Modern midwife ‘labors’ to reduce C-sections
February 19, 2018
One of Nevada County's popular certified nurse-midwives, Vanita Lott, is on a mission to reduce the rate of unnecessary Cesarean sections throughout the United States.
After years of study and a 35-year career of helping deliver more than 1,500 babies, Lott asserts that while necessary "C-sections" can be life-savers, most surgical deliveries today are performed on healthy women with normal pregnancies.
A 2017 Consumer Reports investigation found that nearly "half of the C-sections performed in the U.S. are not required. And performing a surgical birth can pose added risks to the mother and her child and also raise costs."
Today, unnecessary C-sections, which Lott has coined "unnec-cesareans," are increasing complications for new mothers and their precious newborns, she said.
"One reason for the Cesarean epidemic is an extreme techno-medical approach to even normal labors — routine interventions often lead to a domino effect that winds up in the operating room," said Lott. "When 1 in 3 women are delivering babies by major abdominal surgery — or 32 percent — something has gone seriously awry. The World Health Organization states a rational rate would be 10 to 15 percent."
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When admitted to a hospital, too often laboring mothers are subjected to what Lott calls a "cascade of interventions" that can hinder a normal delivery. For example, she said, while many women are eager to get up and move around during labor, they are often tethered to an electric fetal monitor, which sounds an alarm if the woman moves.
Instead, Lott advocates for a more holistic approach, taking into consideration a woman's preferences, personality, emotions, fears and the family dynamic.
"One thing we've lost in the hospital system is really getting to know the mother — in preparation for home births, midwives spend an hour at every prenatal visit," she said. "It's amazing how much women choose to move around when they are in labor at home. Some are up and making tea two hours after birth."
"If you're forced to just lie there, you're setting yourself up for problems. It can decrease circulation. There's no reason for a woman to be attached to a monitor during a normal labor," she said. "And men like machinery — many times I've seen husbands watching the machine instead of focusing on their wives. Then nurses become obsessed with the heart rate.
"We should only be using technology when appropriate — not when there aren't signs that anything is wrong. Our patriarchal system's bond with technology has nothing to do with what works better for the mother or the child."
In hospitals, Lott said too often the preferences of women and their midwives are marginalized or pushed aside. Women act differently at home, she said. As a midwife invited a client's living space, Lott says feels more like an "honored guest."
Seen a lot
During a career that spans more than three decades, Lott says she has cared for hundreds of normal and high-risk pregnant women, having delivered babies in hospitals, birth centers and homes, through her professional home birth practice.
She currently serves as a prenatal and well-gynecology specialist in the Maternity Health Unit at Western Sierra Medical Clinic in Grass Valley, working alongside Dr. Christopher Genobaga, an obstetrician and gynecologist she admires. She also sings the praises of the holistic care offered at Sierra Nevada Memorial Hospital's birthing unit, whose C-section rates are consistently lower than the national average. But on a grand scale, she says, there is much work to be done.
"Our dangerous nationwide 'unnec-cesarean' epidemic is the most glaring example this very unbalanced approach needs a dramatic overhaul to become wellness and prevention-oriented and to truly meet the real needs of mothers, babies and their families," she said.
Carlyle Miller of Nevada City said she was in labor for nearly 24 hours when Lott, who was her home birth nurse-midwife, suggested she transfer to the hospital. Miller's labor had temporarily stalled and because her water had broken, she ran the risk of infection. She labored for another 20 hours at the hospital before giving birth to a healthy 10-pound, 7-ounce baby girl.
"I never felt in danger — having a medically-minded professional like Vanita made me feel safe," she said. "My labor was long, but Vanita knew I was healthy and wanted a vaginal birth. It was huge to have her there the whole time, advocating for me. The doctors were pushing for a Cesarean, but fortunately I didn't have to participate in that debate. Vanita knew what I wanted and she knew that the baby and I were stable. I get teary when I think about it — I'm so grateful for Vanita."
On Feb. 4, Lott "gave birth" to her new website, AwakeningBirthNow.com, which features suggestions on how to side step the current "unnec-cesarean" epidemic and create safer, easier and "more beautiful" births. She is also offering her services nationally as a "transformational holistic pregnancy coach."
"We're lucky — Nevada County is a home birth and midwifery hot spot boasting a successful planned home birth rate of more than 10 percent, which is six times higher than the national rate of 1.5 percent," she said. "But I'm part of an international movement to move birth from being technocratic to holistic. It's a whole power shift — we're 'giving birth to' a new holistic paradigm."
To contact Staff Writer Cory Fisher, email her at Cory@theunion.com.