EBB 320 - Evidence on the Impact of Epidurals on the Pushing Phase of Labor
Evidence Based Birth®
The impact of epidurals on the second stage of labor has sparked a lot of discussion. Research suggests that epidurals can prolong this stage... and a prolonged second stage can be associated with increased risks of infection, severe tears and the need for interventions like forceps-assisted delivery or Cesarean. But does an epidural mean that you are higher risk for complications during the second stage of labor, or are there ways to lessen your risks? In this episode, Dr. Dekker explores the physiological effects of epidurals (and how they impact your body's birthing reflexes), the...
info_outline
EBB 319 - Exploring Love and Intimacy in Birth with Debra Pascali-Bonaro, Founder of Orgasmic Birth
Evidence Based Birth®
Dr. Rebecca Dekker's joined by Debra Pascali-Bonaro, host of the Orgasmic Birth podcast, to explore the connections between love, intimacy, and childbirth. A world-renowned speaker and doula trainer, and the creative force behind the documentary "Orgasmic Birth: The Best-Kept Secret," Debra shares her origins into the world of childbirth education and her groundbreaking work. Debra and Dr. Dekker delve into how intimacy can enhance the birthing experience by promoting relaxation, reducing fear, and allowing for a more joyous and fulfilling labor. Learn how the power of pleasure and joy can...
info_outline
EBB 318 - Advocating for Waterbirth in Hospitals with Dr. Liz Nutter, DNP, CNM, and Retired Lieutenant Colonel
Evidence Based Birth®
Dr. Liz Nutter, a retired Lieutenant Colonel with over 20 years of nursing and healthcare leadership experience, is bringing her expertise as a board-certified nurse midwife and national expert in waterbirth and hydrotherapy evidence-based practice. Dr. Nutter shares her journey from serving in the United States Army to becoming an assistant professor at St. Martin's University in Washington State. She discusses her pivotal role in advocating for waterbirth practices within the military healthcare system and maternal health rights within the military, including extending maternity leave to...
info_outline
REPLAY: EBB 186 – A Positive Pregnancy and Birth Outcome with Multiple High-Risk Labels with EBB Childbirth Class Parent, Angela Jones
Evidence Based Birth®
Today, we’re sharing a replay of our podcast episode with EBB Childbirth Class parent, Angela Jones, about having an uncomplicated pregnancy and birth when labeled as high risk. Angela is a macro-level social worker, wife to her husband, Tony, and mom to her son, Allister, and their cats, Pumpernickel and Lion-O. Angela and Tony graduated from the Evidence Based Birth Childbirth Class with EBB instructor, Victoria Michonski. Both Victoria and Heather McCullough, who is also an EBB instructor, were Angela and Tony’s doulas for Allister’s birth. In today's replay, we talk about Angela’s...
info_outline
EBB 317 - Evidence on Epidurals for Pain Management during Labor
Evidence Based Birth®
Have you ever wondered what the evidence is on epidurals for pain management during labor? Join us on today’s podcast as we discuss most recent evidence on epidurals, spinals, and combined spinal-epidurals! We’ll begin with some background on these methods, including how common they are in the U.S. and around the world, before moving on to the effectiveness, benefits, and risks for use during labor. We’ll also talk about alternative methods of pain relief during labor, and share recommendations from professional healthcare organizations. [Bonus addition to the podcast at 20:00: We talk...
info_outline
EBB 316 - Discovering a Passion for Birth Work and Training the Next Generation of Black Doulas with Brandie Bishop, CEO of the National Black Doulas Association
Evidence Based Birth®
Brandie Bishop, CEO of the National Black Doulas Association (NBDA), joins us to explore the vital role of doulas in supporting pregnant individuals and families within Black and Brown communities. From her early experiences working with refugee families to her passion for advocating for marginalized populations, Brandie's unique journey into birth work led to her role today— continuing NBDA's mission of training the next generation of Black doulas. Through comprehensive trainings and mentorship programs, NBDA aims to empower doulas to make a meaningful impact in reducing maternal mortality...
info_outline
EBB 315 - Supporting LGBTQ+ Families from Fertility through Parenthood with Gena Jaffe, Founder of Connecting Rainbows
Evidence Based Birth®
In this episode, Dr. Dekker's joined by Gena Jaffe, an LGBTQ+ activist, attorney, and founder of Connecting Rainbows©️. Gena shares her personal story of embarking on reciprocal IVF with her wife and the legal hurdles they faced as a lesbian couple. From navigating complex parental rights to accessing inclusive healthcare, Gena sheds light on the challenges faced by some LGBTQ+ individuals and families on their path to parenthood. Gena's experience led her to creating Connecting Rainbows©️, a groundbreaking organization offering free legal and fertility resources tailored to the...
info_outline
EBB 314 - Babywearing Benefits and Tips with Whitney Dula, IBCLC, Postpartum Doula, and Babywearing Expert
Evidence Based Birth®
Learn about the world of babywearing, including its impact on infant development, digestion, and sleep with Whitney Dula, a maternal child health advocate and founder of The Mama's Dula. Whitney shares her personal journey into babywearing, the rich cultural history of babywearing, its role in community-based child-rearing practices, and practical tips for parents. From fostering a close bond between caregivers and babies to being an affordable alternative to expensive baby carriers, learn how this practice could benefit you and your child. Learn more about Whitney and The Mama's Dula . Follow...
info_outline
EBB 313 - A Birth Story with Hydrotherapy and Injectable Opioids for Pain Management with Melissa and Brendon Smyles, EBB Childbirth Class Graduates
Evidence Based Birth®
In this episode, EBB Childbirth Class graduates Melissa and Brendon Smyles' share their experiences preparing for an unmedicated birth while embracing flexibility in their birthing plan. From the unexpected premature rupture of membranes to the decision to use fentanyl for rest during labor, Melissa and Brendon tell their birth story, emphasizing the importance of informed choices and personalized support. Join us as they reflect on the transformative power of evidence-based education and the profound impact of tailored guidance and informed decision making in achieving a positive birth...
info_outline
EBB 312 - Evidence on Injectable Opioids for Pain Management during Labor
Evidence Based Birth®
Were you aware that beyond the standard epidural, there is an additional medication option for managing pain during childbirth? Today, Dr. Dekker discusses another common option, intravenous (IV) or intramuscular (IM) opioids. Dr. Dekker explains the different types of injectable opioids available during labor, how they work, and the current evidence that you need to know to make an informed decision. Plus, learn about the benefits and risks of IV opioids for pain relief labor and an in-depth look at one opioid in particular: Remifentanil, which is commonly given through a...
info_outlineIn this episode, I am excited to share the evidence on vaginal birth after Cesarean, or VBAC. We have received many requests at Evidence Based Birth to cover this topic, so I want to share with you the information on VBAC that I present in a class we teach in the EBB Higher Ed program.
In this podcast, I define some common terms related to VBAC and talk about the history of the procedure. By the end, you will have the facts on the prevalence and risk factors for uterine rupture, and you’ll understand some of the maternal, fetal, and newborn risks of VBAC, elective repeat Cesarean, and Cesarean birth after Cesarean.
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:
- American College of Obstetricians and Gynecologists/ Society for Maternal-Fetal Medicine (2018). Placenta accreta spectrum. Obstetric Care Consensus No. 7. Obstet Gynecol, 132, e259-275. Click here. Free full text!
- Bujold, E., Goyet, M., Marcoux, S., et al. (2010). The role of uterine closure in the risk of uterine rupture. Obstet Gynecol, 116(1), 43-50.
- Carlton Fagerberg, M. and Källén, K. (2019). Third trimester prediction of successful vaginal birth after one cesarean delivery - a Swedish model. Acts Obstet Gynecol Scand. (Epub ahead of print.] Click here.
- Grobman, W. A., Lai, Y., Landon, M. B., et al. (2007). Development of a nomogram for prediction of vaginal birth after cesarean delivery. Obstet Gynecol, 109, 806. Click here.
- VBAC calculator for use at first prenatal visit: https://mfmunetwork.bsc.gwu.edu/PublicBSC/MFMU/VGBirthCalc/vagbirth.html\
- Guise, J.-M., Eden, K., Emeis, C., et al. (2010). Vaginal Birth After Cesarean: New Insights. Evidence Report/Technology Assessment No.191. (Prepared by the Oregon Health & Science University Evidence-based Practice Center under Contract No. 290-2007-10057-I). AHRQ Publication No. 10-E003. Rockville, MD: Agency for Healthcare Research and Quality. Click here. Free full text!
- Landon, M. B., Hauth, J. C., Leveno, K. J. et al. (2004). Maternal and Perinatal Outcomes Associated with a Trial of Labor after Prior Cesarean Delivery. N Engl J Med, 351, 258-2589. Click here. Free full text!
- Landon, M. B., Grobman, W. A. and Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network (2016). What We Have Learned About Trial of Labor After Cesarean Delivery from the Maternal-Fetal Medicine Units Cesarean Registry. Seminars in perinatology, 40(5), 281–286. Click here. Free full text!
- Metz, T. D., Stoddard, G. J., Henry, E., et al. (2013). Simple, validated vaginal birth after cesarean delivery prediction model for use at the time of admission. Obstet Gynecol, 122, 571. Click here. Free full text!
- VBAC calculator for use at time of admission for birth: https://mfmunetwork.bsc.gwu.edu/PublicBSC/MFMU/VGBirthCalc/vagbrth2.html
- Sandall, J., Tribe, R. M., Avery, L., et al. (2018). Short-term and long-term effects of caesarean section on the health of women and children. Lancet, 392(10155), 1349-1357. Click here.
- Silver, R. M., Landon, M. B., Rouse, D. J., et al. (2006). Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol, 107(6), 1226-1232. Click here.
- Smith, G. C. S., Pell, J. P., Cameron, A. D., et al. (2002). Risk of Perinatal Death Associated With Labor After Previous Cesarean Delivery in Uncomplicated Term Pregnancies. JAMA, 287(20), 2684–2690. Click here. Free full text!
- Vlemminx, M. W., de Lau, H. and Oei, S. G. (2017). Tocogram characteristics of uterine rupture: a systematic review. Archives of gynecology and obstetrics, 295(1), 17–26. Click here. Free full text!
- Access the International Cesarean Awareness Network’s "Terminology: What is a CBAC?” here.
- Visit VBAC Facts here.
- Visit ICAN here.
- See the Association of Ontario Midwives Clinical Guidelines Statement on Vaginal Birth After Previous Low-Segment Cesarean Section here.
- Get the Association of Ontario Midwives handout, Thinking About VBAC: What’s Right for Me, here.
- Get information on VBAC from Power to Push here (http://www.powertopush.ca/birth-options/types-of-birth/vaginal-birth-after-cesarean/).
- Click here (https://evidencebasedbirth.com/the-evidence-for-skin-to-skin-care-after-a-cesarean/) for the Evidence Based Birth® Signature Article, The Evidence on: Skin to Skin Care After Cesarean.