EBB 410 - Evidence and Controversy Surrounding Freebirth
Evidence Based Birth®
In this episode, Dr. Rebecca Dekker and Dr. Sara Ailshire examine the available evidence on planned unassisted birth, also known as freebirth, defined as intentionally giving birth without a qualified midwife or physician present. They explore why some people choose a planned unassisted birth, including previous trauma, distrust of the medical system, barriers to preferred care, and a desire for greater autonomy. Dr. Dekker and Dr. Ailshire also explain how freebirth differs from midwife-attended home birth, what research shows about planned community birth, and the safeguards a trained...
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EBB 409 - Business Advice for New Doulas with Katie Nyberg, Doula Trainer and Founder of The Iowa Baby Ladies
Evidence Based Birth®
A passion for supporting families during birth is the foundation for a career as a doula. But once that foundation has been laid, it takes business skills, boundaries, and collaboration to be sustainable. In this episode, Dr. Rebecca Dekker talks with Katie Nyberg, founder of The Iowa Baby Ladies, about her journey from fifth-grade teacher to doula, trainer, and owner of one of Iowa’s largest doula agencies. Katie shares the early lessons she learned about setting fees, communicating with clients, and navigating the unpredictable realities of on-call work. Katie also opens up about...
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REPLAY: EBB 344 - Crash Course in Perinatal Mood Disorders and Treatment with Dr. Kat Kaeni, Perinatal Psychologist and Past Board Chair of Postpartum Support International
Evidence Based Birth®
Perinatal mental health is often a misunderstood landscape shaped by stigma, cultural expectations, and invisible struggles that touch entire families. In this replay episode, Dr. Rebecca Dekker sits down with Dr. Kat Kaeni, perinatal mental health certified psychologist, author of The Pregnancy Workbook, and host of the Mom & Mind podcast, to break the silence around postpartum anxiety, depression, OCD, and psychosis. Drawing on her professional expertise and personal experience, Dr. Kat reveals why shame and isolation are so common, how symptoms really show up for new parents,...
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EBB 408 - "What They Didn't Tell Me about Birth and Parenthood" with Dr. Jessica Vernon, Board-Certified OB/GYN and Perinatal Coach
Evidence Based Birth®
Pregnancy, birth, and postpartum care should support the whole person, physically and mentally. In this episode, Dr. Rebecca Dekker talks with board-certified OB/GYN and perinatal coach Dr. Jessica Vernon about how integrative medicine can create a more holistic and personalized approach to obstetric care. Dr. Vernon explains how integrative care combines traditional Western medicine with complementary approaches such as therapy, physical therapy, acupuncture, yoga, breathwork, meditation, and nutrition. She also shares how her own experience with postpartum anxiety and depression...
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EBB 407 - Migraines and Insulin and Umbilical Vein Varix, Oh My! An Empowering Pregnancy and Hospital Birth Story with Heidi Gustad, Librarian and EBB Childbirth Class Graduate
Evidence Based Birth®
After years of hearing traumatic birth stories and questioning whether parenthood was right for her, Heidi Gustad entered pregnancy determined to make informed decisions every step of the way. When she was diagnosed with insulin-managed gestational diabetes, debilitating migraines, and a rare umbilical cord abnormality called an umbilical vein varix, the birth center birth she had envisioned was suddenly no longer an option. In this episode, Heidi shares how evidence-based education, a supportive care team, and careful preparation helped her navigate unexpected changes with confidence....
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EBB 406 - Critical Info Every Expecting Family Should Know about Cytomegalovirus (CMV) with Megan Nix, Author of Remedies for Sorrow
Evidence Based Birth®
Congenital cytomegalovirus (CMV) is the leading infectious cause of congenital disorders in the United States, but many pregnant families have never heard of it. In this episode, Dr. Dekker is joined by author Megan Nix who shares the personal story behind her memoir, "Remedies for Sorrow," and discusses how gaps in the system leave many families unaware of this common virus. Megan shares how her daughter Anna's congenital CMV diagnosis changed her family's life and launched her years-long investigation into why such a common condition remains largely absent from prenatal education. You’ll...
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REPLAY: EBB 267 - Debunking Myths about Fundal Massage with Barbie Christianson, RN
Evidence Based Birth®
Fundal massage, also known as uterine massage, is often performed as a routine procedure after birth, but research shows it does little to prevent postpartum hemorrhage and can be painful for many. On today's replay episode of the EBB Podcast, nurse, community educator, and advocate Barbie Christianson joins Dr. Rebecca Dekker to talk about the myths surrounding this common postpartum procedure and how it connects to broader patterns of obstetric violence in maternity care. Barbie explains the difference between a fundal assessment, a routine massage, and the massage used to treat active...
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EBB 405 - Navigating Unexpected Turns in Pregnancy, Birth, and Postpartum with Emily Cook, EBB Childbirth Class Graduate and Preeclampsia Survivor
Evidence Based Birth®
Emily Cook hoped for a low-intervention birth. But after managing high blood pressure throughout her pregnancy, her plans changed when she was diagnosed with preeclampsia late in her third trimester. In this episode, Emily shares how the EBB Childbirth Class helped her prepare to navigate an unexpected induction, magnesium therapy, and an epidural while still advocating for the birth experience she wanted. She talks about asking questions, requesting a lower-dose epidural so she could remain mobile, advocating for wireless fetal monitoring and hands-and-knees pushing, and finding...
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EBB 404 - Mini Q&A about Average Time Spent Pushing, Precipitous Labor, and Okra Water During the Third Trimester
Evidence Based Birth®
How long does the pushing phase of labor typically last? Does precipitous labor run in families? And can drinking okra water actually make labor and birth easier? In this Q&A episode, Dr. Rebecca Dekker tackles three questions submitted by EBB Pro Members. First, Dr. Dekker details the findings of a recently published study from France that found many birthing people spent less than 15 minutes actively pushing before birth. She explains the concept of delayed pushing and why these results may not be easily replicated in other birth settings. She also reviews the available evidence on...
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EBB 403 - Why Is My Hospital's Cesarean Rate So High (or Low)? with Dr. Emily White VanGompel, Family Medicine Physician and Research Scientist
Evidence Based Birth®
Even when caring for similar patient populations, some hospitals have significantly higher Cesarean rates than others, and factors like teamwork, psychological safety, leadership, staffing, and beliefs about childbirth can affect outcomes. In this episode, Dr. Rebecca Dekker talks with family physician and researcher Dr. Emily White VanGompel about how the culture of labor and delivery units can shape decision-making and influence the birth experience for families. Dr. White VanGompel explains the NTSV (nulliparous, term, singleton, vertex) Cesarean rate, why it is used as a quality...
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.