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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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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Navigating a neonatal intensive care unit (NICU) experience can be overwhelming and emotionally taxing. In this episode, Dr. Rebecca Dekker talks with Mary Farrelly, a certified NICU nurse, doula nurse educator, and founder of The NICU Translator. With over a decade of experience in a Level 4 NICU, Mary shares how families can find empowerment and confidence in the NICU. Mary discusses the importance of emotional, social, and informational support for families, and how NICU-informed doulas can play a critical role in bridging the gap between parents and medical teams. From...
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How can art serve as a powerful way to honor pregnancy, birth, and parenting experiences—especially for families who are often underrepresented in birth spaces? In this episode, Dr. Rebecca Dekker explores this question with Lauren J. Turner, a Baltimore-based artist, birth worker, and founder of Birth Nerds. Lauren shares how her own home birth experiences, her journey with postpartum and neurodivergence, and a diagnosis of multiple sclerosis shaped her path into birth work and fine art. Together, Rebecca and Lauren explore how art can be a healing, meditative...
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Dr. Rebecca Dekker is joined by Camilla Costa Goetz, a graduate of the EBB Childbirth Class, to share her story of advocating for herself during labor. Camilla, a former fashion student turned full-time mom, opens up about navigating pregnancy with POTS (Postural Orthostatic Tachycardia Syndrome), preparing for birth while her husband was away at Army Ranger School, and making the bold decision to push back against hospital norms to have the birth she wanted. Tune in as Camilla and Rebecca discuss why self-advocacy is crucial in birth, how hospital policies can conflict...
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In this mini Q&A, Dr. Rebecca Dekker digs into the evidence on three important questions submitted by EBB Pro Members. Tune in as we explore: The evidence on peanut balls during early and active labor—do they really shorten labor and increase vaginal birth rates? Whether induction at 39 weeks is necessary for IVF pregnancies—what does the research actually say? Dysphoric Milk Ejection Reflex (D-MER)—what is it, what causes it, and how can parents cope? (02:30) How to Join the EBB Pro Membership & Submit Questions (04:15) (Q1) Peanut Balls in Labor – What...
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Dr. Shilpa Babbar, a double board-certified maternal-fetal medicine specialist and OB/GYN, joins Dr. Rebecca Dekker to discuss the role of integrative obstetrics in pregnancy and birth. Dr. Babbar shares her journey into maternal-fetal medicine, how she became interested in yoga and breathing techniques, and the growing body of research on prenatal yoga. They discuss how breathwork can support pregnant individuals, the physiological effects of deep breathing, and how birth workers can incorporate these techniques into prenatal care. Dr. Babbar also shares her experience using alternate...
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Madi van Tonder is a birth photographer, doula, and educator based in the Netherlands. Originally from South Africa, Madi has lived in multiple countries and brings a unique perspective to birth work, particularly for families navigating new healthcare systems. Join Dr. Dekker and Madi as she shares insights into the Dutch maternity care system, where midwives play a central role, home birth is considered a national heritage, and postpartum families receive in-home support through the Kraamzorg system. We explore how Dutch birth culture prioritizes physiological birth, minimizes...
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EBB Childbirth Class graduate Krista DeYoung joins us from her hospital room to share her journey through a high-risk pregnancy, an extended antepartum hospital stay for partial placental abruption, and preparing for a scheduled Cesarean at 37 weeks. Krista opens up about the challenges of long-term hospitalization, advocating for herself in a complex medical system, and the emotional toll of being away from her family. Dr. Rebecca Dekker walks Krista through creating a Cesarean birth plan, covering topics like delayed cord clamping, optimizing the operating room experience, and postpartum...
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In this episode, Dr. Rebecca Dekker is joined by Trish Ware, Registered Nurse, childbirth educator, and host of The Birth Experience with Labor Nurse Mama. With 16 years of labor and delivery nursing experience, Trish shares her journey from feeling disempowered during her first birth to becoming an advocate for changing the birth culture one birth at a time. Tune in as Trish and Rebecca discuss how to effectively advocate for yourself during labor, overcome fears of being "that patient," and navigate common labor scenarios like refusing unnecessary interventions. Learn tips for building 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.