REPLAY: EBB 221 - Evidence on Birthing Positions and Tried-and-True Midwifery Practices for Protecting the Perineum
Evidence Based Birth®
In this episode, Dr. Rebecca Dekker explores the research on birthing positions and tried-and-true midwifery practices for protecting the perineum during childbirth. She explains why the flat-on-your-back position we often see on television isn’t ideal and walks through the key differences between upright, sacrum-flexible positions, and common hospital practices like lithotomy and routine episiotomies. Dr. Dekker reviews data from global research as well as real-world wisdom from midwives, including the extraordinary outcomes of hands-off, undisturbed birth approaches in the...
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EBB 379 - A Challenging Birth Story with GBS, Prolonged PROM, Pitocin, and an Epidural, with EBB Childbirth Class Graduate Erica Wright and EBB Instructor Tara Thompson
Evidence Based Birth®
After more than 80 hours of labor, Erica Wright found herself exhausted, emotional, and determined to keep trusting her body. With the steady support of her doulas (including EBB Instructor Tara Thompson), she discovered that birth doesn’t have to go “according to plan” to be powerful. In this episode, Dr. Rebecca Dekker talks with Erica and Tara about how preparation, advocacy, and teamwork carried them through a marathon labor filled with unexpected turns. From switching hospitals late in pregnancy to finding strength through challenges, their story exemplifies flexibility,...
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EBB 378 - Embracing the Dual Calling of Doula Work + Midwifery with Chanté Perryman and Elder Charlotte Shilo-Goudeau
Evidence Based Birth®
Across generations, birth workers have held space for families with skill, love, and deep purpose. In this episode, Dr. Rebecca Dekker talks with Elder Midwife Charlotte Shilo-Goudeau, a licensed Certified Professional Midwife from Louisiana, and Chanté Perryman, Director of Programs at Evidence Based Birth®, certified doula, and student midwife. Together, they explore what it means to embrace the dual calling of doula work and midwifery and how both roles are acts of service, advocacy, and healing. Elder Charlotte shares her journey from personal loss to becoming one of only a few...
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Bonus Announcement: Surprise Project for Doulas
Evidence Based Birth®
Introducing the My Doula Visit Workbook by Evidence Based Birth®. A tangible, interactive, and evidence-based guide designed to facilitate conversations, strengthen the doula-client relationship, and guide families through the most pressing topics related to pregnancy, birth, and postpartum. What’s Inside the My Doula Visit Workbook? A 115-page, full-color, spiral-bound workbook packed with evidence-based resources Structured guides for up to six prenatal visits + one postpartum check-in (but fully customizable to your practice!) 18 official EBB handouts, birth plan templates,...
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EBB 377 - Medicaid Coverage for Doula Care with Amy Chen, Senior Attorney at the National Health Law Program
Evidence Based Birth®
What if everyone had access to a doula, no matter their income? In this episode, Dr. Dekker talks with Amy Chen, Senior Attorney at the National Health Law Program (NHeLP), about the growing movement to make doula care accessible through Medicaid and insurance coverage. Amy shares how her personal birth experiences inspired her work advocating for Medicaid reimbursement for doulas and explains how more than 20 states (and counting) are now implementing or expanding coverage. They also unpack the biggest challenges and successes so far, from sustainable reimbursement rates and...
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EBB 376 - How to Find and Interview a Doula with Team EBB Members Julie Fors and Chanté Perryman
Evidence Based Birth®
Hiring a doula can be one of the most impactful choices you make during pregnancy, but how do you actually find the right one? In this episode, Dr. Rebecca Dekker talks with Team EBB members and experienced doulas, Julie Fors and Chanté Perryman, to share insider tips on finding and interviewing a doula with confidence. Julie and Chanté walk you through where to begin your search, the most important questions to ask, and how to know if a doula’s personality and philosophy are the right fit for you and your partner. They also tackle misconceptions about doula work, explain...
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REPLAY: EBB 218 - The Evidence on Perineal Massage during Labor with Dr. Rebecca Dekker
Evidence Based Birth®
Can perineal massage during the pushing phase of labor really prevent tears? In this episode, Dr. Rebecca Dekker takes a close look at the research to uncover whether this technique truly helps reduce perineal trauma during childbirth. She explains how health care staff provide perineal massage during labor, breaks down findings findings from key studies and meta-analyses, and examines how biases and variations in clinical practice shape the evidence. Dr. Dekker also explores why results from settings with high episiotomy rates may not apply everywhere and why skilled, supportive care and...
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EBB 375 - A Rainbow Baby and Preeclampsia Birth Story with Dr. Sara Ailshire and Dr. Siavash Samei
Evidence Based Birth®
Dr. Sara Ailshire, an anthropologist and Evidence Based Birth® Research Team member, and her husband, Dr. Siavash Samei, an environmental archaeologist, share the story of welcoming their rainbow baby after loss. In this episode, Sara and Siavash open up about navigating miscarriage care in the wake of changing abortion laws in Ohio, the anxiety and hope of pregnancy after loss, and Sara’s experience with developing preeclampsia near the end of her pregnancy. They describe how they worked with a supportive midwifery team, hired a doula for advocacy and comfort, and ultimately experienced an...
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EBB 374 - Educating the Public about Stillbirth Prevention with Ingrid Haas, Director of the Short Film "PUSH"
Evidence Based Birth®
Filmmaker Ingrid Haas is the writer and director of PUSH, a short film created in partnership with PUSH for Empowered Pregnancy to raise awareness about stillbirth prevention. In this episode, Ingrid shares her personal journey through pregnancy loss, how those experiences led her to advocate for families, and the creative process behind PUSH and the Stillness is an Illness campaign. Together, Ingrid and Dr. Dekker discuss the realities of stillbirth, the importance of listening to families’ concerns, why fetal movement matters, and how storytelling can educate both the public and health...
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Signature Training Announcement - Unpacking New Research on Big Babies
Evidence Based Birth®
What does the newest research on Big Babies say? We’ll be unpacking it all during our live 90-minute Signature Training + Q & A on Wednesday, October 15 at 7 PM EDT, exclusively for EBB Pro Members. In this session (1.5 contact hours), we’ll walk you through the latest evidence, address common questions, and bring clarity to this ginormous issue in birth. You’ll also get the chance to ask your biggest questions and hear directly from Dr. Rebecca Dekker and the EBB Research Team. Join us for just $29 and get 30 days of full access to everything the EBB Pro Membership...
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.