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.

A Complete Guide About Shoulder Dystocia

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What is Shoulder Dystocia?

Shoulder Dystocia is a birth complication that happens during vaginal delivery. When this occurs, one or both of the baby’s shoulders get stuck inside the mother’s pelvis during labor. This causes a stall in the delivery process, which can be life threatening. In most cases, babies born with this complication are delivered safely. However, it can cause problems for both the baby and mother. 

Shoulder dystocia happens in 0.2 to 3 percent of pregnancies, and sadly, is unpredictable and unpreventable. When complications happen during labor, doctors turn to urgent cesarean delivery or surgery to avoid further issues. Although this may work in most cases, urgent cesarean delivery or surgery cannot correct this condition. 

Continue reading below for answers to all questions regarding this topic. 

Frequently Asked Questions:

What Does Shoulder Dystocia Look Like?

When Shoulder Dystocia occurs, the fetal head is delivered but the shoulders are not seen and are not being delivered with normal maneuvers. In other words, this delay in labor causes the baby to be trapped mid delivery. When this is happening, your midwife or provider tries to move your body and baby into better positions to continue natural delivery. 

The shoulder of the baby normally gets stuck behind the mothers pubic bone or sacrum. During this delay, the baby cannot breathe and the umbilical cord may be squeezed or wrapped around the baby’s neck. It is dire that everyone stays calm but acts quickly and efficiently to prevent further complications. The midwife will ask the mother to cease pushing so she can reposition her and the baby as needed.       

Why Does This Happen?

Shoulder Dystocia can occur during any vaginal birth, and without warning. Some of the most common causes for this are that the baby is too big, the baby is in the wrong position or the mother being in a restricting position. Oftentimes, your midwife or provider will change the mothers position to help free the shoulders from the pelvic area. 

It is nearly impossible to predict the risk factors of whether or not your baby will have this complication, but there are some things that can make it more likely. This includes:

  • Shoulder Dystocia occurred during previous pregnancies
  • Fetal Macrosomia (having a larger baby)
  • Having twins or multiple babies
  • Mother is overweight
  • Mother has diabetes
  • Labor induced 

Although these factors may increase the risk of a baby being born with Shoulder Dystocia, it is not clear why some pregnancies experience this complication while others do not. One statistic states that women with a history of having a delivery with Shoulder Dystocia are 10- 20 percent more likely to have a recurrence. 

What are the Complications?

Although most mothers and babies may not experience any further issues regarding this complication, it can bring about further issues. When delivering a baby with Shoulder Dystocia, a midwife or provider may have to break the baby’s collarbone to help with removal of the shoulders. This is a last resort, but may be necessary. This is only one risk that may come from this condition. 

Further risk for the baby may include:

  • Fractured collarbone (clavicle) or arm
  • Fetal brachial plexus injury
  • Lack of oxygen to the body
  • Brain injury due to lack of oxygen (this is rare)
  • Loss of baby (this is rare)

Further risk for the mother may include:

  • Maternal hemorrhage/ postpartum hemorrhage
  • Repairs for episiotomy or tearing during delivery 
  • Uterine rupture

Can You Prevent or Treat Shoulder Dystocia?

Like we touched on above, Shoulder Dystocia is extremely unpredictable and there is very little prevention. Being mindful of potential risk factors like diabetes and watching your weight during pregnancy are all things to help lower your chance of complications during labor. At Midwife360, we recommend our mothers to give birth lying on their side or on all fours to help natural movement of the delivery process. This will help prevent complications like Shoulder Dystocia. 

It is important to inform the expecting mother about the complications and risks of Shoulder Dystocia.  As well as reassure her that, as a midwife, we are trained thoroughly on how to deal with these complications in the safest and most efficient way for the safety of you and your unborn child.  

If You Have Further Questions

If you have any questions unanswered or need more information contact us at Midwife360. At Midwife360 we provide holistic gynecology and pregnancy services, including home and water birth to women throughout South Florida. Our mission and practice is designed to meet the individual needs of each woman and expecting family we care for. We believe women should be informed and educated about their healthcare options for routine care, family planning and birthing.

A Complete Guide to Miscarriage at Home

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Is Miscarriage Normal?

Pregnancy and miscarriage carry a ton of emotions, and one may feel devastated or uneasy when going through a natural miscarriage. Although this is can be an extremely tough time mentally and physically, it may be comforting to know you’re not alone. 

An estimated 10%-20% of women who know they are pregnant will have a miscarriage. Also, most women (87%) who do experience a miscarriage will have a successful pregnancy and birth following that miscarriage. 

Maybe your pregnancy test was positive after missing your period, or some women have that gut feeling without having missed a period yet. Feeling excited, scared, happy, nervous, or just numb are all in the normal range of emotions when you first discover a pregnancy. Or maybe you’ve been trying for months to get pregnant and now you finally are. 

Just when you feel like you are beginning to get comfortable with your pregnancy, you start to have some spotting, maybe a little red bleeding, and then some light cramping. 

Next Steps

Contacting your health care provider and making them aware of what is going on is important. They may offer to have an ultrasound or blood work done. The bleeding becomes heavier and the cramping gets stronger and you no longer have the pregnancy symptoms you were starting to feel prior. Unfortunately, you are most likely experiencing a miscarriage. 

If your body is already starting to bleed and cramp, this is a sign your body is getting ready to expel the products of conception. Sometimes there’s not an actual fetus present. This means it could be a chemical pregnancy with no fetus, just a gestational sac. 

If there are no complications, you can safely miscarry at home. You may want to have some ibuprofen on hand and a hot water bottle. Soaking in a warm bath can also be very soothing. The worst of it can take about 2 hours with some pretty intense cramping and heavy bleeding. 

When to Seek Help

You would need to seek out medical care if you have pain that you cannot tolerate, or if you begin to hemorrhage. The definition of a hemorrhage is, soaking a maxi pad to where you can wring it out, and doing this for 2 hours. Of course, if the bleeding is much heavier than that or you feel unsafe, don’t wait to get medical help. 

Missed Miscarriage

A ‘missed miscarriage’ is where the fetus stops growing but there’s no signs of bleeding or cramping right away. It’s usually during the first ultrasound that this will be diagnosed. Or if you were following the beta HCG hormone, and it isn’t doubling or rising appropriately in the first 10 weeks, a miscarriage can be diagnosed this way, as well. 

If you do have a missed miscarriage, do not wait before seeing your provider for an intervention. It is dangerous for the pregnancy to sit in your womb for months, as it can cause some dangerous bleeding when the natural miscarriage begins. You will most likely be given several options, depending on the preference of the provider. It is always best to be informed ahead of time, in case your provider does not offer all the common or available options. 

Intervention Options for Missed Miscarriage

  • D&C or Dilation and Curettage

A D&C is a fairly common procedure to eliminate uterine lining and pregnancy contents. This procedure is very safe and complications are rare. Light spotting and cramping is common in the first few days after a D&C. 

  • Medications

Medications like Misoprostol are also an option, which cause your uterus to cramp. This process usually takes about 24 hours to complete. This option is also very safe and complications are rare.  

Miscarriage is Common

Miscarriage is very common, you would have to have 3 in a row before it is considered a medical problem. An option is to see a Maternal Fetal Medicine doctor to have a consult regarding any specific blood tests needed to determine if you have a genetic predisposition to miscarriage. These may include: Anticardiolipin, TSH, Lupus anticoagulant, beta 2 glycoprotein, and maternal karyotype. 

Some providers will recommend taking a baby aspirin every day to reduce the risk of miscarriage. And sometimes they may recommend taking progesterone to help you maintain the pregnancy. These all depend on the results of the blood tests and the actual medical diagnosis that is causing the miscarriages.

Next Cycle and/or Pregnancy After Miscarriage 

You can have your beta HCG levels checked, or simply wait for your next cycle. You should have a period by 4-6 weeks after the miscarriage. If you don’t have your cycle within 4-6 weeks, contact your care provider for further testing or ultrasounds. It is recommended to actively prevent pregnancy for 2 cycles following a miscarriage to lower your risk of having another miscarriage right away.

Holistic Gynecology and Pregnancy Services

If you are looking for holistic gynecology and pregnancy services, including home birth and water birth in South Florida, contact Midwife 360 for all of your questions and needs.

Birth Plan: Why You Need a Midwife and Doula

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The Birth Plan

If you are an expectant mother, then you understand the importance of having a birth plan. Each couple will have a different plan for their pregnancy and birth; this plan is associated with their wishes and values. Do you have a birth plan? Does your birth plan include a Midwife and Doula? First, it is necessary to understand how a Midwife and Doula can help you before, during and after your pregnancy.

Midwives and Doulas

Ever since the beginning of humanity, women have been giving birth, and they have had individuals who were there to support them in their birthing process. Midwives and Doulas are the individuals who help mothers to create and fulfill their desired birthing plan. Even though these specialists have job descriptions that pertain to pregnancy and delivery, their responsibilities are actually quite different.

The Work of a Doula

Doulas are individuals who are particularly concerned with the mother’s comfort and care before, during and after the birthing process. Doulas are able to give the mother the comfort that she needs. This comfort can include massages, soft music, aromatherapy, encouraging words or other techniques that will help the mother to have the best birthing experience possible. A Doula is not a medical professional and cannot perform any medical procedure. She cannot help a woman give birth, she is only there for the comfort of the mother who is in labor.

What is a Midwife?

A midwife is a medical professional who works directly with a mother who is giving birth. The job of this specialist may vary according to the state where she practices. Generally, midwives have received training from an accredited establishment that has licensed them as a midwife.  Midwives are able to help the mother in the delivery process. A Midwife also has the skills and knowledge to know when a delivery may require the skills of an obstetrician.

Your Birth, Your Choice

You have a choice when it comes to your birth plan and who attends (doctor, midwife, doula etc). There are traditional methods, holistic methods and natural methods that you can choose from for your labor and delivery. There is nothing that can be more special or personal than giving birth, and a midwife and doula will help make the experience more comfortable and personalized.
We’d love to help. Contact us today.

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!

Birth Similar to Love Making?

Pregnant couple relaxing on bed at home
Pregnant couple relaxing on bed at home

Birth Similar to Love Making?

Pregnant couple relaxing on bed at home

Birth Similar to Love Making?

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I believe that giving birth is similar to making love.

Normal, low-risk childbirth is very difficult to achieve in the hospital setting. Even when you have the most amazing provider, the very atmosphere prevents it. I believe the reason for this is related to the fact that childbirth is similar to making love. It’s not really such a wild idea if you think about it like this… For most people with a natural pregnancy, lovemaking is the act that starts the whole process. Pregnancy ensues and the body nurtures and grows the seed into a baby and through the maturation process until the appropriate time to release it into the world.

There is believed to be a multifactorial triggering process that is not well understood. However, it is common knowledge that once it gets going, labor responds well to dim lighting, quiet surroundings, and the soothing, loving support especially from the birthing person’s partner. Sound familiar?

What doesn’t work

When frightened, our mammal cousins have been known to stop their labors in order to move to safety. The same is true for humans, which is why there is an epidemic of Pitocin in use in most hospital Labor and Delivery units around the world. Normal labor does not respond well to bright lights, loud noises, and strangers. This has been discussed at length by obstetric greats such as Grantly Dick-Read and Michel Odent – both ardent proponents of unmolested birthing. Imagine trying to make love and achieve orgasm with all of that activity going on around you!

Your Partner

Another parallel between love-making and childbirthing has to do with the birthing person’s partner. Of course, the partner is included and involved with all aspects of the process as they were an integral part of making it happen. (What other hospital-based care takes place with the ‘patient’ AND their partner? No surgical procedures or any other procedures are a family event unless it’s a small child who needs a parent present for comfort.) In the majority of cases, the partner was present and responsible for planting the seed, and therefore is integral to the birthing process.

They have a bond in their union making the partner the one unique person in the room who is intimate with the birthing person. When the partner lovingly strokes and massages, whispers loving words of encouragement and is just completely present to the process, it causes the birthing person to release oxytocin which in turn causes the labor to intensify. Also, just like in love-making, the need for single-minded concentration is paramount to achieve the level of trust, openness, and surrender that is necessary for birth to happen.

Uncomfortable & Fearful

The combination of poorly designed rooms and standard interventions that are not evidence-based has created the need for using a dangerous drug on nearly all normal labors! When birthing people are not comfortable or if they are fearful, they will not be able to achieve the level of relaxation and focus required for efficient birthing.

Pitocin

Pitocin is the synthetic version of oxytocin – also known as the ‘love’ hormone. It is produced by our bodies when we hug another person (or animal) or make love, and it is this hormone that causes the uterus to contract and expel the baby.

We have discovered that we can give the synthetic version to pregnant individuals to start labor or make contractions stronger and closer together. But it is not without risks. It is a dangerous drug that can cause contractions that are too close together and too strong creating distress for the baby.

Pitocin is the reason for many emergency cesareans in labor. Having Pitocin creates the need for other non-evidence based interventions such as continuous monitoring and IV which in turn lead to another non-evidence based intervention – immobility, being stuck in the bed, usually on the back – all of these being extremely unhelpful to the laboring person. Another downside to Pitocin is the accompanying liters of IV fluids that the laboring person tends to receive.

It is not uncommon for someone to get 4, 5, even 6 liters of fluid during an induction, especially if they elect to get an epidural. All of this fluid can cause swelling and difficult breastfeeding due to the extreme engorgement that occurs. So instead of giving a dangerous drug to augment labor when people come into the hospital, why not redesign the physical space to encourage natural labor to do the job?

Let’s change things

We have birthed successfully without Pitocin for millennia before birth entered the hospital in the early decades of the 1900s. Let’s alter the external physical space and encourage practices that support the human body and psyche to birth naturally. The only people who require drugs to enable lovemaking are those with hormonal imbalances, it should be the same for normal, low-risk childbirth.

I propose that labor and delivery units set aside a block of rooms with dimmers on all the light switches, electronic candles sprinkled throughout the room, handheld dopplers for intermittent monitoring, multiple options for hydrotherapy including showers big enough for 2 people and a birth ball or shower chair and labor/birth tubs. They should have a welcoming attitude for partners and doulas; no standard IV or continuous monitoring; and healthy snacks. I believe that providers would find less of a need to augment labors and we could reduce our overall cesarean rates while improving client satisfaction.

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Holistic Gynecology FAQ

Q. What is a Holistic Approach? A holistic approach to modern medicine is characterized by treating the person as a whole, rather than treating specific

I believe that giving birth is similar to making love.

Normal, low-risk childbirth is very difficult to achieve in the hospital setting. Even when you have the most amazing provider, the very atmosphere prevents it. I believe the reason for this is related to the fact that childbirth is similar to making love. It’s not really such a wild idea if you think about it like this… For most people with a natural pregnancy, lovemaking is the act that starts the whole process. Pregnancy ensues and the body nurtures and grows the seed into a baby and through the maturation process until the appropriate time to release it into the world.

There is believed to be a multifactorial triggering process that is not well understood. However, it is common knowledge that once it gets going, labor responds well to dim lighting, quiet surroundings, and the soothing, loving support especially from the birthing person’s partner. Sound familiar?

What doesn’t work

When frightened, our mammal cousins have been known to stop their labors in order to move to safety. The same is true for humans, which is why there is an epidemic of Pitocin in use in most hospital Labor and Delivery units around the world. Normal labor does not respond well to bright lights, loud noises, and strangers. This has been discussed at length by obstetric greats such as Grantly Dick-Read and Michel Odent – both ardent proponents of unmolested birthing. Imagine trying to make love and achieve orgasm with all of that activity going on around you!

Your Partner

Another parallel between love-making and childbirthing has to do with the birthing person’s partner. Of course, the partner is included and involved with all aspects of the process as they were an integral part of making it happen. (What other hospital-based care takes place with the ‘patient’ AND their partner? No surgical procedures or any other procedures are a family event unless it’s a small child who needs a parent present for comfort.) In the majority of cases, the partner was present and responsible for planting the seed, and therefore is integral to the birthing process.

They have a bond in their union making the partner the one unique person in the room who is intimate with the birthing person. When the partner lovingly strokes and massages, whispers loving words of encouragement and is just completely present to the process, it causes the birthing person to release oxytocin which in turn causes the labor to intensify. Also, just like in love-making, the need for single-minded concentration is paramount to achieve the level of trust, openness, and surrender that is necessary for birth to happen.

Uncomfortable & Fearful

The combination of poorly designed rooms and standard interventions that are not evidence-based has created the need for using a dangerous drug on nearly all normal labors! When birthing people are not comfortable or if they are fearful, they will not be able to achieve the level of relaxation and focus required for efficient birthing.

Pitocin

Pitocin is the synthetic version of oxytocin – also known as the ‘love’ hormone. It is produced by our bodies when we hug another person (or animal) or make love, and it is this hormone that causes the uterus to contract and expel the baby.

We have discovered that we can give the synthetic version to pregnant individuals to start labor or make contractions stronger and closer together. But it is not without risks. It is a dangerous drug that can cause contractions that are too close together and too strong creating distress for the baby.

Pitocin is the reason for many emergency cesareans in labor. Having Pitocin creates the need for other non-evidence based interventions such as continuous monitoring and IV which in turn lead to another non-evidence based intervention – immobility, being stuck in the bed, usually on the back – all of these being extremely unhelpful to the laboring person. Another downside to Pitocin is the accompanying liters of IV fluids that the laboring person tends to receive.

It is not uncommon for someone to get 4, 5, even 6 liters of fluid during an induction, especially if they elect to get an epidural. All of this fluid can cause swelling and difficult breastfeeding due to the extreme engorgement that occurs. So instead of giving a dangerous drug to augment labor when people come into the hospital, why not redesign the physical space to encourage natural labor to do the job?

Let’s change things

We have birthed successfully without Pitocin for millennia before birth entered the hospital in the early decades of the 1900s. Let’s alter the external physical space and encourage practices that support the human body and psyche to birth naturally. The only people who require drugs to enable lovemaking are those with hormonal imbalances, it should be the same for normal, low-risk childbirth.

I propose that labor and delivery units set aside a block of rooms with dimmers on all the light switches, electronic candles sprinkled throughout the room, handheld dopplers for intermittent monitoring, multiple options for hydrotherapy including showers big enough for 2 people and a birth ball or shower chair and labor/birth tubs. They should have a welcoming attitude for partners and doulas; no standard IV or continuous monitoring; and healthy snacks. I believe that providers would find less of a need to augment labors and we could reduce our overall cesarean rates while improving client satisfaction.

Creating Value in Childbirth

young pregnant woman

Costs of Care Creating Value Challenge

In 2007, the Institute for Healthcare Improvement (IHI) proposed a framework for optimizing health system performance known as the “triple aim”. The three components are:

  • Improve the experience of care
  • Improve the health of populations
  • Reduce the per capita costs of healthcare

At Midwife360 we hit the bullseye on all three! Now, where is that friendly OB who wants to play with us?

It’s time to apply the IHI triple aim to childbirth!

It is well known that the American childbirth culture is very expensive with very poor performance AND little of what happens to birthing people in hospitals is evidence-based.

Childbirth for low-risk healthy women (who comprise the majority of people giving birth) benefits from less, rather than more technology. It is, after all, the only physiologic human function that has been relegated to hospital care. Achieving good outcomes usually goes hand in hand with a positive experience of care and this can be done in a very low-tech, inexpensive way by creating teams of home birth midwives and OBs.

Comfort is key

ACOG approves of home birth under certain conditions – choosing the appropriate client, with a CNM, in an integrated environment. As giving birth is much like making love, it is easier to imagine this happening in an environment where the birthing person feels the most comfortable – whether that be her home, a birthing center, or a hospital. So creating a culture that truly supports choice for birthing people without removing the option of access to a higher level of care can be accomplished by having a care team of a homebirth midwife and OB with hospital privileges.

Recreating home

Short of that, making hospital labor rooms more homelike – dimmers on the main lights, several options for water immersion (large shower, birthing tubs), small refrigerators in the room, and a second bed for family members or the doula to use – and updating care to reflect the evidence and patient preference are all absolutely necessary to achieve the IHI triple aim.