DRAWING DATE IS HERE!!
A week ago I announced that my past birth clients will have the opportunity to win three giftc ards in a past birth client raffle, and today is the day!
DRAWING DATE IS HERE!!
A week ago I announced that my past birth clients will have the opportunity to win three giftc ards in a past birth client raffle, and today is the day!
I love how mama looks at her first born (daughter) in such awe and admiration as if to say with her eyes — we did it, together!
When I first walked into her labor room in the middle of the night at labor and delivery in Boca Raton, the first thought I had upon seeing her was ‘wow this mama is powerful!’
She was laboring on all fours, at the very end stages of her labor, as her body was naturally progressing to 10cm on its own, without any medications, and I was in absolutely awe of her natural born power.
South Florida is a focal point in the U.S. with the highest c-section rates. And in today’s day, it can be terrifying to be an African American woman giving birth, because the mortality rates and mistreatment of women of color during pregnancy and birth are the highest out of any race of women in the world.
That is why this mama knew she wanted the most natural and holistic and safe birth experience so she made well researched choices when choosing her birth team. She went with a hospital midwife team (CNMs Courtney McMillian and Polina Goldenberg) that have the 3rd lowest c-section rate in south Florida and a reputation for being extremely gentle and natural minded. (Boca Midwifery)
I am so wowed by this amazing first time mom! And so humbled that she would trust me 110% with capturing this moment for her!
Best of all, mama recognizes that I am a birth photographer on a mission and completely stands behind me with sharing her birth photos with you all and this powerful message.
The best position for the baby to be in to pass through the pelvis is with the head down and the body facing towards the mother's back. This position is called occiput anterior (source: medlineplus.gov)
That is the position this sweet baby girl is being born in, about to be caught by her midwife & her mom.
When I was about to become a mom 6 years ago, I had never seen a beautiful, not intimidating photograph like this one. This doesn't show fear, grossness, chaos, danger. Instead, this image shows grace, peace, comfort, safety. We’ve been taught that birth is a hugely medical process and the scariest moment of a woman's life. But this moment proves that birth can be peaceful, calm, supported and completely safe, where ever you choose to birth if you make smart, educated choices.
The midwife catching this baby is Licensed Midwife, Gelena Hinkley of Peaceful Pregnancy Pathways and Natural Birthworks Birth Center in Margate, FL. She is also our Midwife Highlight of the week.
I have received permission from my birth photography client, a woman of color, to speak out about the safety, tidiness and comfort of her birth. Having your baby the way she did, unmedicated and at home, does not have to be a lower class irresponsible, cheap and messy route to choose as sometimes is the common myth discussed among women of color. Having your baby unmedicated and at home can be empowering, clean, safe, and a wonderful experience for you and your entire family - as this mom felt.
Did you know that the statistics of mortality/complications during labor, birth and post partum are the worst numbers for black women in America?
Key to changing these statistics begins with knowledge during pregnancy. Interview multiple providers with low c/section rates, low mortality rates and high positive feedback, hire experienced doula & make smart choices about the location you choose to birth in.
I am grateful to my birth client for being brave in giving me permission to share photos from her birth. Women of color have suffered far too long, it is time to bring peaceful, supported, empowered birth to all women.
I remember so vividly the feeling after you hope you conceived and between the time you were able to test positive on a home pregnancy test. Those days were the longest. Except maybe the last month of pregnancy. The start and the end of every conception to birth journey is so unique in that you need to let go, and let time just happen. But it really feels like you’re briefly sucked into a time vortex where the clocks stop moving and you’re just tapping your finger and waiting.
Remember, none of the below is medical advice. I am just a mama, and I happen to love pregnancy and birth and love to write about it. If you are genuinely concerned about your pregnancy, issues conceiving, or with upcoming labor/birth, make sure you ask your medical provider your questions.
With both pregnancies (when we were trying to get pregnant) I read that if you tried at the very beginning of your ovulation cycle, or even 2-3 days before your ovulation cycle began, you’d have increasingly higher odds of getting pregnant with a girl because something about male DNA carrying sperm dying out quicker, so by the time you were at the peak of your ovulation cycle, only female DNA carrying sperm remained. I can only prove this twice, because I have only two kids, but both of them are girls, so maybe it worked? :)
Another method for getting pregnant that I used was called the candlestick method. It’s when you kick your feet up in the air, and place the palms of your hands against your back. Apparently this is a known fertility exercise during ovulation and conception. I again don’t know if its effective, but its what I tried with both babies. It’s known well as a yoga move too.
Both times that I got pregnant with my two daughters, the very first early pregnancy symptom that I experienced with each pregnancy before I could even test positive with a home pregnancy test was a fever! Yes a fever! With both pregnancies! It lasted a very short amount of time, I can’t remember exactly anymore because my very first pregnancy was 7 years ago, and my second pregnancy was 4 years ago, but I believe the fever was less than 24 hours in duration and it was a low-grade fever both times, around 100.6. I can only guess the reasoning behind this was my body lowering its immune defenses as it prepared for implantation.
Once we tried for each baby, I was so impatient to know if I had gotten pregnant successfully. Instantly I started googling what early symptoms of pregnancy could feel like before a home pregnancy test would actually give me real results.
With both of my times getting pregnant, one of the earliest symptoms of pregnancy that I was personally able to feel was menstrual type cramping. Later on I found out that this could be a sign of a fertilized egg traveling down the fallopian tubes to your uterus.
With both pregnancies very early on I experienced slight bleeding between weeks 6-8 which I thought could be implantation bleeding.
Right away with both pregnancies in the first trimester, I immediately felt tremendous fatigue. When I got pregnant with my first baby, I’d come home from work, and fall asleep right away for a late afternoon/early morning nap. Once I got pregnant with my second baby (and something nobody tells you that complicates things with pregnancy related fatigue!) I couldn’t nap anymore when I felt exhausted! Because it seemed that the moment I got pregnant with my second baby, my first child who had just turned 2 years old, completely stopped napping.
HELLO Pregnancy! The Metallic Taste is the one thing most complained about by myself during both pregnancies, family members of mine, friends of mine and even my birth photography clients. It just tastes like you have pennies in your mouth, and its super unpleasant. It can make food taste awful and unappealing causing you to eat less, causing you an empty belly and more nausea, and it can just be an overall frustrating feeling to not be able to wash it out of your mouth no matter what you do!
My favorite trimester has always been the 2nd trimester. The second trimester goes from week 13 to 26 of pregnancy.
My belly always started to look more round, so I was visibly pregnant, my skin was tight around my belly, which made me feel more confident in myself, pregnancy caused fatigue went away, and although I was still nauseous during this time with my first pregnancy, the nausea definitely got better with my second pregnancy during this trimester and by the middle of the second trimester my pregnancy related nausea was completely gone.
Nausea was something I unfortunately experienced A LOT of during both pregnancies.
During my very first pregnancy with my first daughter, my nausea started at about 6-7 weeks and lasted consistently every day until the 37th week when it finally dissipated. No matter what I tried to eat or drink, I couldn’t keep anything down. In the middle of the day, either just before lunch or immediately after lunch time, I could keep down anything chocolate, but that was literally it. So it was no surprise to me that my now almost 6 year old daughter is a huge chocolate addict!
It wasn’t until my first baby was about a year and a half old that I found out that I experienced during my first pregnancy a similar condition to Kate Middleton called Hyperemesis Gravidarum. It was actually in an article about her pregnancy which is how I found out.
Hyperemesis Gravidarum is a pregnancy complication that is characterized by severe nausea, vomiting, weight loss, and possibly dehydration. Signs and symptoms may also include vomiting many times a day and feeling faint. Hyperemesis gravidarum is considered more severe than morning sickness. (source).
I also later found out that many women who experience Hyperemesis Gravidarum (also called HG) during their pregnancy end up being hospitalized for dehydration and malnutrition since they cannot keep anything down to hydrate properly or nourish themselves.
The OBGYN I was with during my first pregnancy never mentioned this medical condition. He also never gave me any solutions to treating it. I realize now looking back, I was very underweight, although I gained a healthy 15lbs, I really should have gained more. I looked very thin until 37 weeks of my pregnancy. My OBGYN recommended oral 8mg zofran tablets but they only barely took the edge of for 30 minutes per day. So every day I had to decide which 30 minutes of the day was worst and take it then. It was misery. It was like being sea sick for 30 weeks of my pregnancy! Or a really bad hangover.
So there you have it, those were the bulk of my early pregnancy symptoms and some of the most prominent during my pregnancies. There were definitely many other symptoms I experienced as time went on. More food cravings, headaches, round ligament pain, back pain, mood swings, etc, but the above were the ones that hung around for most of my pregnancies! I hope this blog post was helpful or insightful to you on what to possibly expect when you’re pregnant.
I am a birth photographer in Boca Raton, FL. I started out 11 years ago originally photographing engagements, weddings, bar mitzvahs, birthday parties. But once I had my first child almost 6 years ago, I felt a calling to only working with new moms. I limited my work to maternity sessions, newborn photography, photographing families and breastfeeding photo shoots. I became very well known in south Florida for my advocacy of breastfeeding.
Shortly after my daughter turned 2 years old, I attended my first birth as a photographer. It was for one of my maternity / breastfeeding photography clients.
The moment I photographed her birth a little over 4 years ago now, I knew then that I wanted to be a full time on call birth photographer & birth videographer as my career.
I never looked back.
Today, I have photographed almost 100 births in the last 4 years, ranging from birth center births, to home births with midwives and doulas, inductions in the hospital, unmedicated births in the hospital, surrogate births, twin births both vaginal and c-section, schedule cesarean births, emergency cesareans, and I love what I do. I have birth great professional relationships with the midwives, OBGYNs and labor doulas here in south Florida, many of my colleagues are baby nurses, lactation consultants, pediatric sleep specialists, physical therapists and chiropractors. I would love to work with you for your birth story, and typically I book about 5 to 7 months in advance, however, it is not unheard of for me to sometimes take a client who is in the last two months of their pregnancy, so don’t hesitate to reach out!
Working in the birth world, I get pretty use to seeing the year in quarters since moms are pregnant for three quarters of a year. I am excited to say I am officially taking my last clients of 2018. I am very eager to meet 2019 with four repeat birth clients birthing between January — April.
I have been waiting over the last few years for my mamas to expand their families and I am thrilled that the first quarter of the new year will be celebrated all with repeat birth clients who’s previous babies births I photographed over two years ago :)
To celebrate the very last birth clients for 2018 I am hosting an exclusive raffle for expecting families birthing before the end of the year.
The winner of the raffle will receive
an Exclusive Maternity Session in a stunning and enchanting park in Coral Springs, FL
as well as
30% off of the story of their choice (birth photography, birth film or siblings meeting story)
To enter the raffle, email me using the contact form below: your family’s love story.
How you & your partner or spouse met, how long you’ve been together, what inspired you to start your family (or grow your family), what dreams you have about welcoming this sweet baby into your family & what your hopes and expectations are for your birth story)
I look forward to meeting the raffle winner!
What the biggest shock about birth is that no one seems to know about this seemingly well kept secret of home birth. The truth is, it’s really no secret. Our modern day society simply does not do a decent job of educating our country’s young men and women to honor, respect and take an interest in parenthood until they find themselves pregnant. The priority in schools is sexual education, but no emphasis or time is spent on educating about the amazing motherhood journey.
Home birth midwives here in south Florida carry a magic with them that needs to be shared with the world. They awake in the middle of the night, grab their luggage packed with midwifery tools, and go to a woman’s home to aid with the delivery of her baby. With a low risk pregnancy, any woman can birth at home under the care and guidance of a licensed midwife.
What is so magical about this to me is that this is how ALL babies use to be born. The shift to hospital births started in the 20th century. I scoured the internet to gather the history of birth for you, and landed whhy.org where an article written under the guidance of Rutgers University professor Margaret Marsh shares the history behind the transition from home to hospital in the 1760s.
“In the colonial period, all the way up to 1760 or so, there was no real challenge to midwives delivering babies,” explained Marsh. When a woman was ready to give birth, her female relatives, and friends would help her through the process, along with a midwife.
Professor Marsh the went onto say that “it was a scary process, babies died, women died, having a baby was a frightening thing,” (Source: whyy.org)
I wanted to touch on that statement, because it honestly stopped me in my tracks. The entire article featuring Professor Marsh was very fascinating, and while I think that is still a common misconception in the modern day world, and many home birth myths exist around this concept, I do think it is unfair to leave it at that statement. Midwives and obstetricians should find a healthy balance between high risk and low risk births, complications during labor / birth / post partum, and when an obstetrician should be required to step into the process.
Professor Marsh continues onto say that: around 1760, upper class women started to want to have doctors at their births. They thought that because the doctors had more education they could deliver a safer birth. Doctors delivered babies in women’s homes, and doctor-assisted births became more popular over time. “In 1900, about half the babies were delivered by midwives. By 1935, only fifteen percent were delivered by midwives,” said Marsh.
“Over time, there developed a rivalry between doctors and midwives, ” she added. “Doctors would say ‘we know more about anatomy, we are better suited to do this.’ Midwives said ‘we are women, we have experience, we know how we do this.'”
For many decades, the tug of war over approaches broke down along the gender lines; all of the doctors were male, and all of the midwives were female.
The shift to hospital births started in the 20th century. “What happened in the beginning of the 20th century was anesthesia for delivering children, and they wanted to have pain-free childbirth.”
But Marsh says the outcomes for women weren’t that great. “Lots of complications, lots of infections, it didn’t have the effect that women desired. They wanted safer, less painful childbirth, but in the first third to half of the century, it was not always safer childbirth.”
Marsh explained that in the 1930s, most of the midwives were practicing in rural areas, and were often called “granny midwives,” people who learned their trade on their own. “It did seem for a while as if midwives were going to become obsolete. The 1940s, 50s and 60s, you get doctors, especially obstetricians delivering all the babies.” Marsh says the feminist movement of the 1970s revived women’s interest in midwives. “Women once again wanted to control their own childbirth experience.” (Source: whyy.org)
This past week I learned for the first time in my 33 years of life that my mom was born at home. My grandmother (my mom’s mother) went into labor in the early morning just as her husband was leaving for work, and she sent her cousin to get the local midwife (back then in eastern European slavic countries a midwife was called an Akuszerka). She was pregnant with twins, it was her second pregnancy. It was ten minutes in between the births of both twins, my mom was born second.
My whole life I grew up in south Florida learning about western medicine. For me, I didn’t even know what a midwife was or did, in all the 27 years of my life leading up to the birth of my first child, I had never been educated about birth, let alone home birth. And now, 6 years deep into motherhood, it is a shock and exciting revelation to me to find out that my own mom was born in her home.
When I got to Hannah’s home, early afternoon, the air was still. The music was soothing.
I felt as though everything was right and still with the world. A peaceful, still afternoon.
Hannah was swaying through contractions. Her husband was at her side.
⚪️⚪️ SELF REVEAL ⚪️⚪️
I’m kind of an open book. Too many things were kept from me by society about motherhood, so I am a proponent of transparency. I think many women can relate to this statement, because how many women can honestly say that they knew much about pregnancy, labor, birth and post partum BEFORE they had their first child? Unless you’re a labor and delivery nurse, a labor doula or post partum doula, a midwife or an OBGYN, chances are, you, similarly to me, didn’t have much of an education about motherhood before you became a mom for the first time to your own child.
A few weeks ago I finally took a deep breath and I went to see a revered specialist (who I still highly admire btw) in the plastic surgery field because I wanted to be “fixed”
Going from being somebody who easily fit into any piece of clothing, never worrying about size labels, never second-guessing my health, to suddenly finding myself with pretty serious self-body image issues after polyhydramnios with two pregnancies... This picture is my body TODAY (btw I’m not underweight! ❌ I’m just inhaling and my ribs say hello!)
Here I have been taking pictures of women in the most compelling moment of their motherhood experiences, truly believing and telling them they are radiantly gorgeous — never did any of their bodies ever make me feel they weren’t stunning. I never looked at weight as a negative. I always saw radiant beauty.
But here I was with a self-body image problem.
I hated my body. Well, my stomach. What polyhydramnios did to it, it became unrecognizable to me. It didn’t matter how much weight I lost after my second pregnancy, the stomach was still there. So I went to a plastic surgeon asking them what they would need to do to “fix me” so I could go back to being beautiful
what I didn’t expect was for that visit to be the moment I would fall in love with my postpartum body.
Someone telling me that they would take away the skin I’ve lived in for 33 years, the stupid dragon tattoo I got when I was 21 that over these years became a symbol of my badass motherhood that I didn’t even realize — until they were telling me that with a tummy tuck, it would have to go. 99% of my abdominal dragon tattoo would have to go.
I walked out of the office a changed woman.
I never in a million years thought I would want to keep this skin, find my pp body beautiful & attractive.
Fast forward a few weeks, I’m laying on my living room floor this morning, taking a photograph specifically to share with women out there who might have body image issues after their pregnancy.
POSTPARTUM IS THE DIVINE FEMININE.
It took me 6 years, and I finally believ
Hosted weekly on FB Live by Paulina Splechta Birth Photographer & Filmmaker and Martha Lerner labor doula, birth photographer and post partum support of Zenmamalove.com. Every week we invite experts in the motherhood world, ranging from fertility/conception and pregnancy through labor, birth and into the post partum, 4th trimester and first twelve months mommy, to discuss their specialties with moms, women and families of south Florida so that women can be supported and have resources at their fingertips to getting through the new transition of motherhood. The Birth Talk Show was born out of our realization of the need of a lot of families in south Florida who don’t have the resources that we’ve gotten the opportunity to learn about over the last three or four years. We really wanted to bring the awareness of these resources to the families of south Florida and that’s why we are on our 8th episode. Today on episode 8 of the show we will be talking about fertility with Dr. Scott Roseff, Board Certified in Reproductive Endocrinology and Infertility at IVFMD in Boca Raton, FL.
We asked Dr. Roseff why his approach to fertility is so vastly different from other fertility specialists
What drew his passion into fertility work at the start of his career
We found out that the age we thought egg quality starts to go down — we were completely wrong! (Spoiler, its way earlier than you thought!)
What his recommended waiting time is before seeing a fertility specialist if you’re trying to conceiving and think you might be having problems
Paulina Splechta (Birth Photographer): Dr. Roseff, I’d really love for you to talk to our viewers about your philosophy of fertility and how you approach it. I feel very swept away with your approach because I feel its very holistic.
Dr. Scott Roseff: I do take a different approach to fertility, I’ve been doing this for almost 30 years and people come to me with a problem. The problem is either getting pregnant or holding a pregnancy or both. I saw a patient this morning who has been trying for four and a half years. She has both difficulty getting pregnant and any time she did become pregnant, she’s lost those pregnancies, she’s had five losses. I’m an expert in getting to the bottom of what the problem is or the problems are.
When people go to a fertility doctor they typically start treatments “okay you’re having difficulty getting pregnant, let’s do this and see if it works” but what I do is I always take a half a step back and say let’s get to the bottom of what’s going on, so I can know what your problems are so we can address them head on. My primary objective with every patient I see is to find out the problems and see if I can fix them or overcome them so that I can have perhaps the man take this pill and the female do this and then go home and get pregnant. I like to restore natural fertility and in doing that its a very complex picture. It’s not just sperm and egg making a pregnancy. It’s psychological issues, its sociological issues, lifestyle habits; its so complex.
The person is a compilation of everything going on in his or her life, it’s not just sperm and egg. So I need to look at stress, food, exercise. Too little exercise can have an impact. Too much exercise can have an impact on their success. I look at body fat. Most fertility experts are not measuring body fat. Too little body fat actually has a very negative effect on health and reproductive outcome. Too much body fat, which is usually more commonly the problem, can have a negative impact on outcome as well as health. The saying is “if we don’t have our health, we have nothing” Many people come to me with health problems that haven’t been addressed, even when they go to their family doctors, the family doctors are not addressing these issues with telling the patients that you have a problem that needs to be addressed before you get pregnant.
I do a lot of what’s called preconception counseling where I go through factors that can cause a baby to be sick, or a baby to be born with health problems, or increased risk of autism for example, and these are things that I look at before people get pregnant so that when they get pregnant, they’re going to have the highest chance of getting pregnant, staying pregnant, having a healthy pregnancy and a healthy baby, and that really takes a very broad approach which is holistic, rather than just “okay we’re going to do this treatment hopefully you’ll be pregnant and out the door and good bye and good luck” I want healthy mom, healthy dad, healthy pregnancy, healthy baby and there’s a lot that goes into mental health, physical health, reproductive health.
It’s a very big picture. People come with problems and its a jigsaw puzzle and my job is to put the little pieces of the puzzle together and it takes a lot of work and it takes some time. I understand the desire for people to be pregnant yesterday, “I’ve been trying for X amount of time and I want to be pregnant now” but you always have to take a half a step back and address the issues. One patient came to me from Russia having failed in vitro fertilization 7 times and when she came to her consult she said “I heard that you’re the best and I want to do IVF with you and I want to do it now.” And I said “that makes no sense, you failed 7 times, there are problems here and I need to level that playing field before you do this again.” So I did, it took 4 months to level her playing field and then when we did IVF she conceived twins and delivered twins first time and the philosophy is to do this once, to do it right and to make it work.
Paulina Splechta (Birth Photographer): But I love what you said “the philosophy is to do this once, to do this right and just make it work.”
Dr. Scott Roseff: And often it does.
Paulina Splechta (Birth Photographer): Before I met you I had never had any experience with doctors who work in this field, and I only have stories from friends and family members of trials and trials of IVF that have failed for years and years and they were just getting to the point where they felt that they were never going to have a baby unless they get an egg donor or a surrogate..
Dr. Scott Roseff: So many people come to me from other fertility practices having been told they need an egg donor. I saw a patient this morning who was told over the last three years she was at her previous fertility practice that she needs a surrogate, she needs someone else to carry the pregnancy — she doesn’t. People who say that they were told they need an egg donor, I’ll test them, and find out that they really don’t need to do that. You really need to know what’s really truly going on, rather than saying “okay, this failed, that failed, so let’s get a sperm donor or an egg donor and maybe that’ll work, let’s get another uterus and put an embryo in there and see if that’ll work.” You really need to find out what the problems are and address them. Sure, some people need an egg donor, yes, there are occasions when someone needs a surrogate to carry the pregnancy, but so many people have been told the wrong thing and when I see them and tell them what they really need to do, first of all, they’re blown away by it and second of all, when they’re successful, I hear every minute of everyday “I wish I came here first rather than having spent X amount of time, X amount of years, X amount of money, X amount of emotional toil elsewhere.
I just like to see if I can help people conceive first objective is natural conception, if that’s not in the cards, if its something thats not likely going to work, then there are tools that I have to assist people in becoming pregnant, but I want to look for the simplest, least invasive, least expensive thing that we can do to achieve a high degree of success. IVF is the bottom of the list, it’s the last resort, its the last thing that I ever want anyone to have to go through. Yeah, a lot of people need IVF, do IVF here, and are successful, but it’s the last thing that I want anyone to have to go through.
Martha Lerner (Zenmamalove.com): Before we go onto the next question, I wanted to ask you, if you wouldn’t mind sharing with us, what got you into this field, what made you decide to get into fertility.
Dr. Scott Roseff: When I was in my training, I had to rotate through different disciplines in the medical field, so we had to do some time in pediatrics, in general surgery, and obstetrics and gynecology and psychiatry, and all the different disciplines, and when I did OBGYN and the first time that I was in a delivery room with someone, and it was just me — they threw me in and said go deliver the baby, and one minute it was the patient in the room with me and the next minute there were three of us in the room, the baby was there, and no one came through the door, I said “this is the most miraculous thing I can ever fathom, bringing another life into the world” and I said “I want to be an OBGYN, I want to deliver babies and take care of pregnant women for the rest of my life.” So then I started my training in just obstetrics and gynecology, and in doing so, one of the rotations that we have to do is we have to go through the infertility rotation, and then when I saw the heart break of people who were having difficulty getting to the point of that miracle, I said “this is what I really need to do, I need to help people to achieve that miracle,” rather than just bring the miracle and deliver the baby, let’s help people who can’t get there to get there. And so I went into the fertility field.
Martha Lerner (Zenmamalove.com): So if a woman comes to you and is having difficulty conceiving, what’s generally something you would recommend for her to do in the beginning?
Dr. Scott Roseff: If she has a partner, that she and her partner need to look at their lives, they need to look at a broader picture of why they may not be getting pregnant or may be losing pregnancies. Look at your lifestyle, look at your nutrition, look at your general overall health. Pregnancy is growing another life inside of your body for three quarters of a year. When I do the first pregnancy ultrasound, and I measure the baby and the baby is 5mm on that first ultrasound, which is the size of your pinky nail and there is a little flicker of a heartbeat and you have this 5mm fetus inside of you and you have to nourish it and you have to grow it and you have to sustain it, if you’re not in good mental health and good physical health, how do you expect your body to nourish and grow successfully another life for three quarters of a year. So people really need to look at the bigger picture, "are we stressed out” because there is a connection between the mind and the body.
You have to look at lifestyle factors, are you overweight, are you obese, are you underweight, because those can have affect as well. Men, can be exposed to high levels of heat, are you going to a sauna, are you going to a jacuzzi or a hot tub several times a week, it has a really bad effect on sperm. So you have to look at certain things that can have effect on fertility. And then, if you’re having difficulty and think there could be a problem, don’t wait too long. Men make new sperm in their bodies every ten weeks until they’re dead, but women don’t make new eggs.
When a woman is 25 years old, her eggs have been in her body for 25 years, but if she’s 30 or 35 or 40, her eggs have been sitting on a shelf for 40 years and since she doesn’t make new ones, her egg quantity goes down, but more importantly, her egg quality goes down. If the egg quality is low, then the egg may not fertilize or if the egg does fertilize and it’s a bad egg, those pregnancies are more likely to miscarry. If its a bad egg or an older egg and the pregnancy doesn’t miscarry, its a greater chance of a genetically abnormal baby, like a down syndrome pregnancy.
One of the important things for women to remember is that they should not wait too long. I ask my patients when they think their egg quality really starts to go down and 90% of the time they say age 35 and that’s not correct. The egg quality starts to go down around age 24, and it’s a slow drop from 24 to 30 and then its a pretty quick drop from 30 to 35, and then it’s a very sharp drop there after. So don’t wait too long. I see people who are 40 years old who go to their family doctor or their health care provider and say “we want to have a baby” and the doctor says “well, you need to try for a year, and if you’re not pregnant then we can do some tests,” and if you’re 40 you don’t wait a year. If you’re 35 you don’t wait a year. So don’t wait too long.
Paulina Splechta (Birth Photographer): So I guess it really depends on the state of a person’s health and their age, when they should start taking it to the next step, but if we could generalize, if a woman has been having issues conceiving for maybe 3, 4, 5 months, what should her next step be at that point, is that too much time to wait?
Dr. Scott Roseff: Well, no, unless there is something in her history or her partner’s history that suggests that we’re going to have a problem right from the onset. For example, there are women who don’t get regular periods. You’re 25 years old, you want to be pregnant, you get a period 8 weeks apart, 12 weeks apart, 6 months apart — don’t wait, there’s a problem. Go to your doctor and start to get tested and find out what the problem is. There’s an infection called chlamydia, its an infectious disease that can cause damage to a fallopian tube. If you’ve had chlamydia when you were 17 years old, and now you’re 22 years old and you want to have a baby, get tested and make sure you don’t have fallopian tube damage, because it’s in your history and therefore you don’t wait and wait and wait because there’s a predisposing factor that maybe something right off the bat that can be addressed or should be addressed or looked at.
In general, if you’re under 35 years old and there’s really nothing in your history that you think suggests you’ll have a fertility problem, you could try for up to a year. If psychologically that’s going to hurt you then don’t wait the year, see a fertility expert sooner. If you’ve reached or passed your 35th birthday, the general rule is 6 months. If there’s really nothing in your history, you can try for 6 months, and if you’re not pregnant after 6 months, see a fertility doctor.
Paulina Splechta (Birth Photographer): What types of fertility treatments do you offer here?
Dr. Scott Roseff: The first thing I want to do with any patient is to try to see if I can address issues or problems to the point of allowing them to go home and have sexual relations and conceive on their own and that’s my primary objective with every patient I see. Sometimes if a patient comes here and had her tubes tied, had two babies and now wants baby number three and she had a tubal sterilization, she’s not going to conceive on her own. Depending on what the tests show, the fertility treatments are dictated by the test results. For example, if the sperm is a little bit poor and all other things are okay, then there is a relatively simple procedure called Intrauterine insemination (IUI for short) that maybe appropriate. But if she’s 39 years old the odds for success with that will be quite low. So we really need to look at the whole picture and say if you’re 29 years old and you have a little bit of a sperm issue and you don’t ovulate regularly then I can give a fertility pill and we can do Intrauterine insemination with the sperm to have a pretty good chance of success. If you’re past your 35th birthday and especially past your 37th birthday, then IUI is really not a great option, fertility pills are really not very effective, if you’re older; So if IUI is not an option or a good option, then the next step above that is injectable fertility drugs that are given with the purpose of stimulating multiple eggs to grow and develop but it would be dangerous to allow 6 eggs to ovulate and inseminate someone, because if we throw a handful of sperm at 6 eggs, she could possibly be pregnant with 6 babies and that’s not a good outcome. If we’re using injectable fertility drugs then the treatment would be to extract the multiple eggs, fertilize them and grow embryos and that’s in vitro fertilization. If we’re doing in vitro fertilization we need to look at the age of the female, because if she’s past her 35th birthday a fairly large percentage of the embryos would be typically chromosomally genetically not normal, so rather than grow the embryos and put one into the uterus we would genetically test the embryos for genetic mistakes like down syndrome before we put an embryo into a uterus and then when we have a genetically normal good quality embryo that would be the one we that would be chosen to put into the uterus. So it has to be individualized and personalized for ever patient, every couple.
One of the other things I see from the records I get from people who have been to other facilities, is that those facilities tend often to do cookbook medicine as I call it. “It’s a recipe, its a cookbook, and you get it and you get it and you get it and you get it”
But she’s different than she is and she is and she is and you can’t turn to page 6 in the cookbook and do the same thing for everybody it has to be individualized and that takes thought it takes thinking outside the box, it takes effort and it takes very individualized, personalized care and I think if I was going through it, that’s what I would want to have done and that’s what needs to be done and should be done.
There are adjunctive treatments that I recommend for all of my fertility challenged patients. I do recommend fertility acupuncture. There are acupuncturist all over south Florida, many of them have special expertise in the fertility field. I tell every fertility patient that they should consider fertility acupuncture. there are many potential benefits of acupuncture.
I look at this as a team effort. I cannot do this without the assistance of other people like acupuncture doctors, I have fertility psychologists that I refer my patients to for stress reduction and mind body balancing along with the acupuncture. Some of them have a speciality of reproductive medicine psychology. We collaborate together and it really helps the stress reduction and these other techniques for achieving greater success.
Martha Lerner (Zenmamalove.com): That’s wonderful, that was my next question, what other alternative or complementary modalities would you recommend?
Dr. Scott Roseff: We have a tremendous demand for nutrition counseling and lifestyle changes in our patients. Many of our patients are overweight. Many of our patients are obese. And some of my patients are severly underweight. They teach us nutrition about one day in medical school so we can’t be the nutrition experts but there are nutrition experts out there and in my practice we have someone who has advanced degrees in nutrition and exercise physiology, she’s a professor of nutrition at one of the universities in Miami and I have my patients see her and work with her to optimize their health and optimize their bodies so that they will have a significantly improved chance of success. The patient who came to me from Russia, with 7 failed IVF cycles, had some physical body issues that needed to be addressed, lifestyle changes, nutrition and exercise, and eating right and eating better, and losing body fat. She worked with our expert, her name is Marta, over those 4 months. And then Marta said, “time to go back to Dr. Roseff and start moving forward,” we did with incredible success.
Like I said, I can’t do this alone, I have great expertise in what I do and knowledge but its a broader picture, its a bigger picture.
Paulina Splechta (Birth Photographer): I’m so excited by the fact that you’re here, you’re in the heart of south Florida, in Boca Raton at IVFMD, so all the families from Port Saint Lucie and Jupiter can have access to you and all the families as south as Miami. Thank you so much for making the time for sitting with us and share with our viewers. We hope we can reach at least one family that could benefit from this gentle approach to fertility. If anyone has any questions for Dr. Scott Roseff, please message us privately or leave a comment below and we will be happy to connect you.
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 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.
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.