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 confidence in making informed decisions even when things didn't go as planned.
 
Emily also reflects on the emotional realities of postpartum, from recovering after preeclampsia and establishing breastfeeding to navigating grief after the unexpected loss of her grandmother just weeks after giving birth. Her story is a reminder that birth is only one part of the transition to parenthood, and that caring for the birthing parent is just as important as caring for the baby.
 
(02:04) How Emily Found EBB
(04:29) Her Original Birth Plan and Adapting to Preeclampsia
(07:36) Advocating for Individualized Care During Labor
(09:22) High Blood Pressure, Triage, and Preeclampsia Diagnosis
(15:03) Induction Begins
(20:08) Magnesium Drip and Feeling "Tethered" During Labor
(25:57) Comfort Measures and Movement
(29:07) Pushing on Hands and Knees and Meeting Her Baby
(35:57) Postpartum Recovery and Continued Monitoring
(40:47) Recovering from Preeclampsia
(42:06) Grief and Postpartum
(49:06) Emily's Advice for Expecting Parents
 
Resources
Learn more about the EBB Childbirth Class: evidencebasedbirth.com/parentclasses/
EBB 391 – Electronic Fetal Monitoring Advocacy Tips with Dr. Jennifer Lincoln, OB/GYN and Author of The Birth Book
EBB 349 – An L & D Nurse's Advice for Advocating in the Birth Room with Trish Ware the Labor Nurse Mama
Evidence on: Pitocin® During the Third Stage of Labor
 
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.

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 precipitous labor, birth that occurs within three hours of the onset of contractions, and discusses whether fast labors appear to run in families. Finally, she examines the growing social media trend of drinking okra water during pregnancy, exploring the cultural history of okra as a nutritious food, separating popular claims from scientific evidence, and discussing what researchers currently know (and don't know) about its effects during pregnancy.
(02:34) Delayed pushing and active pushing times under 15 minutes
(04:22) Understanding delayed pushing practices in France versus the United States
(05:33) Study methods, hospital protocols, and participant characteristics
(06:56) Results: Average pushing times, epidural effects, and birth outcomes
(08:14) Key takeaways from the delayed pushing study
(10:53) Does precipitous labor run in families?
(12:21) Research on precipitous labor risk factors and prevalence
(14:20) Is there evidence that fast labor is hereditary?
(15:05) What are the benefits of drinking okra water during pregnancy?
(17:46) Popular social media claims about okra water
(18:46) What researchers did and did not find about okra water
(21:15) Okra's cultural significance in pregnancy and postpartum traditions
For a full list of references, visit ebbirth.com/404.
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.

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
science/article/abs/pii/S0884217522003914
 
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.

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: ebbirth.com/summer

The way we move during labor shapes far more than our comfort. It helps determine how a baby navigates through the pelvis, and whether a birth can unfold with fewer interventions!
In this replay episode, Dr. Rebecca Dekker talks with Brittany Sharpe McCollum, a childbirth educator, doula, lactation counselor, and pelvic biomechanics educator. Brittany explains how the bones of the pelvis move during labor, why that movement matters for fetal positioning, and how everyone can benefit from intentional position changes during labor-- whether you're planning an unmedicated birth or not!
They explore the three planes of the pelvis, why opening the pelvic inlet and outlet require opposite movements, and how to match specific positions to where the baby is located in the pelvis. Brittany also shares her 5-4-3 rule for position changes, practical tips for inductions and epidurals, the power of asymmetrical positioning, and why movement is one of the few birth tools that carries benefit without risk.
(06:25) Exploring movement in childbirth
(10:19) Understanding baby's position in labor
(13:03) Benefits of movement during labor
(17:31) Subtle pelvic movements in labor
(23:05) Partner role during contractions
(25:17) Managing rectal pressure during labor
(27:57) Movement during labor
(32:21) Importance of prenatal education
(37:35) Understanding racism in obstetrics
Resources
EBB Signature Article on the Evidence on Birthing Positions: ebbirth.com/birthingpositions
Learn more about Brittany: blossomingbelliesbirth.com
"Baby Got VBAC: An Inspiring Collection of Wisdom for Better Births After a Cesarean"
Connect with Brittany on Instagram: @blossomingbelliesbirth
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.