot be controlled

Interventions in childbirth give the illusion of control over a natural bodily function that cannot be controlled. Women’s bodies will open and release the baby inside when the body and the baby are ready. This is normal, natural childbirth in a nutshell. Even the women doing the opening and releasing have no control over the process. The only control that is possible and productive is the act of surrender to this most basic bodily function. When a woman is able to fully surrender to every aspect – when and how – then when her body and the baby are ready, it will happen. The more surrendered a woman is to the process, the more efficient it is.

Thirty-eight percent cesareans in Palm Beach County

Our community (and there are many like ours) has not embraced this principle. It is very typical for women to be induced at 38 or 39 weeks of pregnancy for a myriad of reasons. We know that when labor is induced before the body and baby are ready, then things can go wrong. The body may not fully dilate no matter how much cervical ripening is chemically encouraged or how much Pitocin is given. Often the baby will not be able to tolerate the cocktail of chemicals involved between the induction drugs and the inevitable epidural. A woman may enter the hospital wanting a natural birth, but very few are able to tolerate the torture of hours of fasting, limited mobility and abnormally strong and consistent contractions, not to mention the flow of strangers into the room, the bright lights, uncomfortable bed, etc. An epidural is the only relief she can get in the hopes of maintaining her dream of vaginal birth. Palm Beach County has an average Cesarean rate of about 38%. That’s more than 1:3 women walking into the hospital expecting a vaginal birth and ending up having surgery to have their baby!This is NOT because Birth is dangerous. This is because our community has a culture of meddling with an otherwise normal, natural process. And that meddling leads to dangerous birth.

ACOG supports VBAC

The national organizations that oversee and regulate birth providers have reasonable recommendations regarding things such as vaginal birth after cesarean and breech birth. But the local OBs tend to disregard these reasonable and evidence-based recommendations. One example of how our local OB community rejects recommendations by ACOG (American College of Obstetricians and Gynecologists, the national organization for obstetricians and gynecologists), is with VBAC (Vaginal Birth After Cesarean) candidates. ACOG recommends that doctors offer vaginal birth to women who have had 1 or 2 previous cesareans. They also don’t recommend inducing labors for VBAC candidates. Yet many OBs in our community still recommend repeat surgery for these women or insist that they birth by 39 weeks. They routinely induce VBAC candidates at 39 or 40 weeks which can lead to the very complication that they fear – a ruptured uterus. Also, there is no solid evidence that a woman with more than 2 cesareans is not a good candidate for a VBAC, but there are very few OBs that are willing to “allow” these women to attempt a vaginal birth.

ACOG supports out of hospital birth

Another example of how our community defies the national recommendations is through a document is known as The Levels of Care document that was endorsed by both ACOG and SMFM (Society of Maternal and Fetal Medicine, the obstetric specialists). In this document, it is recommended that all healthy, low-risk women birth outside the hospital in Birth Centers. If the situation changes, the woman is transferred to a higher level of care – one where the ability to perform a cesarean or other interventions such as Pitocin or epidural is available. There are even higher levels of care such as Intensive Care where caring for someone who is on life support machines is available and not all community hospitals have this option for women during or after childbirth, so she would have to be transferred from the lower level hospital to a higher one. The idea is that we have lots of birth centers, less of the community hospitals and only one or two regional centers to care for the very complicated cases. However, our local OBs do not encourage their healthy, low-risk women to birth outside the hospital. Rather, they look for reasons to elevate a woman’s risk and encourage interventions such as unnecessary inductions.

Birth is sacred

Birth is a sacred event that happens to each of us only once as we enter the world. How it happens is important for the one being born and for the one giving birth. If we are going to see a world that is healed from all of the devastations of poverty, war, climate change, and abuse it has to start with how we care for those giving birth and being born. I have grown up in my Midwifery career hearing the saying that ‘Peace on Earth begins with Birth’. We have to honor the process and respect both mother and baby by not causing pain and trauma but rather supporting, facilitating, and protecting the process. This can happen more easily out of the hospital in a woman’s home or in a birth center. However, I have not given up hope that we can shift the culture of childbirth within the hospital by spreading information and demonstrating a better way. We do this by supporting natural childbirth centers and encouraging the growth in the number of birth centers in our community.

Support the ‘birth’ of Gentle Birth Centers

I’m happy to announce the addition of a new natural childbirth center in Wellington – opening soon. Gentle Birth Centers will be teaming up with Midwife360 to create an integrated practice of home, birth center, and hospital care for healthy, low-risk candidates. We plan to open this spring and are located within a mile of the nearest hospital. Let’s change birth together!

Top Ways to Prepare for a Positive Birth Experience

The top ways to prepare for a positive labor and birth experience begin long before the actual labor starts. At Midwife360, we talk about our “Recipe for Success” when we are discussing a client’s birth plans. 

The core of our recommendations include self-education through reading books and online resources (see the reading and web organization list at the end of this article) and commitment to a healthy lifestyle through clean eating and regular exercise. We strongly advise eliminating processed foods, dairy, and inorganic foods. Through clean eating and regular exercise, it is likely that there will be an absence of disease processes such as diabetes and high blood pressure which can make a pregnancy cross the line into a truly high-risk status. If the pregnancy can be maintained in the low-risk status range, then recommendations such as induction of labor are more easily declined. 

Our “Recipe for Success”

Our “Recipe for Success” also includes hiring a doula and taking a deep meditation for labor course such as Blissborn or Hypnobabies. Many times the doula will be the one who teaches these courses. Doulas are invaluable as educational resources and typically have a wealth of information regarding comfort measures and labor preparation activities. They will meet with the client usually two times prenatally and will be the first to show up at the labor. They help with labor support if things are not progressing, and will let you know when to call the midwife or leave for the hospital. Meditation or hypnosis is a tool that can be used to cope with the surges of labor. It helps to keep the mind occupied with positive thoughts to allow the body to perform the work of releasing the baby unimpeded.

Positioning of the Baby 

The most common reason that labor doesn’t progress is the positioning of the baby. We recommend becoming familiar with an online resource called “Spinning Babies” that teaches postures that can be used prenatally to help ensure proper positioning of the baby in relation to the mother’s bony pelvis. This will ease the baby’s passage and create a more efficient labor process. Your doula will most likely be familiar with this resource and have the ability to guide you through the postures as well as know when to employ them in labor.

Using a Birth Tub 

The final recommendation in our “Recipe for Success” is to use a birth tub for labor and birth. The benefits of hydrotherapy have been recognized by midwives and laboring women for years. Some people call it a ‘liquid epidural’ as the sense of relief is so great when entering a warm tub of water in active labor. Sitting on a yoga ball or stool in the shower can have some of the same sense of relief, but immersion in water is better and helps lift the belly to remove the heaviness caused by gravity. Also, releasing the baby into the water helps with vaginal and perineal stretching and reduces tearing.

Visiting a Chiropractor and Acupuncturist 

In addition to the “Recipe”, we strongly recommend developing relationships with a chiropractor and acupuncturist who are skilled in caring for pregnant people. Get regular massages and take yoga classes or do yoga at home. All of these adjunctive therapies contribute to a body that is well adjusted and free from muscular and energetic blockages that can inhibit the passage of the baby when it’s time for birth. 

Preparing for a positive labor and birth experience ideally starts before pregnancy. However, with a determined mindset and a willingness to do the work, preparation for a positive experience can easily be accomplished in the 40 weeks of pregnancy. Decide where you want to give birth and hire a care provider that you trust. Check out the resources listed below and prepare to have an amazing, informed, respectful labor and birth experience!

An Open Letter to Hollywood Producers and Screenwriters

I am writing this letter to appeal to you to stop portraying birth in the manner that nearly every single movie, sitcom, or miniseries has always seemed to portray birth – that of a screaming, sweaty woman lying on her back with her feet up in stirrups and everyone else in the room standing over her, yelling at her to push. The baby comes out and the cord is immediately cut (even in Call the Midwife – the truest to real-life series which portrays childbirth) – this is not beneficial to the baby, was not likely done back in the 1950s in England, and shouldn’t be done today.

Human birth has been domesticated much the same way we have domesticated animals for our benefit. Human birth (especially for low, risk, healthy women) is the only physiological, normal process of the human body that takes place inside a hospital. It doesn’t belong there. It doesn’t work well with bright lights and loud noises and strangers hovering around. Much like our mammalian counterparts, humans do better to birth in a familiar environment, with dim lighting and no distractions. It is a bodily process that requires no input from the thinking mind.

Ask some of the Hollywood actresses and singers who have chosen to birth at home (or in a birth center) how they feel about this. Every one of them have raved about their experience and found an amazing bond with their baby and an easing into motherhood that doesn’t always happen so easily when babies are born in the hospital. Oftentimes, mothers and fathers are frightened by well-meaning care providers and may be treated disrespectfully or even neglected due to the assembly-line nature of hospital birth.

If birth was portrayed in the media as physiological, natural, and low tech (which it actually is for a low risk, healthy person). Then perhaps more people would have the courage to take responsibility for this bodily process that is more of an intimate experience involving the 2 people who created the baby than of the institutions who seek to profit from it.

After all, having a baby is a lot like pooping – what if we had to go to the hospital and get permission to poop? That would be weird… Clients can easily find well trained medical providers to assist them in the out-of-hospital setting to ensure that any potential complications are handled appropriately. This will have a dual benefit of making birth better for birthing people and unclogging the medical system that exists to help those who truly need it.

Let’s start seeing real birth scenes on TV and in the movies – please.