Beyond Our Low C-Section Rate: How Roots is Providing Exceptional Care to Twin Cities Families

2023 Reflections

As we settle into a new year, we always like to reflect on the previous year, though not

necessarily to make resolutions. Rather, we prefer to examine the areas where we grew

and how we can continue serving our community, while also exploring aspects of our

birth center and growing family practice that need refining.

We’re moving forward in 2023, and we have some successes that we’d like to share

from 2022. This is more than our year-end statistics — although, of course, as an

evidence-based practice, we know data is important. Most birth centers have a low

C-section rate, and Roots is no different. Our 2022 surgical birth percentage of 10.98

was well below the national average of about 32 percent.

However, there’s so much beyond our low C-section rate that positively impacts

families! In this blog, we’ll discuss how Roots is providing exceptional care to birthing

people in the Twin Cities.

5 Ways Roots is Helping Birthing Families in the Twin Cities

Providing high-quality reproductive care involves a mindset of education and

collaboration. As midwives, we are not here to tell you what to do. Instead, we aim to

provide evidence-based information, discuss risks and benefits, and trust you to decide

what’s best for you, your body, and your baby. Here are five ways we support you as a

whole person, not just physically but also emotionally and mentally.

Informed Consent

In mainstream obstetrics, there is an unfortunate trend, especially in birthing rooms,

during which a healthcare worker will say something along the lines of, “I’m going to

check you now.” They are, of course, referring to a cervical check, and their wording

leaves no room for discussing options or declining the procedure. At Roots, we always

ask consent before touching you — before every vaginal exam, before every cervical

check, and even before palpating your belly to assess your baby’s position or listen to

their heartbeat.

Informed consent is foundational to our care at Roots. Before touching you or

conducting a test or procedure, we explain why we are asking permission. How does it

benefit you and/or your baby? What are the risks, if any? After you understand and feel

educated enough to make a decision, we ask for your consent. You are also free to say no; we call this informed refusal.

VBAC Success

Have you had a previous cesarean birth? If so, someone might have told you that your

only option for subsequent births is more surgery. However, that’s not always the case!

At Roots Community Birth Center, we accept clients who choose VBAC, an acronym for

vaginal birth after cesarean, and we even support parents who want to have a VBAC

waterbirth. In 2022, the percentage of Roots birthing parents who planned a VBAC and

had a vaginal birth was 70 percent. Additionally, we cared for five families planning

repeat C-sections.

Due to some logistical hiccups, we had to take a brief pause in taking VBAC clients at

the tail end of December. We are incredibly happy to be able to say we will be

continuing to provide VBAC births at Roots going into 2023.

When it comes to a VBAC at Roots, benefits for the birthing parent include the following.

● Encouragement of spontaneous labor and physiologic birth, minimizing

unnecessary interventions

● Supportive, intervention-free care, which leads to greater satisfaction with the

birth experience

● Water immersion during labor and birth to cope with the discomfort of

contractions

● Easier recovery and avoidance of possible complications, like blood loss, incision

pain, or wound infection

● Possibility for more pregnancies and births in the future if you choose to expand

your family

Cultural Competence

We serve a diverse community at Roots. Among our clients, about 65 percent are Black,

and 75 percent of our families have at least one partner who is a person of color. We

also care for folks who identify as Indigenous and LGBTQIA+, and we are committed to

providing affirming care to all of these groups in Minneapolis. One of the ways we

achieve this goal is through cultural competence, a term that means we recognize the

importance of culture and adapt to meet the needs of the community. We believe

culturally competent care helps us respond to inequities, making healthcare more

accessible and improving clients’ satisfaction with their care experiences.

Our entire staff — from the people who greet you at the front desk to those who provide

hands-on care — is committed to anti-oppression work. Roots is dedicated to equity in

all care situations, and we require staff members to attend social justice training. In

addition, we have a diverse team, many of whom identify as Black or LGBTQIA+. This

means that Roots not only offers culturally competent care, but we are also able to

provide culturally congruent care. For example, Black midwives are caring for Black

parents, and Black doulas are supporting Black families.

Lactation Support

When we surveyed our clients, 95 percent of them were still nursing their babies at six

months postpartum. This is an incredibly high number, well above the most recent

national percentage of 55.8. Our midwives are committed to helping you achieve your

lactation goals. During the immediate postpartum time after birth, our environment gives

you the opportunity for plenty of skin-to-skin snuggles and undisturbed time to initiate

breastfeeding gently.

As you continue with your infant feeding journey, we are always available to support you

by taking your phone calls and answering questions. In addition, we have our Lactation

and Baby Feeding Support Group, during which prenatal and postpartum families can

meet in-person with a board-certified lactation consultant to address infant

feeding-related questions and concerns or to learn about lactation and prepare for

feeding their baby in a relaxed, casual environment. This free drop-in clinic meets from

10 a.m. to noon on the first and third Tuesday of every month in the Roots yoga studio.

Postpartum Care and Support

After you give birth at Roots, we do multiple postpartum appointments, which are often

a combination of home, virtual, and clinic visits, depending on your schedule and needs.

All of these appointments are 30-60 minutes long and are to assess both the birthing

parent and the baby. We talk about lactation, mental health, healing, and any concerns

you have. This postpartum care model is quite different from what you’ll find in

hospital-based practices, which typically see you only one time six weeks postpartum.

We also know that postpartum can be challenging. It’s a time of huge adjustment,

learning how to care for a tiny human while your body feels different. In 2022, we

conducted 612 combination postpartum-newborn visits, with roughly one-third being

home visits. Our nonprofit Seed Community Fund provided numerous families with

postpartum supplies, such as breast pads, diapers, meals, and more.

Takeaways About Reproductive Care at Roots

When you choose Roots, you can be confident that you’re receiving high-quality care

during pregnancy, birth, postpartum, and beyond. Our entire team is dedicated to

providing an affirming, gentle experience. To schedule an appointment, call the front

desk at 612-338-2784 or fill out our form!

Photo credits: Chey Varner