Chronicle photo by Vanessa McGuigan Shanna Mastrangelo, Certified Professional Midwife and owner of Birthroot Midwifery, is shown.

Shanna Mastrangelo, owner and certified Professional Midwife at Birthroot Midwifery, located at 217 S. Duke St., suite 100, knew she wanted to be involved with the birth process after having children of her own.

She was a birth doula for almost five years and attended many hospital and birth center births. She was later invited to attend a home birth and it struck a chord. She knew that was where she was supposed to be.

Mastrangelo went through a midwifery school for 18 months, a traditional 2-year clinical apprenticeship with midwives who attend home births, a six week clinical apprenticeship in Indonesia at a maternity clinic that serves high-risk women, completed volumes of paperwork and sat for an 8 hour exam all to receive her national certification.

Helping women experience a natural birth determined by the birth mom’s physiology, not necessarily defined by traditional medical context is Mastrangelo’s passion.

“Midwives don’t intervene unless it’s for safety,” Mastrangelo said. “Doctors tend to intervene to speed things up and make it more efficient. If mom and baby are doing well, we don’t push things. We allow it to happen in its own time.”

According to Mastrangelo, intervention can cause more harm than good – for mother and baby.

“There are times when induction and C-sections are absolutely necessary, but the World Health Organization estimates that the United States has been doing these procedures too frequently,” Mastrangelo said. “It has actually caused our maternal mortality rates to rise. We’re the only industrialized nation in the world that has a continually rising maternal mortality rate. Every other developed nation in the world is trending downward, and we’re going up.”

This information was corroborated by the Institute of Health Metrics and Evaluation, a research group funded by the Gates Foundation and based at the University of Washington. The institute found that there were 28 maternal deaths due to complications from pregnancy or childbirth per 100,000 births in the United States in 2013, up from 23 in 2005.

There are different reasons for this trend. Mastrangelo said, “There’s really good evidence to suggest that high-risk (pregnancy) women should receive more care and testing than what we’re doing.” She continued saying, “On the other side, when a low-risk mom who’s having a healthy, uncomplicated pregnancy comes in and doesn’t want all sorts of extra testing, they’re kind of shamed and made to feel like they’re not healthy. With the medical system and maternity it’s like you’re unhealthy until proven otherwise. It’s not an okay approach to take. They don’t need all the testing that they’re bullied into. If they want it for peace of mind, that’s awesome and they should be able to do that. We tend to find to ‘problems’ that aren’t really problems by doing all this extra testing, and then treat them accordingly.”

According to Mastrangelo, women who are bullied into making decisions don’t really have informed consent. They often aren’t allowed to make informed choices about their care and are told if they want to use a particular practice or hospital, they have to bow to the protocol of a particular institution. As a result, more women are choosing to give birth outside of hospitals.

Mastrangelo says a lot of her clients are first-time moms who want to avoid the primary cesarean section.

“Again, if you need a cesarean, then that’s great that you have access to that, but if you don’t and get bullied into an induction-and half of all inductions fail and lead to c-sections-then it complicates every pregnancy after that,” she said.

Other clients are ones who have had traumatic experiences in the hospital or who have not been allowed their own preferences in terms of labor and delivery.

“The care I provide is very much a partnership. It’s not me telling you’re going to do to have a baby, it’s us making decisions together and figuring out what’s the best for each individual mom,” Mastrangelo said.

Clients come to the office for every visit up to 36 weeks then she goes to their homes for the subsequent visits and home birth.

She accepts a limited amount of clients, but says there is a great network in place with other midwives in the area to provide overlapping care when necessary. She also works with certain obstetricians and doctors in case she needs a second opinion.

According to Mastrangelo, she has been involved in the medical field since she was 16. She became an EMT in Williamsport, Maryland and actively ran calls for seven years until she had children. She still maintains her West Virginia EMT certifications so that she can keep up with those skills. With a family who frequently goes rock climbing, hiking or spending time on the river, she said those skills have come in handy on several occasions.

Mastrangelo said likes developing strong relationships with her clients and as such would like to expand her practice to provide full care for families in the future, although she says she will always be a midwife in some capacity. She is currently attending Shepherd University to complete her Bachelor of Science in Nursing, then she would immediately like to start graduate school in the family nurse practitioner program.

“We are sometimes called the ‘Guardians of Safety,'” Mastrangelo said. “We are there in case something goes wrong. Midwives literally save lives. I love what I do.”