The mothers have spoken, and the hospitals are listening.

As more and more expectant moms choose midwives during childbirth, both hospitals in Boca Raton are now offering that experience.

It’s part of the trend toward more natural parenting choices, beginning at, well, the very beginning.

And according to The New York Times, it’s also becoming a status symbol.

Midwife Christine Hackshaw, who attends births at both West Boca Medical Center and Boca Raton Regional Hospital, says moms are looking for a more personal touch in the delivery room.  A doctor may be in and out, but the midwife tends to stay with the patient, even through hours of labor.

“Midwives are more open to natural birth methods,” she said, helping the mothers choose how to deliver.

Their Ceasarean section rates are usually lower.

Hackshaw got into midwifery after working as a labor nurse and seeing things she wanted to change.

“I allow women to labor, I don’t rush them,” she said. “You don’t have to have Pitocin every single time. Your body can do this on its own. As long as you’ve got a healthy mom and a healthy baby, give her a chance.”

Midwives only work with uncomplicated cases. High-risk pregnancies stay with the obstetricians.

Midwives once attended mostly home births, but now most of them work in hospitals and even offer prenatal and gynecological care in doctors’ offices, Hackshaw said. Their services are usually covered by insurance.  She has been certified for 10 years – four years of training to become an RN and another two for a master’s degree – and is among three midwives in the practice of Drs. Birnbach, Lubetkin and Schey.

MORE ON MATERNITY

• Read more about maternity services at West Boca and Boca Raton Regional in the BocaParent blog.
• Download West Boca’s maternity tracker app
• Both hospitals get high ratings

- CHARLENE PACENTI

Amanda Nickerson, executive director of the International Breast Milk Project, with her two daughters.

An international charity that collects donated breast milk for sick infants in Africa and in NICUs across the United States is based right here in Boca Raton.

Executive Director Amanda Nickerson, a mom of two with a third on the way, runs the International Breast Milk Project, which delivered 11,000 ounces (2,375 bottles) of donor breast milk to South Africa just last month.

Moms all over the country – many of them champion pumpers whose babies cannot consume all the milk they have stowed in the freezer – are donating it, rather than pouring it down the drain.

For sick babies, it can be a life saver.

Twenty-five percent of the milk donated through the IBMP is earmarked for organizations in South Africa, where HIV is rampant – an orphanage in Durban and neonatal intensive care units in Cape Town hospitals.

Many babies who need donor breast milk are born preterm.

The region’s high HIV rate causes many complications for breastfeeding, chief among them that the virus can be transmitted through breast milk. Babies can be born preterm, before the mom’s milk comes in. Mothers may die of HIV/AIDS, soon after giving birth, or abandon a baby who has the virus. They end up on the Durban orphanage’s doorstep.

In Cape Town NICUs,  preterm babies born at 3 to 5 pounds, can be provided donor breast milk via a doctor’s prescription. For them, an exclusive diet of human milk, which is easier to digest, is their best chance of survival.

“These babies wouldn’t live without it,” Nickerson said. “It’s that extreme.”

The International Breast Milk Project started in 2006 with Jill Youse, a mom in Missouri who realized her daughter would never consume the freezer full of frozen breast milk she had pumped when she returned to work.

Tossing it seemed a waste, so she searched for a way to donate it.

She found the Durban orphanage, which was pleading for milk donations.

Youse formed a partnership with Prolacta Bioscience, a for-profit company, to process the milk for donation.

Once the project was featured on Oprah and the national news, Youse became overwhelmed and started looking for help. Nickerson, who was consulting for nonprofits after the birth of her second child, got involved as a milk donor, then as a volunteer. (She has worked with the Red Cross and the American Cancer Society in Miami). She took over as executive director of IBMP two years ago.

The IBMP’s partnership with Prolacta continues: After the 25 percent of the first 400,000 ounces of donated breast milk is processed for infants in South Africa and other countries in need, Prolacta uses the remaining 75 percent to make its fortifier for critically ill and premature infants, which it sells to in NICUs in the United States.

Prolacta donates a dollar to IBMP for every ounce of milk that remains in the United States, Nickerson said.  That money is used to support local milk banks in Africa, among other projects.

So far, IBMP has donated 288,682 ounces of milk to Africa, according to its website. The shipping company Quick International donates its service to keep the milk frozen and transported there.

As a for-profit company, Prolacta’s involvement with milk donations has its critics. But it’s a way for IBMP to  get its milk processed safely for transport, an expensive process.

“They do everything to ensure that it’s as safe as it could possibly be,” Nickerson said.

There are nonprofit milk banks around the country, but none in South Florida. One is under development in Orlando.

IBMP can take donations from anywhere. The rigorous application process starts online. All materials, storing and shipping supplies are sent to the donor’s door. FedEx picks it up.

In between, donors need doctor’s notes, a blood test – IBMP also sends a technician to the donor to do it – and more to be sure they qualify.

For Nickerson, it’s a way to do something good with the excess milk. And it doesn’t cost you a thing.

TO LEARN MORE

Get the details on milk donation and read more about IBMP’s work at its website

Follow IMP on Twitter @GiveMilk

- CHARLENE PACENTI

Keeping notes through your pregnancy and baby’s first year – from doctor’s appointments to labor pains to baby’s many “firsts” – can be maddening when you don’t even have time to shower most days.

But new features added to the mobile app from West Boca Medical Center make it easy to keep track of all that, as it happens.

The new maternity section of the app has a built-in journal, plus sections for noting the baby’s movement, mom’s contractions and at-your-fingertips info on the signs of labor.

There’s also a long list of baby names to mull over while you’re waiting for those doctor’s appointments, or you’re just too uncomfortable to leave the sofa.

The Baby’s First Year part of the app is also a convenient place to store all kinds of information, like immunization charts, eating charts and a growth tracker. It also has a place for recording “Baby’s Firsts” – likely to save anguish (weeks or months) later, as you sit down with that blank baby book trying to recall dates.

Also very helpful: a Diaper Bag Checklist, as well as a way to organize photos.

The app even plays lullabies.

Beyond the maternity section, you can also use the app to check ER wait times – and the let the hospital know you’re on the way, should the need arise.

The app is available for Apple’s iPhone, iPad and iTouch, as well as Android and Blackberry devices. It’s free.

Read more about it here.

LEARN MORE

• 3-Minute Guru: Pediatrician advises keeping kids’ medication info handy

A new report on maternity care gives five-star ratings to both Boca Raton area hospitals.

Healthgrades.com, a consumer website that helps patients find doctors, dentists and hospitals, gave its top rating to the maternity departments at West Boca Medical Center and Boca Raton Regional Hospital. It’s June 21 report, Trends in Women’s Health in American Hospitals, used three years of data (2008-10) from 19 states where hospital patient outcomes data are publically available. The 224 best‐performing hospitals, including Boca’s two, were designated as five stars.

The hospitals were evaluated on:

• Vaginal delivery maternal complication rates for single live deliveries
• C‐section delivery maternal complication rates for single live deliveries
• Overall volume and volume of low birth weight deliveries
• Risk‐adjusted infant mortality rates for single live deliveries

The report also notes that after a few years of increasing, the number of C-sections nationwide has been flat since 2009,  at 33 percent – although Florida is still among three states with the highest percentage of C-sections, compared to vaginal births, at 38.3 percent.

This may be the result of a nationwide push to eliminate induced labor or scheduled C-sections that are not medically necessary, according to the report.

Besides maternity care, the report made a startling find about women’s cardiovascular care: “Being a woman increased the likelihood of death in cardiovascular surgery and acute heart attacks
when compared to men.”

Cardiovascular disease is the No. 1 cause of death among women. That’s right – more than all forms of cancer, including breast cancer.

The report found:

• In 2010, only 39.5% of women who suffered a heart attack received a surgical intervention compared to 54.3% of all men.
• Among heart attack patients receiving an intervention, the mortality rate for women was 29.1% higher than for men.

Part of the problem: “Women’s heart attack symptoms are easily confused for many other conditions–both by women who may ignore symptoms and by the medical team treating them,” the report said.

Learn more about the symptoms and risk factors in the full report at Healthgrades.com.

MORE ON MATERNITY

Read all about the maternity departments at West Boca Medical Center and Boca Raton Regional Hospital in the BocaParent blog.

If you’re scheduling pre-camp or summer checkups for your tweens, chances are your pediatrician is going to talk to you about the HPV vaccine.

It helps prevent certain types of cancer that are caused by the human papillomavirus, including cervical, vulvar, vaginal, penile, anal, and some oral cancers, according to the Centers for Disease Control and Prevention.

Because HPV is spread through sexual contact, the ideal time to get the vaccine is before kids become sexually active.

Because vaccines of any nature have been the topic of much anxiety for parents, BocaParent talked to a local pediatric infectious disease specialist, Dr. Jose R. Mateo, about why we should consider this one – for girls and boys.

For him, it comes down to the severity of the disease the vaccine aims to prevent – in this case, cervical cancer, of which HPV is the main cause.

“It should be used in every adolescent because there is a lot to prevent here,” Mateo said.

Cervical cancer causes about 4,000 deaths in women each year in the United States, according to the CDC. There are about 15,000 HPV-associated cancers in the United States that may be prevented by vaccines each year in women.

Beyond that, the vaccine can also prevent some oral cancers in men – and genital warts. Mateo says billions are spent every year to treat genital warts, which can also be transmitted to babies during birth and cause serious respiratory problems.

The vaccine is underused, with about 32 percent of eligible girls getting it in 2010. Mateo attributes that to its newness and the fact that it isn’t required by schools or other organizations.

There are two HPV vaccines: Gardasil, approved in 2007, and Cervarix, approved in 2009. Mateo said there are no significant side effects with either. Gardasil protects against four strains of the virus and is the only one approved for use in boys.

Mateo said the HPV vaccine, which is not a live virus, is safe to get alongside the other immunizations required for entry into seventh-grade: Tetanus, Diphtheria, Pertussis and Meningococcal Conjugate.

Some insurers do cover Gardasil and Cervarix.

GETTING THE HPV

For girls and boys age 11-12, the CDC recommends three shots over six months.

Mateo recommends bringing the kids in well-hydrated and having them sit in the doctor’s office a few minutes after receiving any shots, to avoid any faintness.

LEARN MORE

The CDC website has more details.

Dr. Jose R. Mateo is in private practice in Boca Raton and Coral Springs and is affiliated with  West Boca Medical Center. You can reach him at 561-997-7686.

Find more on medical issues from local experts on our Kids’ Health page.

- CHARLENE PACENTI