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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.

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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.

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Natural Birth After C-Section

Can I have a vaginal birth if I already had a c section?

The short answer is, “YES! YOU CAN!” While the long answer requires a conversation about various risks – risks of a VBAC, or vaginal birth after cesarean, AND risks of repeat surgery. Unfortunately, it is the second set of risks that are routinely left out of the conversation when you speak with a hospital provider (OB or CNM) about it. And, also, unfortunately, these same providers often offer the VBAC and then find a reason at the end of the pregnancy that either induction of labor is ‘necessary’ (not the best plan for a successful VBAC) or a repeat surgery if the pregnancy goes beyond 39 or 40 weeks. 

Where can I have a successful VBAC?

This drives many women to seek an out-of-hospital birth provider for their planned VBAC, even though everyone agrees that the hospital is the best place due to the easy and quick access to emergency services. Since VBAC is prohibited in Birth Centers, this leaves home birth as the only option. And home birth is not for everyone. It is certainly not the best idea for someone whose main reason for choosing it is to avoid the hospital. It is always better to run towards something rather than running away from something. In other words, the choice to have a home birth should be driven by the desire to have your baby in the comfort and safety of your home, not by the fear of the hospital.

Successful home birth requires dedication and preparation

We have seen a situation like this where the client chose to have her baby with us because of her fear of having another c section and her inability to find a hospital provider who would support her decision to birth vaginally. She did not have a doula or take a birth preparation class. (These are 2 of Midwife360’s 3 keys to successful, efficient birthing. The 3rd is using the birth tub.) Consequently, she was unprepared and unsure when her labor did start, and did not request the midwife presence in a timely manner. She birthed on the toilet and her baby actually went into the toilet! They had the midwife on the phone throughout the process and she was able to guide them verbally (the part about the toilet came out later!) and everything turned out well. 

This is an example of how normal the process is for most people – even those who have had previous c sections – and for most babies. Babies are resilient and born to survive and know how to start breathing with little to no help in most cases.

Most predictions by OB providers are wrong

“Your baby is breech, and even if it turns, your pelvis is too small to push. There’s an 80% chance you’ll have to have a c section if you try, and then it would be an emergency surgery, which is more dangerous. So let’s just schedule the c section as this will be safer.”

I’ve heard this same speech from many clients over the years. This particular client told us this story of her first birth – the baby turned out to be 5#5oz. When she got pregnant the second time, they said she would have to have another surgery – it would be safer, they said. “But my mom had a c section and then pushed my brother out right after – he was over 10# – can’t I at least try?” “No”, they said, “it’s not safe”. There was no discussion of the risks of surgery, all focus is on the risks of trying a vaginal birth.

You can do it!

When this woman got pregnant a third time, she knew that she could birth her baby vaginally. She drove an hour away from her home to find a provider that believed in her and would support her. And although she did not take advantage of the 3 keys to success, (she used the birth tub only), she was so determined and dedicated that she was able to adequately prepare herself mentally for the big day. She was able to birth an 8#3oz baby vaginally in the birth tub with her sisters, husband, mother-in-law, and daughters all present and cheering her on! She pushed for over 2 hours, but barely tore and the baby came out quickly with no problems.

Our bodies and our babies are made for birth

When will OB doctors and other birth providers stop telling women what their bodies cannot do? Women are created with the social imperative to create life and deliver it to the outside world. Among many other things, we are very well designed birthing machines! If you didn’t know this already, then you do now!

Be empowered, be informed, stand up for yourself and your baby!

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High-tech Childbirth is Not Always Better

Baby girl few minutes after the birth

America excels in high-tech medicine

When it comes to healthcare and medicine, America is the greatest country in the world. If you get into a car crash or have a heart attack, or need a life-saving surgery, then you are very grateful to have that happen in the US of A. However, this statement is not true if you are pregnant and healthy. It is well known that the US scores shamefully low on the two standards used worldwide to evaluate how well a country is doing in the area of childbirth – infant mortality and maternal mortality. And it’s not a mystery as to why this is the case. We know that the standard interventions performed on pregnant women in the hospital on low-risk, healthy moms and babies are not evidence based. Withholding food and fluids by mouth.  Limiting movement and positioning in labor.  Use of continuous fetal monitoring for low risk labors.  Non-medically indicated inductions.  Immediate cord clamping.  Overuse of Pitocin for labor augmentation. All of these standard interventions can lead to perceived and real problems that trigger the cascade of events leading to an operative delivery – forceps, vacuum extraction, or cesarean (and occasionally a cesarean with forceps or vacuum delivery!).

Low-tech better for physiologic childbirth

When it comes to childbirth, high tech is not better than low tech. I have been privileged to attend many out of hospital births and many more in hospital births. Even a ‘normal’ birth in the hospital typically comes with continuous fetal monitoring and epidural. And unless it is the middle of the night and the lights are kept dimmed, the nurses use intermittent monitoring, the cord is left alone for at least 10-15 minutes, and the baby is kept on the mother AT ALL TIMES, no hospital birth worker has truly witnessed natural birth. There are many, many videos of home birth on the internet and it can be seen time and again the beauty and wonder of birth as it is meant to be.

Out-of-hospital birth should be first-line care for all low-risk childbirth

We have such great prenatal care standards, that any significant problem with the mom or the baby will most likely be detected prior to labor so that a baby that may need more high tech assistance can be born in a place where she can receive that assistance in a timely manner. It is so unlikely that a healthy mom and baby will have a major life-threatening problem during the birth process, that out of hospital birth and midwifery have been approved through legislation in most states. And statistics have proven that most transports from an out of hospital setting are done for non-emergent reasons. The American Congress of Obstetricians and Gynecologists have suggested that the out of hospital Birth Center should be the first level of care for healthy pregnant women. They recommend only moving up the chain to a hospital capable of performing a cesarean if there are risk criteria that have been demonstrated.

Low-tech interventions for childbirth

So that means in order to fix the problem, more doctors need to be trained in the low tech hand skills that are truly helpful to laboring women. These include Leopolds maneuvers (feeling the baby from the outside to determine it’s position), which, when performed properly, can assist the provider to be able to tell not only the baby’s position but if there is adequate fluid around the baby. Keeping hands out of the way other than to provide warm compresses during the actual birth. Turning a breech baby to avoid a breech delivery. Even being able to perform a breech delivery – these are skills that are slowly being lost to us because they are not being taught in medical schools. And delayed cord clamping is probably the single most important non-intervention that can be supported at a birth! We have been complacent, and have allowed an intervention – immediate clamping and cutting of the umbilical cord (that typically happens in the course of surgical birth) – to become standard of care for all births without studying the effects. It is part of the OB culture and doctors and CNMs are taught to do it without question. This is what happens when you put surgeons in charge of a physiological event.

Women’s complacency has really been the main cause of our loss of control over our bodies and our labors. It is time for us to stand up and reclaim our bodies, our labors, and our births. Support your local midwife, demand respect and evidence based care. Maintain a healthy lifestyle and prepare yourself for an out of hospital birth – it will transform your life!