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

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.

Photo courtesy Boca Raton Regional Hospital.

Whenever a baby is born at Boca Raton Regional Hospital, a lullaby plays over the intercom throughout the hospital, even in the outlying office buildings.

It’s an “aaaaaaaawwwww” moment that happens about 150 times a month.

The hospital’s Toppel Family Place is known for its mother-baby model of care, which supports keeping the two together as much as possible, under the care of a single nurse.

“We know that early bonding is really important,” said Karen Edlington, the hospital’s director of women’s & children’s services.

Even if a baby needs to spend some time in the neonatal intensive-care unit, hospital staff encourage the mother’s “kangaroo care” – holding the baby close – and breast-feeding.

The hospital offers a daily breastfeeding support group and 90 percent of patients do start breastfeeding. (A twice-a-week support group is free and open to the public, no matter where you gave birth). And the hospital calls new mothers to follow up after they have gone home.

“Early support is really important,” Edlington said.

Birth plans

Edlington said more women are looking to experience natural childbirth and a host of alternative birthing plans. Some women are choosing hynobirths, or to go through labor in a tub of water (many working through Amazing Births and Beyond).

Boca Regional also works with six midwives who practice with local obstetricians.

“We’ll support whatever kind of birth experience you want,” Edlington said. “It’s a privilege to be part of somebody’s birth.”

She is happy to conduct private tours or meet with parents-to-be to discuss birth plans.

An obstetrics-only anesthesiologist is available 24 hours a day. Two operating rooms are reserved for obstetrics.

NICU

Boca Regional is certified as a Level 2 NICU, with an in-house neonatologist and nurses that are all trained to Level 3.

If babies need surgery, are born before 28 weeks gestation, or weigh less than 1,000 grams, they are likely to be transferred to specialists at Joe DiMaggio Children’s Hospital in Hollywood or Miami Children’s Hospital.

Amenities

All rooms are private and decorated with homey touches – wooden headboards, armoires, nicely upholstered sofas and gliders. Some may share a bathroom if many of the rooms are occupied.

The hospital has wi-fi (and people are Skyping, Tweeting and Facebooking their births).

There’s a Daddy shower room.

Maternity patients can order food from a special menu.

There are no hard-and-fast visitation rules.

Classes

Besides breastfeeding support and child-birth classes, the hospital offers classes on infant CPR for the whole family; a class for siblings-to-be; prenatal yoga; baby signing and more.

Get descriptions of classes and more details on the hospital’s website.

To learn more

Maternity tours are 6 p.m. Wednesdays and 10 a.m. Saturdays. Call 561-955-3276 to register. The hospital is at 800 Meadows Rd. in east Boca.

Visit the hospital’s website.

• Read about West Boca Medical Center’s maternity services in a previous post.

- CHARLENE PACENTI

So, your kid has a broken arm. Maybe. You’re not quite sure. It seems to hurt a lot, but you can’t really tell if it’s swollen.

What do you do? And where do you go for help?

Emergency room? Pediatrician? Orthopedist?

BocaParent checked with a couple of local experts for some guidance.

(Of course, if an arm, leg, or any other bone is obviously broken, get to the nearest emergency room or call 911 for a severe injury.)

In other cases, it can be trickier.

Margaret Neddo, emergency department director at West Boca Medical Center, said children can often sustain more pain than adults, and their bones aren’t as hard as ours. So a bone break may not be as obvious.

The child may be able to move it at first and may not have swelling initially. It might get worse the next day.

It’s always best to get it checked out, said Neddo, a mom of three. “For me, it is about peace of mind.”

West Boca Medical Center has a pediatric emergency department, which sees about 30 kids a day, and has the area’s only pediatric orthopedist,
Dr. Kenneth Jeffers.

How a broken bone is treated in the West Boca ER depends on the nature of the break. For a simple case, a child can get X-rayed, get a cast and you can be on your way. For a more serious break, the orthopedist will need to weigh in. Doctors are particularly concerned about breaks near a  growth plate in the arm, knee or ankle – and that’s why it’s good to see a pediatric orthopedist, if possible, Neddo said.

If the injury is severe or requires surgery, the child will be admitted to the hospital. If he has a lot of swelling, it may only be splinted in the ER. Then you’ll need to see an orthopedist a day or two later for a cast.

West Boca also has a new call-ahead service for non-life-threatening injuries that allow you to reserve a time to come in and cut out some of the ER wait time.

Boca Raton Regional Hospital in East Boca doesn’t have a pediatric department, but they do treat children in the emergency room. They don’t, however, do casts.

If you go in with a suspected break, they will do the X-ray, splint it and refer you to an orthopedist.

For minor injuries, or if you’re just not sure what to do, you may start with your pediatrician. If he feels an X-ray is in order, he may send you to the ER or, during regular hours, a walk-in X-ray facility. Once a break is confirmed, you still may end up in the ER, or be sent to an orthopedist. If you cannot get in to see Jeffers, you will likely be referred to other practices in Broward.

No one we spoke to could say why there is only one pediatric orthopedist around Boca Raton. The number of bright pink and blue casts spotted around the school grounds this year – and the overflowing waiting rooms at the offices in Broward – indicate a demand for that specialty.

TO LEARN MORE

Get some extensive information on broken bones at KidsHealth.org.

Share your experiences and recommendations in the comments.