Evidence Based Birth®

The evidence shows that vaginal birth after cesarean (VBAC) is a safe option for many families, but it's still frequently inaccessible to them. In this episode, Dr. Rebecca Dekker and Dr. Nicholas Rubashkin discuss the systemic barriers that limit families' opportunities to choose a VBAC. They explore how hospital policies, outdated guidelines, and clinical tools like the VBAC calculator have shaped who's a "good candidate" and who is not.
 
Dr. Rubashkin also shares insights from his research on inequities in maternity care, including how race-adjusted algorithms reinforce disparities, why the "immediately available" standard still impacts hospital policies today, and how geography, provider practices, and induction policies can influence VBAC access. Plus, hear evidence-based strategies for advocating for a VBAC, including how to evaluate providers and interpret VBAC rates.
 
(01:36) Dr. Rubashkin's background and path into obstetrics
(08:32) Major barriers to VBAC access in the U.S.
(11:37) The "immediately available" standard explained
(14:38) Misconceptions about emergency cesarean availability
(16:58) Ethical and legal implications of VBAC restrictions
(18:02) Institutional barriers
(20:17) The VBAC calculator and how it influenced access
(26:12) Racism, bias, and interpretation of VBAC data
(30:02) Induction and VBAC: evidence vs. practice
(36:17) What informed consent for VBAC should include
(37:18) Identifying supportive vs. reluctant providers
 
Resources
ACOG's VBAC guidelines and recommendations: acog.org/clinical/clinical-guidance/practice-bulletin/articles/2019/02/vaginal-birth-after-cesarean-delivery
Human Rights in Childbirth: humanrightsinchildbirth.org/
UCSF's Better Birth Research Initiative: betterbirth.ucsf.edu/
International Cesarean Awareness Network: ican-online.org/
 
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.

Learn more about EBB's upcoming Induction Bootcamp on Tuesday, April 28 from 2:00 - 4:30 PM EDT.
To save your seat or access the replay, join the EBB Pro Membership for just $39 for your first 30 days: ebbirth.com/membership.

Postpartum care wasn't always rushed, clinical, or isolating. In many African-American communities, the weeks after birth were treated as sacred time where families and communities gathered to care for the mother so she could focus on caring for her baby.
 
In this episode, Dr. Rebecca Dekker talks with renowned midwife, cultural historian, and author Shafia Monroe about the traditions documented in her new book Mothering the Mother: African-American Postpartum Traditions, Recipes, and Healing. Mama Shafia shares how historically rooted postpartum practices—from the 42-day "lying-in" period to nourishing soups, herbal teas, and hands-on community support—helped mothers rest, recover, and bond with their babies.
 
They explore what's missing from the modern Western postpartum model, how traditional wisdom from Black midwives supported physical and emotional recovery, and why caring for mothers is essential for healthy families and communities.
 
(02:43) Why Shafia wrote Mothering the Mother and the lack of resources on African-American postpartum traditions
(07:47) The love letter to Black mothers and words of affirmation for postpartum parents
(11:56) What's missing in modern postpartum care and how Western systems differ from traditional community care
(19:06) Hypervigilance, stress, and supporting postpartum healing
(21:26) The 42-day "lying-in" period and traditional postpartum rituals
(25:45) Postpartum food traditions, soups, and healing foods from African and African-American culture
(33:50) Why these traditions matter for all families, not just one culture
(37:45) "Mother wit": trusting intuition about your body and your baby
(41:25) Advocating for yourself in healthcare and trusting your body during pregnancy and birth
 
Resources
Get Mama Shafia's book, Mothering the Mother: African-American Postpartum Traditions, Recipes, and Healing: shafiamonroe.com/mothering-the-mother/
Learn about the International Center for Traditional Childbearing (ICTC): thenaabb.org/
Read about SMC Full Circle Doula Birth Companion Training: smcdoulas.com/
EBB 152 – Shafia Monroe on Traditional Black Midwifery, Spirituality, and Community Advocacy
 
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.

Every pregnant person deserves the information and support they need to make truly informed decisions about labor induction. In this encore episode, Dr. Rebecca Dekker talks with Dr. Ann Peralta and Kari Radoff, CNM, the co-creators of Partner to Decide, a nonprofit improving decision-making in perinatal care. They discuss their free, multilingual decision aid that helps families understand their options around routine induction of labor and empowers them to advocate for their own values, preferences, and autonomy.
Ann shares how her own birth experience, shaped by access to education and privilege, sparked the creation of the tool. Kari offers insight into how the decision aid has changed conversations in clinical settings, bringing clarity, reducing bias, and fostering truly shared decision-making. Together, they illuminate how access to balanced information can reduce anxiety, improve trust, and shift the culture of perinatal care.
(03:02) What Is a Decision Aid and Why It Matters
(07:12) Ann's Birth Story and the Origins of Partner to Decide
(11:09) Gaps in Shared Decision-Making from a Provider's Perspective
(14:24) Personal Values, Intuition, and Cultural Differences
(18:19) Designing the Decision Aid with Equity and Accessibility
(23:49) The Power of Absolute vs. Relative Risk in Birth Conversations
(25:01) Surprising Patient Feedback: From Access to Empowerment
(30:31) Provider Reflections and Challenging Bias
(36:11) Why "Routine" Induction Language Matters
(43:59) How to Respond to Pressure or Coercion Around Induction
(46:16) How to Access the Free Decision Aid and Support New Tools
 
Resources
Access the free Induction of Labor Decision Aid in seven languages: www.inductiondecisionaid.org

Learn more about the nonprofit: www.partnertodecide.org

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! Want more resources? Check out our Signature Articles 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.

Artificial intelligence is rapidly changing how people search for information, including how families learn about pregnancy and birth. As this technology grows, it raises important questions about accuracy, ethics, and the role of human expertise in healthcare information.
 
In this episode, Dr. Rebecca Dekker and Dr. Sara Ailshire share a behind-the-scenes look at how Evidence Based Birth® developed its own AI policies. They discuss concerns about misinformation, bias, privacy, and environmental impact, as well as the potential effects on critical thinking and human connection.
 
Learn why EBB has chosen to avoid the use of AI in our research, and what that means both for our team and for you.
 
(03:22) Why EBB began developing an AI policy 
(10:39) Defining AI, generative AI, LLMs, and hallucinations 
(17:03) Ethical concerns: Accuracy, bias, and risks to evidence-based information 
(20:14) Environmental impact of AI and data centers 
(21:47) Privacy concerns and data security risks 
(26:21) Intellectual property, sustainability, and loss of research context 
(27:03) Humanitarian concerns and the impact of AI on jobs and communities 
(31:24) AI's potential effects on cognition and critical thinking 
(37:30) Why EBB takes a cautious, evidence-based approach to AI 
(38:20) Research team policy
(42:06) Content team policy
(45:01) Programs team policy and guidance for applicants 
(47:32) Hiring practices and commitment to human review
(52:29) Final takeaways: EBB's overall stance on AI 
 
References
Read EBB's Statement on Artificial Intelligence: ebbirth.com/artificial-intelligence-statement/
For a Student Who Used AI to Write a Paper, by Joseph Fasano: https://poets.org/poem/student-who-used-ai-write-paper
Barrington, F. (2025). "Thirsty for power and water, AI-crunching data centers sprout across the West." & The West Magazine, Stanford University. April 8, 2025. https://andthewest.stanford.edu/2025/thirsty-for-power-and-water-ai-crunching-data-centers-sprout-across-the-west/
Gecker, J. (2025). "Big Tech is paying millions to train teachers on AI, in a push to bring chatbots into classrooms." Associated Press. October 20, 2025. https://apnews.com/article/artificial-intelligence-teacher-union-microsoft-f7554b6550fb90519dd8129acac8e291
Han, Y., Wu, Z., Li, P., et al. (2024). "The Unpaid Toll: Quantifying and Addressing the Public Health Impact of Data Centers." arXiv preprint arXiv: 2412.06288. https://arxiv.org/pdf/2412.06288
Hou, H., Leach, K., & Huang, Y. (2024). "ChatGPT Giving Relationship Advice - How Reliable Is It?" Proceedings of the Eighteenth International AAI Conference on Web and Social Media: 610–623. https://ojs.aaai.org/index.php/ICWSM/article/view/31338
Kosmyna, N., Hauptmann, E., Yuan, Y. T., et al. (2025). "Your Brain on ChatGPT: Accumulation of Cognitive Debt when Using an AI Assistant for Essay Writing Task." arXiv preprint arXiv:2506.08872. https://arxiv.org/abs/2506.08872
Marrinan, C. (2025). "Data Center Boom Risks Health of Already Vulnerable Communities." Tech Policy Press.com. June 12, 2025. https://www.techpolicy.press/data-center-boom-risks-health-of-already-vulnerable-communities/
NASA. (2024). "Defining Artificial Intelligence." Accessed November 17, 2025. https://www.nasa.gov/what-is-artificial-intelligence/
Notre Dame Learning. (2025). "AI Overview and Definitions." Accessed November 17, 2025. http://learning.nd.edu/resource-library/ai-overview-and-definitions/
Pataranutaporn, P., Karny, S., Archiwaranguprok, C., et al. (2025). "My Boyfriend is AI: A Computational Analysis of Human-AI Companionship in Reddit's AI Community." arXiv preprint arXiv:2509.11391.https://arxiv.org/pdf/2509.11391
Sonka, J. (2025). "The AI data center boom is coming for Kentucky. What will lawmakers do about it?" Kentucky Public Radio. December 9, 2025. https://www.lpm.org/news/2025-12-09/the-ai-data-center-boom-is-coming-for-kentucky-what-will-lawmakers-do-about-it
Stryker, C. (n.d.) "What are LLMs?" IBM.com. Accessed November 17, 2025. https://www.ibm.com/think/topics/large-language-models
Tabuchi, H. (2025). "Elon Musk's A.I. Company Faces Lawsuit Over Gas-Burning Turbines." New York Times. June 17, 2025. www.nytimes.com/2025/06/17/climate/naacp-musk-xai-supercomputer-lawsuit.html/
United Nations (UN). (2025). "AI has an environmental problem. Here's what the world can do about that." UN Environmental Programme. November 13, 2025. https://www.unep.org/news-and-stories/story/ai-has-environmental-problem-heres-what-world-can-do-about
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.