A Mama's June Birth Story (Hospital Birth) Boca Raton, FL | Paulina Splechta Photography

Story by guest writer, Sarah A.

With my first pregnancy, I didn’t hire a doula or have any other support team aside from my husband. I was pregnant with twins, a first time mom and I was inexperienced in the ways of a hospital birth. So much of the process was out of my control, preeclampsia meant I needed to be induced, I had to have an epidural early on in case of an emergency c-section and I had to deliver in an OR. Birth isn’t something you can predict or control, but with my first birth, I felt so disconnected and left out of the process itself. I also felt my birth preferences were largely ignored and that left me with feelings of sadness and regret about my twins’ birth.

When I became pregnant for the second time with a singleton in 2017, I wanted to take full advantage of the experience and make sure I was as connected and present as possible throughout my pregnancy and baby’s birth. This led me to the decision to hire a doula. I researched several doulas in my area and ended up hiring Lisa Raynor. In addition to attending my birth, Lisa was a strong support to me throughout my pregnancy. She helped me craft a detailed list of birth preferences and was instrumental in communicating them to my medical team and making sure they were followed the day of the birth.

During my pregnancy, she was always available if I needed to talk and helped me tremendously through some scary weeks after a few worrisome ultrasounds.

She reminded me that I had a say-so over my birth and helped me think through my options during stressful moments.

On the day of my son’s birth, Lisa was with me as much or as little as I needed, stepping in during the moments when things got tough and supporting my husband and I through a birth process we had never navigated before.

This time around, I was lucky to have a calm and beautiful birth experience but I also credit my doula with making this possible through her knowledge, experience and caring support. I felt like an active participant in my birth this time around and it truly made all the difference. Having a doula helped me achieve the pregnancy and birth experience I envisioned and heal some of the old wounds of regret from my last birth. Lisa provided such seamless and loving support, she felt like a member of our family and I will forever be grateful to her. I would absolutely recommend hiring a doula for pregnancy and birth to any mama-to-be, first time or otherwise.

Only 5% of babies are born on their Estimated Due Date (Birth Center Birth) Hollywood, FL | Paulina Splechta Photography

Only 5% of babies are born on their EDD ( Estimated Due Date )

We knew that very well going into Madison’s pregnancy with baby. Her due date was 8 days into September, but her entire pregnancy, she felt that her baby boy would make an appearance earlier than expected. Sunday night I was up late printing birth preferences for Madison and Drew (just in case they needed to be transferred from their birthing facility - the Hollywood Birth Center, to the hospital, (Joe DiMaggio Hospital) for any reason, so that the medical staff would know that we are grateful that she can deliver at their facility and willing to work with them as a team). I knew it in my heart that Madison was going to labor and birth smoothly, my intuition was telling me that we wouldn’t need to pull the birth preferences list out, but I always like to be prepared just in case.

Madison and Drew became a very special couple for me through their pregnancy. They carried an energy with them as first time parents. They are the sweetest couple that lived next door to each other for 18 years, blissfully unaware of the radiant future that awaited them. But they are completely and utterly the ‘girl next door’ fairytale that we all day dream about.

From the first time I met her, I loved how she said to me how important pictures are to her.

I know that because I’m a photographer that its expected for me to say pictures are important to me too. But even before I ever became a professional photographer, pictures have always been such a vital part of my life. I have albums from before I was born from eastern Europe of my families on both sides. Albums from my childhood, from my first school dance, from Christmases for decades, of my own children. I look through photos constantly and love to think back on those memories. For me, my albums and my pictures are priceless.

So these powerful words from Madison “pictures are really important to me,” completely resonated with me.

And just like that, as part of this mama’s intuition, two full weeks before her estimated due date, labor went into strong contractions 5 to 6 minutes apart 2:30am.

(((As I sit here, thinking back on the night of August 27th, just two days after my second daughter turned 3 years old, and write this blog post, I find it completely makes sense that my notifications for my Instagram app pop up on my phone, that in this exact moment, Madison shared a photo from her birth story on Instagram and tagged me. Sharing a wave length! This mama is SO special to me!)))

I drove to meet them at the birth center and walked in at about just before 7:45am, about 15 minutes after they arrived. I see Madison experiencing the full, raw, pangs of labor, surrounded by waves of support coming from Drew and his sister Daye. Midwife DellaReece filling up the birthing tub with warm water. The sun aching to rise from the horizon.

Despite the intensity of the waves of labor, Madison breathed and swayed fluidly through each, almost as if she was a third time mama.

She was surrounded by the flawless support of her birth team.

Fully trusting in them and in her laboring body.

She knew she would be meeting her baby boy soon.

Only minutes later she asked if we could turn off the lights.

Nothing made me happier.

I cannot tell you how much I love working with the natural, available light in a birth. Photography is the art of working with light, and when I am looking for light sources to tell a story, it is when I am at my best and most magical.

What made this room so special is that Madison chose the room in the Hollywood Birth Center that faced the East, the ocean. I know how special that is to her, because she is a child of the ocean.

For me, it was the room that faced the birthing sun of August 27th, 2018.

Drew Krush

Born, August 27, 2018

9:45am

Togetherness - The Birth Journey Done Together with your Partner (Home Birth) Miami Beach, FL | Paulina Splechta Photography

As first time moms, even sometimes second time moms, we often don’t know what we should expect from the last few weeks of our pregnancies, let alone our labors and births. So it is completely normal when the partner (or spouse) is clueless as to how to support their significant other who is in labor.

Even if you’ve spent the entire pregnancy supporting her through hyponbirthing, childbirth education classes, maybe even the Bradley method (which involves both parents, prepares the mother to deliver her baby without pain medications and educates the partner in birth coaching techniques), it is still quite common and normal for partners to freeze during labor.

Birth is complex and often unpredictable. No two labors are alike, not even among a woman’s own three children.

I am a big believer in go with the flow, and fill the role that you feel called to.

You may not know what to say, you may not know what to do, but just being there can often be enough.

When a Birth Photographer Puts Down their Camera

When the camera gets put down: moments rarely documented in a birth story

I cannot accurately describe to the fullest, the positive energy and empowerment in this room in one moment. You know how when you have a child sometimes you think to yourself: wow I had no idea how much I needed this child to become the best version of myself?

I cannot tell you what an overpowering realization it is to me that these two women here make me feel this way. 

When I met Lisa (Lisa Raynor Coral Springs and Boca Raton Childbirth Doula) my mentality and philosophy of my work was almost 180º from what it is today. My confidence level, my energy level; everything in my entire life as a momtrepreneur was so different. It’s not that this level of different was a bad thing, but I was stuck in that post partum 4th trimester for far too long, and Lisa saw it immediately, but more importantly, it’s what she saw that I didn’t see that made the tremendous impact on my life: she saw what I could be. 

And isn’t that a sign of the greatest life coach? Precisely. That is what Lisa has been to me since May 2017. The most unexpected blessing that fell upon my life and I am utterly grateful that this woman, wise beyond her years, so intuitive and remarkable, saw in me what I had lost sight of. 

In comes Kat. (Dr. Kathleen Vigo, Painless Pregnancy) I had no idea what this woman would do for me when I first met her. Even after learning extensively about the amazing work she does in physical therapy with her pregnant and post partum patients, and after recommending her to a dozen of my clients in a year, I still remained so blissfully unaware and unknowing of how powerful her work is.

Who could have possibly predicted that this soulful, stunning individual would come to my home for a 9 month follow up (following our previous physical therapy sessions), literally 10 days before giving birth to her daughter, and heal me of six years of trauma?! I didn’t even know until the night before my daughter's 3rd birthday, barely one month after Kat's visit, when I revisited the slideshow I had made of cell phone pictures from my second child's birth and realized - I was no longer feeling the Pandora's box of the negative range of emotions I have been feeling for the past 6 years of motherhood. Instead, I was feeling gratitude, relief, joy, self-awareness; I felt as though I was for the first time in six long years that had been riddled with emotional trauma from two very off-course labor and birth experiences, instead I was suddenly feeling ONLY full of joy for the first time ever. I shocked myself.

But instantly I was in doubt. The 60mph thoughts racing through my head distracted me from realizing this was all Kat's work from a couple weeks back. I started to doubt and ask myself would I still be as passionate about my work now that my trauma had vanished? I had always thought the foundation for why I was passionate about my career was because I was holding onto two traumatic births.

Then I wondered, would all these positive feelings go away after this celebration of the third year of life for my baby girl passed?

I waited and waited, but saw that none of this came to fruition.

My life had changed.

My perspective had changed.

My heart and soul had healed.

So when Kat went into labor with her second child, there was no doubt in my mind that I would have to give it my all to be present in this moment for her. In a room with two women who had completely changed my life, who had empowered me to become the best version of myself. With one of my favorite OBGYNs in south Florida, Dr. Feldman (of Omega Women's Care). 

The pictures above show a story of what happens when a birth photographer puts their camera down. In the first moment, Kat reached out for me to hold her hand during a contraction while her most amazing doula, Lisa Raynor supported her with affirmations and physical support. And in the second moment I was waiting to receive her placenta to help package it for transport. These pictures show why my relationships with my clients mean everything to me in my work. It is a realization and transformation of the artist unraveling, that it may have been my experiences with my daughters in the form of emotional trauma that inspired me to change what purpose I did my work for, but it is my relationships with my clients that is why I continue to work in this most fulfilling field of supporting women through their pregnancies and births as their birth story artist. 

Evolution Yoga & How it has begun to create a mama tribe

I just joined Evolution Yoga (in Coconut Creek off of 441 just south of Hillsboro Blvd). There are a few studios in Coral Springs and I spent a few days testing out classes in each but ultimately this is the one I felt most connected to. 

Jennifer Radnay, labor doula and yoga instructor

One day after class I ran into Jennifer Radnay (who is an incredible labor doula as well as prenatal yoga instructor). I also ran into Dr. Kathleen Vigo -- my dearest friend, she is an obstetric physical therapist -- which means she only works with expecting and post partum mommies! (I am also capturing her baby girl's birth in the next couple of weeks!) It was a very surprising and beautiful day! 

I learned that every Tuesday at 1030am Jennifer teaches a prenatal yoga class at Evolution Yoga off of 441 in Coconut Creek. I had just finished a hot yoga session there with yogi Maxine Schwartz and I decided to stay for the prenatal yoga class to create my own opinion of the class before recommending it to other mamas, so that I could say that I really tried it and it is amazing. I really love that the class started off with Jennifer giving out positive affirmations printed on papers, each mama chose the ones that spoke most to her, I even found two that spoke to me as a mommy who gave birth nearly 3 years ago, and we went around in a circle and shared the positive affirmations out loud which really made the mood in the room peaceful and positive before the yoga practice. 

My favorite part of the class was when Jennifer came around to each mommy and helped correct her position for the ultimate stretch and comfort sinking into it. I wasn't really expecting this in a prenatal class, or I guess I don't know what I was expecting! I didn't realize it would be so personalized and connected, it really made me feel like I was doing the best thing for my body, not just attending a class where I was just another attendee.

The different yoga positions allowed for using foam blocks/blankets when pregnant, or doing them without the extra items for more of a challenge. When I left the class I really felt like it challenged me, and the pregnant mommies all said they felt really relaxed. It was a beautiful class filled with so much positive emotion and positive energy that I ended up tearing up as we were all saying goodbye until next Tuesday. 

This experience was so amazing I wanted to share it with you all, even if you pop in for one class to try it out, I think you'd leave feeling the same way as we all did. I do not get any sort of referral credit for bringing in mommies, I simply wanted to share the love with you all! And the exciting part is that the studio is doing 30 days for $30 right now, which is the reason I signed up, and plan on going every day. I missed one day because I had a birth client in the hospital, but today I was back at 12pm with a class with Tresa Anderson which was the exact level of intensity I needed to heal my body from all the energy and tension that tends to build up when you're a birth worker. (Thank you Tresa!!)

If anyone would like to go on Tuesday next week, July 24th, at 1030am (thats July 24th) just pop me and email and I'd be happy to accompany you so you don't have to go alone :) 

This is also a really wonderful opportunity for mommies to build their mommy tribe for their pregnancy and their post partum. Meet other mommies who are going through exactly what you are and can relate to you and support you in your journey.

MOMMY & BABY YOGA

with Jennifer Radnay

This is a new class coming July 27th at 11am, also taught by Jennifer (who has a great deal of experience working with post partum, healing mommies (both emotionally and physically healing) and she is bringing this class starting that Friday morning. I would be happy to join you all too! I am curious to see for myself :) All babies between the ages of 6 weeks - 12 months are welcome! 

Sending all my love to each and everyone of you! 

Beautiful Mom of Twin Girls Expecting a Baby Boy

I remember how Dayna and I met. It's not the way I use to meet mommy clients four years ago, and that's why I love it. It made me reflect on how we evolve as women and as mothers and I wanted to share the entire story behind it with you.

I have been a birth photographer for four years, and I could not even imagine 4 years ago how my career would unravel as my daughters grew and as I delve deeper into the birth world as a birth worker.

Dayna and I met through our local community, our girls (her twins and my almost 6 year old) spent the past year going to VPK together in the best preschool at Kids Academy in Coral Springs, FL. One of her girls and my daughter Kate were in ballet the entire year, and her other day and my niece were in the same VPK classroom together. Through the year we got to know each other as mamas in the same community and build a relationship that I had never imagined I could have with moms! As my girls grew and I changed everything about the way I ran my business, the way I approached our lives as a family of four, I began to develop relationships just like with Dayna, with other birth clients. Dayna was one of my last birth clients before I made the huge leaps and changes that have grown my community and my work to the beautiful, organic, living vessel that it is today.

Three and four years ago, to find birth clients, I'd post my photos on facebook as much as possible, with a 2 year old toddler at home. I rarely had the chance to blog. I rarely had the chance for anything because I had a toddler at home and was a work from home mommy! 

I didn't know my community very well. I had made some mommy friends going to the playgrounds, parks and south Florida beaches with my daughter Kate, but I was so new to the field of birth that I didn't know many doulas or midwives, obgyns or labor and delivery nurses at all. I was just starting to dip my feet into the birth world.

Fast forward four years, so much has changed and I have evolved.

About a year and a half ago, I realized that birth was really my passion.

I also realized I was very overwhelmed.

Trying to balance (keyword trying!!) motherhood to two kids under 5 years old as a stay at home mom, run a household, AND run a full time photography business was leaving me really overwhelmed. 

About one year ago I realized what I had to do. I met Lisa Raynor, my dearest friend and doula here in Coral Springs and in Boca Raton, and she helped me with the final push to bring my career goals to fruition. She told me to try out full time preschool.

I was so nervous about this. I was juggling being a full time stay at home mom to two young kids, a full time job, all my maternity, breastfeeding, newborn and family photography clients in addition to my birth clients, my marriage, my home, and I was so nervous how we would pull off putting two young kids in full time preschool. How could we afford it?

That's when all the big changes fell directly into place.

Let me tell you, it was terrifying.

Change #1: 

I put both of the girls in full time preschool.

It didn't happen over night. I started with only VPK hours for Kate from 9-12pm and Emma was going two days a week from 9am-12pm. Slowly I started adding hours, and then days. By the end of three months, both of my girls were attending preschool from 830am-5pm five days a week.

I cannot tell you how much guilt this brought me. Having been a stay at home mom for almost 5 years while juggling a work from home business, I felt SO guilty that I was putting my kids in full time school. So many mommies can do it both, I told myself. I am so embarrassed and ashamed that I am saying I can't do it, I don't want to do it. 

Over the next 6 - 12 months I would start a healing journey to learn to not compare myself to other mothers, what they do, what their approach towards life and parenting is, and what their life looks like. I would learn that it's not my business to worry about what other mothers and women are capable of, it is only of importance for me to focus on what I want out of my life journey.

Change #2:

I gave up all photo sessions besides birth photography.

This was an absolutely terrifying leap of faith.

Family photo sessions, Maternity and Newborn Photography, and Breastfeeding photoshoots consisted of 50% of my years earnings. 

You might be thinking "and she gave it all up?"

Trust me, I WAS THINKING IT.

Let me tell you why I did this change in my life. I decided that if I was going to be paying for two children to go to full time preschool every week, all of those hours at home while they were at school would be dedicated to focusing 110% on my birth clients and my birth photography and birth films. This is after all, my passion, I realized. And the investment I make on the BEST preschool in Coral Springs needs to pay off on me investing all of my time and energy into growing my relationships with my birth clients everyday, every week, every month.

Trust me, I still love all the other sessions I use to do. And it broke my heart when I had so many families reaching out to me after I had slowly started my transition, asking for family sessions, breastfeeding sessions, and I had to turn them away and recommend one of my colleagues.

But as the weeks and months passed, I started realizing that I had made the best decision I ever could have. I went from juggling 120 families every 12 months to working intimately with 24 families. I got to really know every single birth family I was working with, I would remember hubby's name as I walked into labor and delivery. I'd remember that older brother was about to turn 3 years old next month. I'd remember that they just got a new puppy. These details (and many more intimate details ranging from fertility issues, loss, difficult pregnancies) became so vital to me to learn and remember. I realized in the past year that my true passion is not necessarily in birth photography. Rather my true passion is supporting, educating and empowering the women I work with, and building my relationship with them.

The change I had implemented thrust my business into a whole different world that I had never known before. I started having more time to dedicate to things I had never had a chance to even do. I started blogging. I LOVE writing. I've been a writer since I was in elementary school, I wrote my first book when I was 8. Being able to pour my soul into something I am so passionate about made my career so much more dynamic and fulfilling.

I finally had the time to network.

I have met so many absolutely phenomenal astonishing individuals in my community in the past twelve months, I did not even know these incredible human beings and specialists in the birth world existed, and now I have such an esteemed honor of calling them my friends. In the past 12 months I have deepened my relationship with Lisa Raynor, my doula soul sister, I met Martha Lerner, owner of Zenmamalove.com who my maternity/newborn/family photo clients from the past had boasted about for years, I got to meet the most amazing expert in the fertility world, Dr. Scott Roseff of IVFMD, who has a heart of gold by the way and works so closely with women and their partners/spouses to build healthy new families.

I had the privilege of building a close relationship with my favorite birth providers in the birth world ranging from Nurse midwives to OBGYNS to licensed midwives. I learned about baby nurses and how crucial they are to the family in the 4th trimester through meeting and growing close friendship with Mercedes Cabrisas, owner of South Florida Baby Nurse and Jennifer Shapiro, owner of Blissful Baby Nurse and Newborn Services.

I met Jackie Polsky, of South Florida Psychologist Associates, specializing in the post partum mama, Natasha Chamely, owner of Baby Love Spa  in Margate, FL, it was such a pleasure to meet and become friends with the amazing Susan Winograd, who owns Pelvic Rehab.com and works closely with post partum mommies and the entire family, as well as Dr. Moshe Winograd, who is a phenomenal post partum and loss psychologist at Coastal Behavioral Health, and became friends with Carly Tokar (Tokar Family Chiropractic) and Gena Bofshever (Dr. Gena Chiropractor). I got to experience first hand chiropractic care through Dr. Elaina Gill, post partum physical therapy from the amazing Dr. Kathleen Vigo of Painless Pregnancy, and Laura Knecht of Good Little Sleeperzzz helped my toddler and now almost 6 year old finally get on the right routine for a proper bedtime (south Florida's BEST pediatric sleep consultant!)

I've also had the immense opportunity to work with the amazing doulas at the Orchid's Nest, the phenomenal labor and delivery staff at Boca Raton Regional Hospital. I had the pleasure of meeting and growing a wonderful partnership with the OBGYN team at Omega Women's Care. 

It's just been an unreal year.

I cannot believe that my closest friends are all in the same birth world that once was a lonely place, now is filled with the same amazing faces I see but in and outside of work. 

Questions to ask an OBGYN or Midwife in Boca Raton for your pregnancy, birth and postpartum

It is VITAL to make sure the OBGYN or Midwife you are hiring in Boca Raton to care for you and your unborn baby during your pregnancy as well as be the most supportive and experienced medical care provider for you during your birth is the right OBGYN or Midwife for you, it is VITAL to ask questions that are important to you during your first consultation or if you already hired the provider, questions to ask during your first, second and third trimester of pregnancy.

Below you'll find a list of questions to ask an OBGYN or Midwife in Boca Raton during your prenatal visits (if you have already hired them) or at your very first visit or consultation appointment if you are still researching who the best OBGYNS are in Boca Raton and interviewing them.

You'll also find a list of questions to ask your OBGYN in Boca Raton when you're in your third trimester. 

You can print this list by going to File > Print

QUESTIONS TO ASK YOUR BOCA RATON OBGYN OR MIDWIFE

INITIAL CONSULTATIONS / INTERVIEWS

1. To Yourself: Do you feel supported and respected by this OBGYN during your initial visit / interview? Does this OBGYN listen and answer your questions patiently or are is this OBGYN or Midwife suggesting holding off on your questions until you’re officially under their care or until you are closer to giving birth?

2. Is this OBGYN open to birth plans? What if instead of calling it a “Birth Plan” you have a birth preferences list?

3. What hospitals does this OBGYN have privileges to deliver at? And What is their opinion of the various labor and delivery units if the doctor has privileges are more than one hospital?

4. How many vaginal checks does the OBGYN do during pregnancy and during labor? Should I get routine vaginal checks starting at 37 weeks of my pregnancy, how necessary are vaginal checks or can I opt out? What are the benefits/downsides and when do I need to have them done?

5. Under what circumstances during pregnancy would the OBGYN recommend an induction? How can an induction affect the outcome of my birth (vaginal / cesarean) What type of inductions do you do? (foley balloon, pitocin, cytotech, cervidil) you want to know which induction method the OBGYN uses most often and what they recommend and what the doctor sees as potential downsides of certain induction methods. What percentage of your patients does this doctor induce on or before their due date?

6. What is the OBGYNs' opinion of Birth Doulas? What percentage of the doctor’s patients use a doula? What doulas does the OBGYN recommend?

7. Under what circumstances during labor would you recommend to administer medications such as cervidil or pitocin?

8. How do you handle past due dates? (Over 40 weeks, over 41 weeks)

9. What is your percentage of your patients get an epidural, What percentage have vaginal births? / percentage of c-sections? Under what circumstances during pregnancy would you recommend a scheduled cesarean?

10. Who is your backup Midwife or OBGYN? Who is the OBGYN covering doctor? How is he/she during labor? When can I meet them? What is your opinion of the Hospitalists at the hospital you have privileges at (if the hospital you are choosing for your birth uses Hospitalists) and under what circumstances would I be delivered by one of the Hospitalists instead of you?

11. How do you handle delayed cord clamping? How long do you delay for? Under 1 minute or over 1 minute? Do you do cord blood banking AND delayed cord clamping?

12. Are you planning any vacations, trips, major surgeries, or other events 3-4 weeks before my due date, or up to 2 weeks after my due date that would interfere with your attendance at the birth? If after we are working together you end up scheduling a vacation or trip around my due date, can I request to be notified?

13. What positions do you feel comfortable delivering in? (on back, squatting (using a squat bar), on all fours (knees and elbows)?

14. Is your practice VBAC friendly? (Vaginal Birth after a C-section) If not, please give your medically backed reasons why.

15. What is your policy on breech pregnancies (babies who are not head down in the third trimester)? Do you support doing a version at the hospital and then continuing the pregnancy in hopes of a vaginal delivery? If not, please give your medically backed reasons why.

Questions to ask when you are approaching the third trimester of pregnancy

1. What are your feelings on the dad catching the baby, or me catching my own baby? Will you deliver the baby? Or will you assist me in birthing him/her/them?

2. How do you feel about hypnobirthing? Are you experienced with delivering babies for moms who are using hypnobirthing?

3. How does it work if I am GBS positive - how often do you administer antibiotics during labor and do you do specific procedures with the baby after birth

3b. Are there other options to drinking the orange drink for the gestational diabetes test? Such as eating jelly beans or drinking orange juice?

4. Do you do IV/Heplock? Are you ok with laboring tubs, (or hydrotherapy by standing in the hospital shower), eating small snacks during labor? What if the hospital I am delivering at does not have a good record of supporting laboring tubs or other birth preferences of mine, will you be supportive of me changing to another birthing facility?

5. What are the pros and cons of vitamin K shot and eye ointment

6. Do you offer or suggest taking specific childbirth preparation courses? What classes do you recommend?

7. During labor, how close together should my contractions be before I head to the hospital?

8. If my water breaks before labor (contractions) even begins, how long can I labor at home for before I am required to go to the hospital?

9. What happens in the event of pre-term labor before 38 weeks?

10. Under what circumstances, if any, do you perform episiotomies? How many episiotomies have you performed in the last 2 years? Do you recommend doing perineum massages throughout pregnancy leading up to birth?

11. How early do you arrive to the hospital (when I am 9 or 10cm or earlier if I request?) How long will you and/or your support team stay with mom and baby after the birth?

12. Is breastfeeding support offered by your practice or do I need to rely solely on the nurses / lactation consultant at the hospital?

13. Do you deliver breech if my baby rotates into breech position during the end stages of active labor during transition? [Most babies will move into delivery position a few weeks prior to birth, with the head moving closer to the birth canal. When this fails to happen, the baby's buttocks and/or feet will be positioned to be delivered first. This is referred to as “breech presentation.”] Do you recommend trying to turn the baby if the baby is in breech position during labor or in the last few weeks of pregnancy or do you recommend a cesarean birth?

Why Every Pregnant Woman should consider a Midwife for her Birth

The first time I attended a hospital birth with a midwife I was very surprised what I saw. I had attended so many births with OBGYNs that I almost wasn't sure what a Midwife does.

Midwife Christine Hackshaw of Midwifery Women's Care, applying pressure to first time mom Emily's lower back during a contraction.

Last March, I hosted a "Match Your Midwife" event at the Women's Center at Boca Raton Regional Hospital. Midwife Courtney McMillian from Boca Midwifery spoke about the different kinds of midwives that there are.

For hospital births, there are two types of midwives:

Nurse-midwives, who are educated and licensed as nurses first, then complete additional education in midwifery. They are known as Certified Nurse-Midwives (CNMs). CNMs are licensed to practice in all 50 states. They are usually licensed in individual states as Nurse Practitioners (NPs).(source) 

The other type of midwife is known as a Direct-entry midwife. They are educated or trained as midwives without having to become nurses first. They may be Certified Professional Midwives (CPMs) or Certified Midwives (CMs). (source) 

Direct-entry midwives are trained to provide the Midwives Model of Care to healthy women and newborns primarily in out-of-hospital settings. They do not have nursing education as a prerequisite for midwifery education. (source)

Certified Midwife (CM): Certified Midwives are individuals who have or receive a background in a health related field other than nursing, then graduate from a masters level midwifery education program. They have similar training to CNMs, conform to the same standards as CNMs, but are not required to have the nursing component.

Certified Professional Midwife (CPM): The vast majority of direct-entry midwives in the United States are Certified Professional Midwives. The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings. Their education and clinical training focuses on providing midwifery model care in homes and freestanding birth centers. In some states, CPMs may also practice in clinics and doctors offices providing well-woman and maternity care.

What I learned and observed at my very first birth with a midwife was that most women who choose a midwife for their prenatal care, labor and delivery are looking to have a less medical intervention approach to their entire prenatal and birthing experience.

Midwives generally work with low risk pregnancies, but they also can serve as a woman's gynecologist. As an example, I see a midwife as my gynecologist. Midwives also work with their patients regarding family planning, monitoring pregnancy, labor and delivery, postpartum and newborn care. But they do so much more than that. Many of our local midwives in Boca Raton in addition to obstetrics and gynecology, also care for women in the fields of menopause, adolescence and teenager care.

At births, often times I will see a midwife help with the delivery of baby for mom, help with the delivery of the placenta, the cutting of the cord and any stitches mom may need in the case of tearing, and then help mom get baby latched on for breastfeeding.

What I have seen from the distance as a birth photographer on my client's birth team, sometimes in the case that a pregnancy (or a labor) may become high-risk, an OBGYN who works closely with the midwife will step in to assist with prenatal care or in the case of birth, to assist in the delivery of the baby. However, depending on the practice, I have seen midwives (such as Midwifery Women's Care and Boca Midwifery) successfully helping mommies with vbacs (vaginal birth after c-section) and I even recently attended a vba2c (vaginal birth after two c-sections) with Courtney McMillian at Boca Midwifery. 

In the case of a cesarean section, OB doctors will step in to do the surgery. What I personally have loved about working with Boca Midwifery when it comes to a mom needing a c-section is that their midwives tend to attend the csections in the operating room for their own patients who they have seen throughout their pregnancy who may have become high-risk due to a developed medical issue in pregnancy, or if they needed a cesarean during labor. For me this is everything. I am a huge proponent of supporting birthing women in all stages of their journey, and to have the midwife who you've trusted your entire pregnancy journey, go with you into the operating room when your birth unexpectedly calls for it, means everything. So much fear fades and so much trust grows in its place. 

When working with an OBGYN, I have personally experienced them typically heading to the hospital (they are usually about 5-15 minutes from the hospital here in Boca Raton) when the nurses update them that the mom is around 8 - 9 centimeters dilated. They usually arrive and wait for mom to get to 10 centimeters dilated and then help mom with pushing. I have seen this common practice at most hospitals throughout south Florida from Miramar/Pembroke Pines all the way through Jupiter, FL. Even in the case where generations of women have used a specific OB (mom, daughter), I cannot recall a single birth in one month shy of four years of birth photography where an OBGYN came and sat with a mom for 4-6 hours of her active labor prior to delivery, (with the exception of retired OBGYNS who are the fathers of my laboring client, attending their birth as a support part of their birth team, not as the delivering OB).

And so why does this matter, when your provider gets to your laboring? Read on...

Many first time moms (and even second and third time moms) will be in labor anywhere from 10 - 24 hours). And you only get to 10 centimeters dilated at the very tail end of that labor process. The first few hours may be manageable, but once things pick up, many women find themselves needing pain management techniques as well as someone to keep them focused, empowered and encouraged.

So it is not ideal to only rely on your OBGYN and labor and delivery nurses for support and encouragement, as they will not be spending 90% of your earlier labor with you. I do not say that to dissuade you from using an OBGYN for pregnancy and delivery though. As there are many benefits and pros of using and staying with an OBGYN. I personally used an OBGYN for the first 20 weeks of my second pregnancy (Dr. Jane Rudolph from Women's Health Partners off of SW 18th Street in Boca Raton, FL) and I absolutely adored every waking minute of my time spent during prenatal visits with her. She was patient, kind, incredibly sweet and warm and compassionate. She'd take the time to ask about my questions and concerns and go through them all. She spoke to me on a personal level about her own kids and pregnancy journeys. She'd end every visit with an exceptionally warm and tight hug. I trusted her completely and felt so warm and safe under her care. And staying under that type of care for a woman's entire pregnancy is definitely an incredible plus. However, it is important to consider what is your individual need for labor support. For women who know they will need a professional who is well educated on pregnancy, labor, birth and post partum to be at their side through labor, who will not have to run off because they are working with other patients (as labor and delivery nurses are often called to do), a highly hospital natural birth experienced labor doula maybe an important consideration. I encourage moms to make a list of their personal needs and expectations for their pregnancy, their labor, their post partum, and evaluate if a labor doula, a midwife, a post partum doula or a registered baby nurse could fit in those needs.

In contrast, in my personal experience having worked with a few hospital midwives, I have witnessed midwives from Boca Midwifery (Courtney McMillian and Polina Goldenberg) and Laurie Gibbons from Women's Health Partners, Kathy Fair and Christine Hackshaw from Midwifery Women's Care and Kathleen Philbin from Select Women's Healthcare sitting for hours with mom, often times on the foot of her bed, sharing positive words of support, advice on how to breathe through contractions, suggestions on position changes to alleviate some pressure / getting baby in a better position, and I have often times seen these midwives provide touch-support to mom. Touch support I would say can range anywhere from applying pressure to the hips or lower back during contractions to running fingers along mom's arms and shoulders along with light pressure for a soft massage. And even applying cold compresses to mom's neck and forehead. This form of extensive support during active labor and end stages of labor can be so crucial and encouraging to laboring moms. 

(all of the above midwives deliver at Boca Raton Regional Hospital in Boca Raton, FL (off of I-95 and Glades Road in East Boca) which is my favorite hospital to work in as a birth photographer but also as a mother with the exception of Kathleen Philbin who works up north at Good Samaritan Medical Center in West Palm Beach, FL) 

Below, you'll find a list of questions to ask a midwife or OBGYN during your first consultation with them to make sure they are the right provider to suit your personal needs and expectations, as well as questions to ask closer to the third trimester. If you'd like to go to a page where you can more easily print them, click here.

MIDWIFE/OBGYN CONSULTATION INTERVIEW QUESTIONS

INITIAL CONSULTATION

1. To Yourself: Do you feel supported, respected, do they listen and answer your questions patiently?

2. Are they open to birth plans? What if you have a birth preferences list?

3. What hospitals do they have privileges at?

4. How many vaginal checks do they do during pregnancy and during labor? Should I get them, how necessary are they, what are the benefits/downsides and when do I need to have them done?

5. Under what circumstances during pregnancy would you recommend an induction? How can an induction affect the outcome of my birth (vaginal / cesarean) What type of inductions do you do?

6. What is your opinion of doulas? What percentage of your patients use a doula? What doulas do you recommend?

7. Under what circumstances during labor would you recommend to administer medications such as cervidil or pitocin?

8. How do you handle past due dates? (Over 40 weeks, over 41 weeks)

9. What is your percentage of your patients get an epidural, What percentage have vaginal births? / percentage of c-sections? Under what circumstances during pregnancy would you recommend a scheduled cesarean?

10. Who is your backup Midwife or OB? Who is the OB covering doctor? How is he/she during labor? When can I meet them?

11. What are your feelings about delayed cord clamping? How long do you delay for? Can you do cord blood banking AND delayed cord clamping?

12. Are you planning any vacations, trips, major surgeries, or other events 3-4 weeks before my due date, or up to 2 weeks after my due date that would interfere with your attendance at the birth?

What positions do you feel comfortable delivering in? (on back, squatting (using a squat bar), on all fours (knees and elbows)?

13. Is your practice VBAC friendly?

CLOSER TO THIRD TRIMESTER

1. What are your feelings on the dad catching the baby, or me catching my own baby? Will you deliver the baby? Or will you assist me in birthing him/her/them?

2. How do you feel about hypnobirthing? Are you experienced with delivering babies for moms who are using hypnobirthing?

3. How does it work if I am GBS positive - how often do you administer antibiotics during labor and do you do specific procedures with the baby after birth

4. Do you do IV/Heplock? Are you ok with laboring tubs, (or hydrotherapy by standing in the hospital shower), eating small snacks during labor?

5. What are the pros and cons of vitamin K shot and eye ointment

6. Do you offer or suggest taking specific childbirth preparation courses?

7. During labor, how close together should my contractions be before I head to the hospital?

8. If my water breaks before labor (contractions) even begins, how long can I labor at home for before I am required to go to the hospital?

9. What happens in the event of pre-term labor before 38 weeks?

10. Under what circumstances, if any, do you perform episiotomies? Do you recommend doing perineum massages throughout pregnancy leading up to birth?

11. How long will you and/or your support team stay with mom and baby after the birth?

12. Is breastfeeding support offered?

13. Do you deliver breech? [Most babies will move into delivery position a few weeks prior to birth, with the head moving closer to the birth canal. When this fails to happen, the baby's buttocks and/or feet will be positioned to be delivered first. This is referred to as “breech presentation.”] Do you recommend trying to turn the baby if the baby is in breech position during labor or in the last few weeks of pregnancy or do you recommend a cesarean birth?

Stunning VBAC Birth in Boca Raton: Midwife Delivers Baby After Two C-Sections

Words from the mama: 

“I am still in shock and awe at what God can do. My pregnancies have been very difficult, from Aaden's loss to complications with Brooklyn's birth (both ending in c-sections). I always dreamed of having a VBAC, a birth without complications, where I could just enjoy my baby. This was it. Having the support of Boca Midwifery made all the difference."

“Everyone was patient with me and my concerns and considered my history. I couldn't ask for more. I had the best support and birth team I could ask for. Everyone was patient with me and my concerns and considered my history. They truly listened to my fears and desires for this birth. Having a midwife and doula who understood my previous c-sections and supported my VBAC journey was so important. I couldn't ask for more. Thank you to Lisa Raynor, my doula, Courtney McMillian, my midwife at Boca Midwifery, Paulina Splechta, my birth photographer and filmmaker, and of course my husband, David. I literally could not have labored nor survived this pregnancy without you."   - Jocelyn

When I first met Jocelyn, I felt an instant connection. Hearing about her previous c-sections really resonated with me and learning of the heartbreaking loss of her baby, Aaden, forged a deep connection between us.

I understood her journey on a personal level, having experienced two unplanned cesareans myself with my babies and neither of my births went as planned.

But Jocelyn had something I didn't: an incredible birth team that included a midwife, doula, and her birth photographer. Seeing the support she had from Boca Midwifery, I was excited to see how her labor would unfold. But I was also a little nervous for her, admittedly, and felt like we all needed to pray together that this mama would be able to experience a healing VBAC after her loss.

I was so excited for her to experience a VBAC and to meet and hold her baby immediately, and I knew it in my heart that this could only happen with Boca Midwifery. They understood her medical history and they cared for her the entire pregnancy, but it was a delicate journey Jocelyn had been on, from experiencing the loss of one of her children and complications with her daughter Brooklyn's birth, and I was anxious to witness the birth of baby Riley. I didn't know if we would witness her having a vaginal delivery or if we would have to go into the operating room. I feel the entire labor and delivery staff was rooting her on at Toppel Family Place (The labor and delivery unit of Boca Raton Regional Hospital in East Boca [off of Glades Road, just east of I-95]). 

A lot of birth workers uncover a deep passion for their work due to their own emotional and personal history, and with me, it is completely true. Originally, I wanted to test the waters four years ago when I photographed my first birth. But once I captured that birth for my client, I knew this is where my heart belongs and its become so much more than photography over the last four years. 

In all this time, four years, I had never witnessed a vaginal delivery after TWO CESAREANS. I had attended many VBACs (vaginal delivery after cesarean) with Boca Midwifery, Women's Health Partners, Dr. Skeete down in Ft Lauderdale, and vbac home births with midwives Gelena Hinkley, Sandy Lo, Mary Harris. But I had in all this time never seen a mommy successful deliver a baby vaginally after having two previous c-sections. And the reason I haven't before seen a vbac after two c-sections is not entirely that the trial for a vbac after two csections failed with previous clients. It's not that at all.

Pros & Cons of VBAC

Many people question the safety of VBAC, but reading through legitimate, backed medical research (such as mayo clinic, cleveland clinic, and going just straight to the National Institute of Health and combing through the latest VBAC research studies, you will see that is merely a myth, and so it begs for us to discuss the pros and cons of VBAC. I do hear a lot of people saying why would you want to go through a vaginal birth if you could just schedule a smooth and calculated repeat c-section.

I will urge you to pause and view this interview I did with Dr. David Lubetkin, who partners with Midwives Courtney, Nikki and Ryan at Boca Midwifery, where I ask him about the pros and cons of VBAC. I think if you are a mom in south Florida and you’ve had a c-section before, and would like to know whether you qualify for a Vaginal Delivery with your next pregnancy after your previous C-section, it’s good to hear from the OBGYN who’s practice has the highest success rate of VBAC in Palm Beach County and Boca Raton:

It's that often times the mommys who have had two csections stay with their provider who automatically schedules a repeat third csection for them with their third delivery. These moms are simply not aware of the option to try for a vbac after two c-sections. No one has even told them that its physically possible to achieve. And what the benefits to having a vbac are instead of scheduling a repeat cesarean. Most of the vbacs I have documented in my four years as a birth photographer here in south Florida have been moms who had a c-section with a practice (sometimes traumatic, physically or on an emotional level) and change practices, hoping for a more positive, empowered and supported experience for their subsequent pregnancy to a practice heavily experienced in achieving safe and successful VBACs. Many of my VBAC birth clients with Boca Midwifery have exactly this story. 

As Jocelyn's entire birth team stood around her during her final pushes, I thought to myself, "this is happening, this mama is going to meet her baby right now"

I felt the tears begin to swell up in my eyes, I tried to hush them and focus on capturing this incredible moment. I stood near mom's shoulders, making sure that her midwife was blocking any angles that would prevent Jocelyn from being able to share photos from her birth story with her family and friends, I looked up at Jocelyn and her husband David, they were smiling at each other, at their doula and midwife, at me. Their doula, Lisa Raynor, was proudly beaming a smile back at them and at me. Baby nurse Donna was eagerly waiting to meet their sweet baby, also wearing a proud smile for mama. Her midwife, Courtney McMillian, was focused and positive and their nurse Peggy knew this moment was about to happen.

This moment would contribute to the shift in the change of the world's view of birth. A successful vbac after two cesareans for Boca Midwifery, for the labor and delivery staff at Boca Raton Regional Hospital, but most importantly, a footprint in the history of birthing women, showing them, that with the right support and birth team for your pregnancy, skilled vbac professionals who have a great deal of patience and success rates, a vbac after two csections is possible.

Knowing this fact, it put chills on my back. 

Knowing that maybe someday, I too could experience a vbac, after my two unjust csections with previous providers and birth teams who had failed to support and encourage me in the ways I needed.

You can watch the film of the birth of Riley below:

Uploaded by Paulina Splechta on 2018-07-05.

Jocelyn's two-time cesarean scar and baby Riley's teensy feet

My Breastfeeding Journeys | It Goes By So Fast

Wow I haven't looked at this blog post in years.

I went back to it tonight as I was talking to one of my birth clients from December about her struggles with how freaking hard breastfeeding a baby can be in the beginning and I went back to this blog post to show her that it can get better...

But mannnn!

It all seems like a distant memory now... like I never breastfed! It's just been so long.

My younger one, Emma, weaned completely - shortly after she turned 1. We had to supplement a ton after she was 3-6 months because I almost completely was unable to produce a few months after she was born, but pushed to about 12, 13 months with her. Now she's 2 and a half and I totally feel like its all a distant memory.

Lasts such a short blink of the eye.

I feel for the mamas who can't. The ones who don't want to. The ones who fight really hard to.

It's the hardest thing ever. Not easy at all.

I have no regrets nursing Kate forever and barely even nursing Emma, just didn't have it in me after two hard pregnancies.

Click here for my breastfeeding journey with my daughters