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Research shows that birth at home is safe for healthy women when they have a licensed CNM who is equipped and experienced. Routine hospital interventions add risk to normal labors for the mother and newborn.

Cesareans can be a blessing if truly needed. However, unnecessary cesareans are epidemic in the United States. In 2003 the cesarean section rate was greater than 27% and the rate is rising. The C/S rate is now over 30%! Women die every year from the side effects of unnecessary cesareans and anesthesia. One year the leading cause of maternal death in the US was anesthesia complications. Newborns born by Cesarean operation have increased risk of complications including breathing problems because the normal forces of vaginal birth were absent. Babies ideally need labor stress and then to be pushed through the birth canal for optimum breathing. The list of cesarean complications is very long including infection, incision problems and scarring, and breastfeeding difficulties. With homebirth almost all Cesareans that are performed after transport were clearly needed.

Interventions can helpful in certain circumstances. However, institutionalizing birth has lead to numerous routine interventions in normal, healthy labors. The continuous electronic fetal monitor, IVs, fetal scalp electrodes, internal uterine monitors, routine artificial rupture of the membranes, narcotics, spinal anesthesia, routine inductions and speeding-up of labor, and post-birth medications etc. have become commonplace. All these interventions carry risks that can introduce discomfort and/ or complications to a birth that otherwise may have proceeded normally. The list of complications from epidurals is very long for mother and baby! At home, only interventions that have been determined to be helpful to a particular woman and her newborn are instituted.
Do you know that epidural and other spinal anesthesias have mulitple side effects for the mother and the baby? Epidurals often lead to many other interventions such as IVs, emergency fetal heart rate patterns, fevers, vacuum assisted and forcep assisted births and an increase in the Cesarean Section rates? Any woman considering planned epidural use should consider researching the many problems associated with this technology. We support women in using this technology when needed or desired when the risks are clearly understood.
Do you know that 1 million fetal scalp electrodes are sold to hospitals each year? There are 4 million births per year in the US. The fetal scalp electrode is a thin wire that is screwed into the fetus' scalp in labor to monitor its heart rate. Though occasionally necessary in unusual situations I was shocked to hear that 1 million are sold every year. This technology is usually not needed and is not offered in home births.

It stands to reason that truly normal childbirth can only happen in a natural environment. The hospital's technological environment introduces stresses that often adversely affect a woman's ability to labor. Today, many women believe that they have had a "natural birth" when in fact the experience may have included the use of narcotics, continuous electronic fetal monitoring, fetal scalp electrodes, intrauterine catheters, spinal anesthesia, unnatural delivery positions, and possibly even the use of forceps or vacuum extraction. These interventions are common in hospitals. I learned early as a nurse that the hospital is not an ideal labor environment and this is a key reason for the high intervention rates seen today.
It is acknowledged that these interventions are sometimes required to optimize delivery, however, most American women are far removed from a truly natural and optimal birth experience. Birth at home surrounded by caring family and friends and skilled providers creates the ideal circumstances to maximize the possibility of a normal childbirth.

Vanita's midwifery practice is a one midwife business with a full time R.N. and doula assistant who also attends the birth. Back-up midwives may be available during busy birth seasons. Clients have the advantage of clearly knowing who will be the midwife at their birth. This one factor greatly decreases the stress on a birthing woman and her family. This added relaxation greatly aids an ideal hormonal milieu that will facilitate labor progress. Continuity of care also allows the midwife to be aware of subtle changes in a woman's condition and to be able to assist her in dealing with psychosocial stresses in more creative ways. The midwife will be very familiar with the woman and her special circumstances. A well established rapport is a priceless asset in troubleshooting potential problems that can interfere with labor and birth.

During the stress of labor a woman should be protected from having to cope with unfamiliar persons, situations and places. Many times women in good labor will have their contractions decrease on admission to a hospital due to the stress of being in an unfamiliar environment. Additionally, many women and/ or their families may associate a hospital with sad or tragic situations such as the serious illness or death of a family member or friend. In these instances strong emotions can be reactivated when the woman is in labor which can slow or stop labor. This obviously is not a problem when labor and birth occur at home.

At home a woman is free to carry on her usual activities when in early labor which often helps to distract her from any discomfort. She may continue to eat and drink familiar foods without restriction. (Most hospitals will not allow women in labor to eat). Woman who are distressed by hunger secrete adrenaline and other chemicals that can slow labor. The dangers of eating in labor are greater in a hospital where women routinely are under the influence of narcotics/ anesthetics which slow digestion. The hospital policies that forbid food in labor are based on a fear of regurgitation and subsequent aspiration (inhaling food into the lungs) under general anesthesia. General anesthesia is no longer commonly used for Cesarean sections. Even in most emergency situations spinal anesthesia is attempted. Aspiration is not generally a problem with spinal anesthesia. If a general anesthetic is needed the anesthesiologist is trained to prevent the possibility of aspiration as needs to be done when a fed person needs any emergency surgery.
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Most physicians share call with other doctors for days off, nights, weekends and holidays. Vanita Lott, CNM and the birth assistant are on-call virtually 24/7 throughout the pregnancy and post-birth period for mother and baby.
Alternative pain relief techniques-surrounded by your loved ones, relaxing home environment, warm water labor & birth tubs, herbs, homeopathic medicines, hypnobirthing preparation, continuous attendance by caring & supportive women, massage, aromatherapy, music etc. Why have women been conditioned that birth is unbearable? Women with normal labors, nurturing care and a proper atmosphere usually don't require pain medication or epidural anesthesia.
Truly family centered care
Increased privacy/ intimacy
No separation from family members or baby
Highly individualized care and intimate environment
Freedom to eat and drink in labor
Avoid unnecessary risk of narcotics & anesthesia. Alternative comfort measures used.
No risk infant abduction/ erroneous infant switching
No prolonged waiting for appointments
Affordable. An uncomplicated birth at hospitals in this area start at $12,000.
Environmentally friendly

The hospital setting has been designed to meet, physician, nursing staff and institutional needs also. One reason birth was moved into the hospital in the early 1900s was to provide "teaching material" for medical students. It is also easier for the provider if all women come to one place. It is much more labor-intensive (get it?) for the provider to go to the client's home than to have the client come to them. In the home environment birth can be truly woman and baby centered. You will have two providers fully attending to you and your baby. The great majority of hospitals do not qualify or have no interest in qualifying for "Mother-Baby Friendly Status". Hospitals must provide access to midwifery care to qualify plus meet other criteria. For more information: www.midwifefriendly.org.

Nationwide, the average time that a woman spends with her obstetrician during a prenatal visit is 5-6 minutes. Doctors are trained to provide mostly physically oriented care- check your blood pressure, check your urine, order tests etc. Vanita's routine prenatal appointments are 45 minutes long. Midwifery care encompasses the entire woman- physically, emotionally, psychologically, and spiritually. The home is a more intimate setting than a hospital. This intimacy combined with an established relationship between the Midwife and the client and her family makes it easier to tailor each birth to the client's wishes (within the realms of safety). The use of alternative healing modalities such as hypnosis are more effective in the home setting.
In Vanita's practice, it is respected when clients refuse certain procedures after they are fully informed of the advantages and risks of certain tests or procedures. Clients in homebirth are involved in the many decisions that need to be made throughout pregnancy and birth. We value Self-Determination highly.
Studies of other mammals have shown that every time an animal is simply touched during labor the labor time increases by an average of five minutes. Routine nursing schedules for blood pressure, temperature checks, vaginal exams, etc. are constantly bombarding the laboring woman. How the constant stimulation and interventions that occur in the hospital setting might effect a woman's labor is an important question to consider.
The home environment can be more easily controlled by the client. There is no fear of being subjected to routine fire drills, unexpected construction or painting, overhead paging, noises of other patients etc. Additionally, clients may use items such as candles or incense which are understandably prohibited in hospitals due to fire department regulations.
Midwives have the goal of keeping the perineum intact. This helps to facilitate early bonding since the woman is not distracted by episiotomy pain and the needed suturing or repair of the wound . Intact perineums substantially decrease a woman's pain for the first week after the birth; episiotomies often require pain medications to be used. Most spontaneously occurring lacerations are smaller and less painful than episiotomies and do not interfere with bowel elimination as significantly.
It has been proven by research that episiotomies are the greatest cause of the worst lacerations since the surgically split tissue tears more easily than intact tissue when stretched by the birthing baby.
It is known that many midwife attended births have less blood loss than physician deliveries. This is because episiotomies are not routinely performed. Blood loss is decreased by an average of one cup of blood per birth. At home, episiotomies will be performed rarely and only if believed to be absolutely necessary.
Hospitals are the largest producer of trash in our country. The In-Home Birth Center ® is designed to consume less energy, equipment and disposable materials. One example is that a sterilizable stainless steel instrument is used to rupture the bag of waters, if needed, instead of the common disposable instruments used daily in hospitals. All the equipment Vanita uses is professionally sterilized.
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