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EBB 113 - The Evidence on VBAC

Evidence Based Birth®

Release Date: 01/29/2020

EBB 363 - A Remarkable Journey from EBB 363 - A Remarkable Journey from "Babies Are Not Pizzas" Student to Critical Care Nurse to Nurse Midwife with Liz Carr, CNM

Evidence Based Birth®

From ICU to birth center, Liz Carr’s story is a reminder that midwives come to this work through many paths, and each journey holds wisdom for the future of maternal care.   In this episode, Dr. Rebecca Dekker reconnects with former nursing student turned certified nurse midwife, Liz Carr. Liz shares her unique trajectory: from critical care nursing to catching babies, from witnessing obstetric violence as a student to providing trauma-informed, evidence-based midwifery care. Liz and Rebecca explore the impact of diverse clinical experiences, the challenges of navigating midwifery...

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EBB 362 - Doula Wisdom and Holistic Practices for Pregnancy and Postpartum with Carson Meyer, Doula and Author of Growing Together show art EBB 362 - Doula Wisdom and Holistic Practices for Pregnancy and Postpartum with Carson Meyer, Doula and Author of Growing Together

Evidence Based Birth®

Carson Meyer, doula, certified nutrition consultant, and author of Growing Together, joins Dr. Rebecca Dekker for a conversation about reclaiming the sacred, intuitive, and evidence-based aspects of pregnancy, birth, and postpartum. Carson shares how she stepped into birth work at a young age, driven by a desire to transform a system that can leave parents disempowered and unsupported. She opens up about her own home birth experience, the spiritual preparation that carried her through, and the tools she now teaches others through her virtual Growing Together Circles. Together, Carson and Dr....

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REPLAY: EBB 210 - Evidence on Warm Compresses and Hands-on vs. Hands-off for Protecting the Perineum show art REPLAY: EBB 210 - Evidence on Warm Compresses and Hands-on vs. Hands-off for Protecting the Perineum

Evidence Based Birth®

Curious how to actually prevent perineal tears during childbirth? In this episode, Dr. Rebecca Dekker breaks down the latest research on three of the most talked-about methods: 1) using warm compresses, 2) provider “hands on” techniques, 3) provider “hands off” techniques, and how these approaches measure up when it comes to protecting your perineum. You’ll learn surprising facts, like how a simple warm washcloth can significantly lower your risk of severe tears (and even ease pain!), plus what the evidence really says about whether a provider should help “guard” the perineum or...

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EBB 361 - Supporting Intersex Communities during Birth with Niki Khanna and Catherine Clune-Taylor, Co-Presidents of InterACT show art EBB 361 - Supporting Intersex Communities during Birth with Niki Khanna and Catherine Clune-Taylor, Co-Presidents of InterACT

Evidence Based Birth®

Most parents are told their baby is either a boy or a girl. But what happens when a baby is born with intersex traits—and how can birth workers and clinicians respond with compassion, accuracy, and care? In this episode, Dr. Rebecca Dekker speaks with Niki Khanna, MA, MFT, and Dr. Catherine Clune-Taylor, co-presidents of InterACT, about how to support families when a baby’s physical sex characteristics don’t fit binary expectations. Together, they explore how often this occurs, what parents are typically told in the hospital, and why rushed decisions about infant genital surgery can...

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EBB 360 - Overcoming Challenges with Low Milk Supply with Katie James, Midwife, IBCLC, and Host of the Midwives' Cauldron Podcast show art EBB 360 - Overcoming Challenges with Low Milk Supply with Katie James, Midwife, IBCLC, and Host of the Midwives' Cauldron Podcast

Evidence Based Birth®

Struggling with low milk supply can feel overwhelming, isolating, and confusing. In this episode, Dr. Rebecca Dekker talks with midwife and International Board Certified Lactation Consultant Katie James to demystify the realities of low milk supply. Together, they explore the hormonal, medical, and systemic factors that can affect lactation, as well as the critical importance of early postpartum support. Katie shares how birth interventions, lack of education, and misinformation can interfere with lactation—and how reclaiming knowledge, honoring instinct, and receiving timely help can make...

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Special Announcement - Become an EBB Instructor show art Special Announcement - Become an EBB Instructor

Evidence Based Birth®

Special Announcement from EBB! If you're an experienced birth worker or health care professional and you're interested in becoming an Evidence Based Birth Instructor, applications for 2025 are opening soon for a limited time only!   Podcast listeners who are interested in becoming an EBB Instructor are invited to on Wednesday, May 28 at 1:00 PM EDT.    We’ll be answering your questions about who is eligible to apply, what the application process looks like, and the support and training you’ll receive as an EBB Instructor.   Whether you're thinking about teaching...

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EBB 359 - Mini Q & A on Early Induction for Gestational Hypertension, Acupuncture/Acupressure for Labor, and Time Intervals between Pregnancies show art EBB 359 - Mini Q & A on Early Induction for Gestational Hypertension, Acupuncture/Acupressure for Labor, and Time Intervals between Pregnancies

Evidence Based Birth®

  In this Q&A episode, Dr. Rebecca Dekker answers questions submitted by EBB Pro Members—each exploring a different facet of evidence-based maternity care.   First, she explores the latest evidence on early induction for gestational hypertension, including findings from the WILL trial and other recent studies. What are the real risks and benefits of inducing labor at 37 or 38 weeks for gestational hypertension? And how should families weigh these decisions with their providers?   Next, Dr. Dekker shares new insights into the effectiveness of acupuncture and...

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EBB 358 - EBB 358 - "I Need to Give Consent" and Seeking Trauma-Informed Birth Support after a First Traumatic Experience with Rivka and Steven Dubinsky, EBB Childbirth Class Graduates

Evidence Based Birth®

A traumatic first birth can shape everything that follows—but with the right support, education, and advocacy, it's possible to turn fear into empowerment.   In this episode, Dr. Rebecca Dekker sits down with EBB Childbirth Class Graduates Rivka and Steven Dubinsky as they share the transformative journey from a traumatic hospital induction and birth injury to a redemptive second birth experience centered on autonomy, education, and trust. Rivka opens up about how her first birth left her physically injured and emotionally shaken, and how she didn’t initially recognize it as...

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EBB 357 - Making Decisions about Elective Induction of Labor with Dr. Ann Peralta & Kari Radoff, CNM, from Partner to Decide show art EBB 357 - Making Decisions about Elective Induction of Labor with Dr. Ann Peralta & Kari Radoff, CNM, from Partner to Decide

Evidence Based Birth®

Every pregnant person deserves the information—and support—they need to make truly informed decisions about labor induction. In this episode, Dr. Rebecca Dekker talks with Dr. Ann Peralta and Kari Radoff, CNM, co-creators of Partner to Decide, a nonprofit initiative improving decision-making in perinatal care. They discuss the creation of their free, multilingual decision aid that supports families in understanding their options around routine induction of labor—and empowers them to advocate for their values, preferences, and autonomy.   Ann shares how her own birth...

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REPLAY: EBB 206 - Evidence on Perineal Tears and the Importance of Avoiding Episiotomy with EBB Founder, Dr. Rebecca Dekker show art REPLAY: EBB 206 - Evidence on Perineal Tears and the Importance of Avoiding Episiotomy with EBB Founder, Dr. Rebecca Dekker

Evidence Based Birth®

In today’s episode, we’re diving into the evidence on perineal tears and the importance of avoiding episiotomies during childbirth. We’ll talk about what perineal tears are, the different types that can occur, and the potential health consequences that can follow. You’ll also hear about the various factors that may increase or decrease the risk of tearing during birth. Finally, we’ll cover why it’s so important to avoid an episiotomy during childbirth. Content warning: Discussion of perineal tears during childbirth, severe tears, episiotomy, and obstetric violence related to...

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More Episodes

In 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.