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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®

Release Date: 07/08/2026

EBB 409 - Business Advice for New Doulas with Katie Nyberg, Doula Trainer and Founder of The Iowa Baby Ladies show art 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 show art 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 - 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 show art 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 show art 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 show art 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 show art 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 show art 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 show art 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...

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Special Announcement: Join me in Summer School! show art Special Announcement: Join me in Summer School!

Evidence Based Birth®

This summer, join Dr. Rebecca Dekker and the EBB Research Team for a four-part live series on "How to Read Research," starting June 30. Get access to the full Summer School Series by joining the Quarterly EBB Pro Membership at a special summer rate! Plus, enroll by June 28 and receive a free digital EBB Pocket Guide to Labor Induction! Learn more and save your seat in our virtual classroom: 

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More Episodes
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 measure, how hospitals have successfully reduced unnecessary Cesareans, and what families can look for when choosing a birth setting that supports vaginal birth. Plus, learn about the Labor Culture Survey (LCS), Dr. White VanGompel’s research on the impact of the ARRIVE Trial on provider attitudes, and why conversations about reducing Cesarean overuse are important from a public health perspective.
 
(01:58) Growing up around home birth and discovering differences in birth culture during medical training
(09:05) How family medicine influences perspectives on childbirth, postpartum care, and long-term family health
(12:46) What NTSV Cesarean rates are and why they are used as a quality measure
(16:19) Defining labor and delivery unit culture and how it affects Cesarean decision-making
(19:23) Lessons from hospitals that successfully reduced Cesarean rates
(23:50) Real-world examples of hospitals that transformed their birth culture and lowered Cesarean rates
(29:36) Common attitudes and beliefs associated with higher Cesarean rates
(32:32) The Labor Culture Survey
(35:44) The ARRIVE Trial, provider attitudes toward induction, and shifting birth culture
(43:01) How families can evaluate hospitals and providers when seeking support for vaginal birth
(48:24) Midwifery models of care and their potential role in supporting vaginal birth
(52:40) How personal birth experiences influence clinician attitudes toward Cesarean and vaginal birth
 
Resources
View the original validation study that explains the creation of the LCS: https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12406
See how the first statewide use of the LCS found an association between labor culture and hospital-level cesarean rates: https://onlinelibrary.wiley.com/doi/full/10.1111/1475-6773.13123
Deep-dive into this qualitative study about how hospitals that lowered their cesarean rates changed their cultures: SpringerAccess research journals, articles, books and more | Springer Nature Linkarticle/10.1186/s12913-024-12108-3
See how this study used the Labor Culture Survey (LCS) to compare clinician beliefs and attitudes about induction of labor before and after the publication of the ARRIVE Trial: Sciencedirectsciencedirect.com
 
For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.