EBB 110 - Inside an Unplanned, Unassisted Home Birth with Parent Sabrina Tran
Release Date: 01/08/2020
Evidence Based Birth®
The evidence shows that vaginal birth after cesarean (VBAC) is a safe option for many families, but it’s still frequently inaccessible to them. In this episode, Dr. Rebecca Dekker and Dr. Nicholas Rubashkin discuss the systemic barriers that limit families’ opportunities to choose a VBAC. They explore how hospital policies, outdated guidelines, and clinical tools like the VBAC calculator have shaped who’s a “good candidate” and who is not. Dr. Rubashkin also shares insights from his research on inequities in maternity care, including how race-adjusted algorithms reinforce...
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Learn more about EBB's upcoming Induction Bootcamp on Tuesday, April 28 from 2:00 - 4:30 PM EDT. To save your seat or access the replay, join the EBB Pro Membership for just $39 for your first 30 days: .
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Postpartum care wasn’t always rushed, clinical, or isolating. In many African-American communities, the weeks after birth were treated as sacred time where families and communities gathered to care for the mother so she could focus on caring for her baby. In this episode, Dr. Rebecca Dekker talks with renowned midwife, cultural historian, and author Shafia Monroe about the traditions documented in her new book Mothering the Mother: African-American Postpartum Traditions, Recipes, and Healing. Mama Shafia shares how historically rooted postpartum practices—from the 42-day...
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Every pregnant person deserves the information and support they need to make truly informed decisions about labor induction. In this encore episode, Dr. Rebecca Dekker talks with Dr. Ann Peralta and Kari Radoff, CNM, the co-creators of Partner to Decide, a nonprofit improving decision-making in perinatal care. They discuss their free, multilingual decision aid that helps families understand their options around routine induction of labor and empowers them to advocate for their own values, preferences, and autonomy. Ann shares how her own birth experience, shaped by access to education and...
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Artificial intelligence is rapidly changing how people search for information, including how families learn about pregnancy and birth. As this technology grows, it raises important questions about accuracy, ethics, and the role of human expertise in healthcare information. In this episode, Dr. Rebecca Dekker and Dr. Sara Ailshire share a behind-the-scenes look at how Evidence Based Birth® developed its own AI policies. They discuss concerns about misinformation, bias, privacy, and environmental impact, as well as the potential effects on critical thinking and human connection. ...
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At the 41-week mark in pregnancy, conversations and decisions about induction can start to feel more urgent and complex. In this episode, Dr. Rebecca Dekker and Dr. Sara Ailshire share why the 41st week has become such a focus in maternity care and what the evidence actually says about induction at this milestone. They discuss elective induction versus expectant management and key findings from major studies like the INDEX and SWEPIS trials. They also talk through potential benefits and risks, including changes in stillbirth risk, newborn outcomes, and maternal experiences. ...
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EBB Childbirth Class Graduates Paige Wener and Kevin Booth hoped for a low-intervention water birth at their midwife-led birth center in rural Vermont. But at 38 weeks and 6 days, a routine prenatal visit led to a surprise diagnosis of preeclampsia and recommendation for induction. In this episode, Paige and Kevin share the story of their 54-hour induction, including misoprostol, a Cook catheter, Pitocin, and eventually an epidural after more than a day of labor, with Kevin supporting Paige with counterpressure, movement, and comfort measures along the way. Paige also shares about recovering...
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Electronic fetal monitoring is one of the most common interventions in hospital birth, but it's also one of the least understood. In this episode, Dr. Rebecca Dekker talks with board-certified OB-GYN Dr. Jennifer Lincoln about what continuous electronic fetal monitoring actually does, what the research says, and why it became such a routine part of labor care in the first place. With recent media attention shining a spotlight on this technology, they break down the history, the evidence, and the real-world pressures that shape how it’s used today. Learn why continuous monitoring can increase...
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In this episode, we explore how the traditional “game of telephone” model in hospitals can leave birthing people out of critical decisions about their own care and what happens when we redesign the system to center them instead. Dr. Rebecca Dekker sits down with Dr. Amber Weiseth, obstetric nurse and Director of the Delivery Decisions Initiative at Ariadne Labs, to talk about TeamBirth—a simple, evidence-based communication model transforming labor and delivery units across the U.S. and globally. Learn how structured bedside “huddles,” shared decision-making, and a visible planning...
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Some of the most effective solutions for improving birth outcomes worldwide are rooted in relationships, not technology. In this episode, Dr. Rebecca Dekker speaks with midwife Stephanie Marriott of the International Confederation of Midwives about the global impact of midwifery care. She outlines what defines a midwifery model of care, why continuity of midwife-led care matters for both outcomes and experiences, and how trust and relationship-based care can influence Cesarean rates, trauma-informed care, and access to services. Stephanie draws on her work across the U.K., Asia, and Africa to...
info_outlineIn this episode, I am joined by Sabrina Tran of Alabama, who recently had a daughter, and took the Evidence Based Birth Childbirth Class with Instructor Traci Weafer. Sabrina, a therapist, is now a stay at home mom.
Sabrina had a precipitous - or, extremely fast labor and delivery. She describes it as exciting! Hear her tell her story of how her baby was born before the midwife could make it to her home. I also share the evidence on perineal tearing, and the relationships between tearing, provider experience, and home birth.
For more information and news about Evidence Based Birth®, visit www.ebbirth.com. Find us on Facebook, Instagram, and Pinterest. Ready to get involved? Check out our Professional membership (including scholarship options) and our Instructor program. Find an EBB Instructor here, and click here to learn more about the Evidence Based Birth® Childbirth Class.
RESOURCES:
Click here for great images explaining perineal tears on the Mayo Clinic website.
More references:
- Albers, L. L., Sedler, K. D., Bedrisk, E. J., et al. (2005). Midwifery care measures in the second stage of labor and reduction of genital tract trauma at birth: a randomized trial. J Midwifery Womens Health. 50(5): 365-372.
- Mizrachi, Y., Leytes, S., Levy, M., et al. (2017). Does midwife experience affect the rate of severe perineal tears? Birth. 44(2): 161-166.
- Begley, C., Guilliland, K., Dixon, L., et al. (2018). A qualitative exploration of techniques used by expert midwives to preserve the perineum intact. Women Birth.
- Kopas, M. L. (2014). A review of evidence-based practices for management of the second stage of labor. J Midwifery Womens Health. 59(3):264-76.
- Shorten, A., Donsante, J. and Shorten, B. (2002). Birth position, accoucheur, and perineal outcomes: informing women about choices for vaginal birth. Birth. 29(1): 18-27.
- Sandall, J., Soltani, H., Shennan, A., et al. (2013). Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. (8): CD004667.
- Hutton, E. K., Cappelletti, A., Reitsma, A. H., et al. (2016). Outcomes associated with planned place of birth among women with low-risk pregnancies. CMAJ. 188(5): E80-E90.
- Hastings-Tolsma, M., Vincent, D., Emeis, C., et al. (2007). Getting through birth in one piece: protecting the perineum. MCN AM J Matern Child Nurs. 32: 158-64.
- Landy H. J., Laughon, S. K., Bailit, J. L., et al. (2011). Characteristics associated with severe perineal and cervical lacerations during vaginal delivery. Obstet Gynecol. 117(3): 627-35
- Klein, M. C., Gauthier, R. J., Jorgensen, S. H., et al. (1992). Does episiotomy prevent perineal trauma and pelvic floor relaxation? Online J Curr Clin Trials. 10.
- Klein, M. C., Gauthier, R. J., Robbins, J. M., et al. (1994). Relationship of episiotomy to perineal trauma and morbidity, sexual dysfunction, and pelvic floor relaxation. Am J Obstet Gynecol. 171(3): 591-8.
- Aasheim, V., Nilsen, A. B. V., Reinar, L. M., et al. (2017). Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database of Sys Rev. 6: CD006672
- Alliman, J. and Phillippi, J. C. (2016). Maternal Outcomes in Birth Centers: An integrative review of the literature. J Midwifery Womens Health. 61(1): 21-51.
- Cheyney, M., Bovbjerg, M., Everson, C., et al. (2014). Outcomes of care for 16,924 planned home births in the U.S.: the Midwives Alliance of North America Statistics Project, 2004 to 2009. J Midwifery Womens Health. 59(1): 17-27.
- Hutton, E. K., Cappelletti, A., Reitsma, A. H., et al. (2016). Outcomes associated with planned place of birth among women with low-risk pregnancies. CMAJ. 188(5): E80-E90.
Click here to access the EBB Signature Article, The Evidence on: Waterbirth.