Evidence Based Birth®

Evidence based care is a term you hear often in medicine, but what does it really mean—especially when it comes to pregnancy and birth? In this episode, Dr. Rebecca Dekker takes you inside the foundations of Evidence Based Birth®, explaining what evidence based care is (and isn’t), and why it matters for families, providers, and communities.   Dr. Dekker breaks down the three essential pillars of evidence based care: the best available research, the provider’s expertise, and the birthing person’s values and preferences. She explores how care can drift away from this model when decisions are based solely on tradition, authority, or convenience rather than the evidence. Along the way, hear how families can use this knowledge to navigate common hospital policies and advocate for care that truly centers their needs.   (02:12) Outdated practices and the rise of evidence based medicine (05:00) Florence Nightingale, Mary Seacole, and whose knowledge counts (08:05) The three pillars of evidence based care: res

For some, the thought of pregnancy and birth fills them with a visceral panic they can’t explain. In this episode, Dr. Rebecca Dekker's talking tokophobia—the fear of pregnancy and birth—with Alexia Leachman, founder of Fearless Birthing and host of the Fear Free Childbirth Podcast. Alexia shares her personal journey of discovering and healing her own tokophobia, how she developed her unique “Head Trash Clearance” method, and why tokophobia is often misunderstood as simple anxiety. She explains the root causes of this condition, including reproductive trauma and lack of control, and offers insight on how both expectant parents and healthcare providers can better recognize and respond to it.   Listening Note: As a head's up... this episode a bit different than our normal focus on the evidence. It's more focused on self help-- how to uncover blocks, find guidance and strength within, and heal past wounds. We also discuss the paradox of trying to feel in "control" in pregnancy/birth and how that relates to

At 41 weeks, Hopey Fink and Ben Levin's birth plans shifted after elevated blood pressure readings led to an induction conversation. But, with the support of their doula, care team, and each other, the Evidence Based Birth Childbirth Class graduates navigated every twist with confidence. In this episode, Hopey and Ben reflect on preparing for a low-intervention birth, the role of comfort measures, how advocacy shaped their decisions in the hospital, and what it meant to welcome their daughter with joy and strength. They also share advice for expectant families on building flexibility into birth plans, communicating with your partner, and finding empowerment in telling your birth story.   (03:07) Planning a Low-Intervention Birth in the Hospital (06:38) Lessons from the Evidence Based Birth Childbirth Class (09:03) Navigating the Emotional Wait at 41 Weeks (12:52) Elevated Blood Pressure and the Induction Conversation (18:00) Advocating Around Pitocin and Weighing Risks (23:31) A Long Night with the Fo

In today’s episode, I’m revisiting a deeply important conversation with Tania Silva Meléndez and Tamara Trinidad González, two inspiring birth workers and Evidence Based Birth® Instructors based in Puerto Rico. Tania and Tamara share their personal journeys into birth work and what led them to become changemakers in Puerto Rico’s birth community. They speak candidly about the immense challenges families face, from one of the world’s highest cesarean rates to the ongoing impacts of colonialism and systemic barriers within maternal health care. You’ll hear what it’s like to provide midwifery services in an environment where midwives aren’t officially recognized, and the impact this has on those seeking safe, respectful, and dignified care.   We also dive into the powerful grassroots and community-led efforts Tania and Tamara are leading, including legislative advocacy, innovative education, and direct, compassionate support for families striving to improve birth outcomes and claim reproductive rights on th

Dr. Nikia Grayson, nurse midwife, family nurse practitioner, and anthropologist, joins us to share how she's helping reclaim and restore Black midwifery in the South. As Chief Clinical Officer at CHOICES Center for Reproductive Health in Memphis, TN, Dr. Grayson has led groundbreaking efforts to open Memphis’ first and only birth center, launch the nation’s first Black Midwifery Fellowship, and provide full-spectrum, justice-centered reproductive care. In this episode, Dr. Grayson reflects on the challenges of dismantling systemic racism in health care, the impact of the Dobbs decision on abortion access in the South, and the importance of investing in doulas, midwives, and community-based care. Dr. Grayson also offers advice for birth workers on building new systems rooted in justice, joy, and liberation. Content note: Discussion of infant mortality disparities as well as difficulties in accessing abortion care post-Dobbs decision. (02:33) The Vision Behind CHOICES (04:44) Obstetric Racism and Health Care

Gestational diabetes (GDM) is one of the most common health issues during pregnancy, and diagnosing it is more complicated than you might think. In this episode, Dr. Dekker is joined by EBB Research Team member Dr. Morgan Richardson Cayama to cover the newly updated evidence on how GDM is diagnosed. They walk through the physiology behind GDM, current testing methods, and why there’s still international disagreement about how to screen. Together, they examine the results of large randomized trials comparing the one-step and two-step screening methods, the research on early screening with hemoglobin A1C, and the evidence on alternatives to the Glucola drink, including candy and home blood sugar monitoring. They also review the risks of skipping screening entirely, and how weight bias and other systemic factors can impact diagnosis and care.   (02:28) What is Gestational Diabetes and Why Is It So Common? (06:30) Risk Factors, Size Bias, and the Role of Race and Ethnicity (10:40) Why We Screen and the Origi

Dr. Morgan Richardson Cayama, public health researcher, doula, and member of Team EBB, joins Dr. Rebecca Dekker to explore the critical issue of mistreatment in maternity care. Drawing from her doctoral research—including interviews with Black women in Florida and data from the Giving Voice to Mothers study—Dr. Morgan shares what respectful maternity care really looks like, and how the lack of it can negatively impact birth outcomes and future healthcare decisions. She also opens up about her own preterm hospital birth, offering insight into how even the most informed parents can feel disempowered by coercive hospital systems. Together, they break down the systemic roots of obstetric violence and offer community-driven recommendations for change.   Content Note: Discussion of obstetric mistreatment, medical trauma, discrimination in maternity care, and stillbirth.   (04:35) How a Global Health Class Sparked a Career in Public Health (08:17) From Dissertation to Delivery: Dr. Morgan’s Birth Story (

Rikki and Nova Jenkins join Dr. Rebecca Dekker to share the personal and powerful story of their second birth: a planned home VBAC that ultimately led to a hospital transfer. Rikki, Evidence Based Birth® Instructor Coordinator, doula, and IBCLC, reflects on the trauma of her first Cesarean birth and the deep healing she found through midwifery care, doula support, and intentional preparation. Nova, a Grammy-nominated music producer and proud girl dad, shares his emotional journey from feeling powerless in their first birth to becoming a protective presence throughout this redemptive experience. Together, they offer a vulnerable, moving conversation about reclaiming birth after trauma, processing grief, and creating a peaceful bubble of support for their family, even when things don’t go as planned.   Content Note: This episode contains description of obstetric violence from (14:05) to (18:55) and of unexpectedly losing consciousness during a Cesarean from (40:54) to (45:43).   (04:36) Why They Chose a Ho

Jennifer Anderson, RN, experienced doula, Evidence Based Birth® Instructor, and member of Team EBB, returns to the podcast to join Dr. Rebecca Dekker in unpacking a new trend in labor induction protocols—starting Pitocin at higher doses and incorporating early artificial rupture of membranes (AROM). Drawing from her work with high-risk clients and firsthand experience inside hospital systems, Jennifer highlights how policies aimed at “optimizing” labor often prioritize speed over patient-centered care. Together, they examine what’s in these new induction bundles, the evidence behind faster-moving protocols like dual-method cervical ripening and 4x4 Pitocin, and the importance of informed decision-making at every stage.   (04:10) A Client Story That Sparked Concern Over High-Dose Pitocin (07:27) What “2x2” vs. “4x4” Pitocin Protocols Mean (09:41) Hospital Protocols: What the Nurse Can (and Can’t) Do (12:25) Inside the New Induction Policy: What’s Changing and Why (18:40) Balloon Checks, Membrane Swee

What happens when a nurse finishing up her PhD in evidence-based practice becomes a parent and realizes her own birth care was anything but evidence-based? In this episode, Dr. Rebecca Dekker take us back to the very beginning and shares how her first birth experience set her on a mission to change maternity care. She reflects on her two contrasting birth stories: one marked by unnecessary interventions and separation from her newborn, the other defined by empowerment, autonomy, and midwifery care. Opening up about how these experiences shaped her purpose, Rebecca shares how these experiences led her to launch Evidence Based Birth in 2012. Since then, the platform has grown from a simple blog into a platform for sharing evidence based info that is trusted by families and professionals around the world. (00:55) Why Dr. Dekker Re-Recorded This Episode in 2025 (05:03) Trying to Be the “Good Patient” (10:00) Separation from Her Baby and Delayed Bonding (13:45) Questioning the Evidence Behind Her Care (16:10)

Welcome to a special announcement episode of the Evidence Based Birth® Podcast! This August, we’re celebrating the incredible people who make up Team EBB. Each Wednesday, you’ll hear directly from team members as they share their experiences and expertise. Listen on your favorite podcast app or watch full episodes on our YouTube channel, and be sure to follow us on Instagram (@ebbirth) for even more behind-the-scenes stories and updates throughout August. Watch full episodes on YouTube Follow us on Instagram @ebbirth for behind-the-scenes stories and team updates       For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. 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

Curious if prenatal perineal massage actually works to prevent tears during childbirth? In this episode, Dr. Rebecca Dekker examines the evidence on perineal massage in late pregnancy, separating fact from fiction and sharing what the research really shows. You’ll learn what major studies say about perineal massage, why some commonly cited research may not be trustworthy, and whether this practice is truly necessary, especially if you’re in a birth setting with low episiotomy rates. You’ll also hear some surprising insights on other ways to protect your perineum and reduce your risk of severe tears. Content note: Discussion of perineal tears during childbirth, severe tears, and episiotomy. (06:14) Evaluating Perineal Massage Evidence (08:32) Comprehensive Perineal Massage Meta-Analysis (11:20) Perineal Massage Study Bias Concerns (16:04) Double-Blind Study on Episiotomy Rates (20:09) Perineal Massage vs. Control Outcomes (24:44) Study Bias and Participant Dropouts (28:11) Research Fraud: Doubts on Dönm

Sophie Walker, host of the Australian Birth Stories podcast and author of The Complete Australian Guide to Pregnancy and Birth and The Complete Guide to Postpartum: A Mother-Focused Companion for Life After Birth, joins Dr. Rebecca Dekker to explore what it really takes to plan for a nourishing postpartum experience and the challenges and strengths of the Australian birth system. Sophie shares how a traumatic first birth sparked her passion for informed decision-making, why continuity of midwifery care matters, and how her country’s publicly funded postpartum home visits and mothers’ groups create critical support networks. Together, Sophie and Dr. Dekker unpack the postpartum cliff that so many new parents face, discuss how to prepare mentally, emotionally, and physically for life after birth, and offer tips on everything from pelvic floor recovery to sleep expectations to navigating newborn feeding.   (02:28) Sophie’s Birth Story and What She Learned from Trauma (06:07) Why Listening to Birth Stories Ca

Leah Van Dale, former WWE superstar known as Carmella and founder of the women’s health platform Snatch, joins Dr. Rebecca Dekker to share her deeply personal story of postpartum recovery after a traumatic birth injury. Leah opens up about her journey through multiple pregnancy losses, the decision to hire a doula, and how the Evidence Based Birth® Childbirth Class helped her prepare for her first birth. She shares the emotional and physical challenges of a long labor, including an undiagnosed nerve injury that left her unable to walk properly for months postpartum. Now pregnant again, Leah reflects on what she’s learned, how it shaped her career path, and why she’s passionate about building an honest, empowering community for women.   (02:55) Leah’s Journey Through Loss and Into Pregnancy (05:20) Why She Chose to Hire a Doula (07:50) Taking the EBB Childbirth Class (09:39) Leah’s Long and Unexpected Birth Story (16:11) Postpartum Depletion and Early Red Flags (22:31) The Long Road to a Diagnosis (25

Licensed community midwife Grace Flannery and doctoral student Ihotu Ali, founder of the Oshun Center for Intercultural Healing, join Dr. Rebecca Dekker for a moving conversation about burnout, boundaries, and building sustainable birth work. Together, they explore the root causes of burnout in maternity care, from systemic extraction to internalized pressure, and how the path to healing lies in slowing down, reconnecting with purpose, and redefining productivity. Ihotu and Grace share the origin of their collaboration through the Sweetwater Alliance, the transformative “One Main Thing” meditation, and their four-part framework for reclaiming balance: Seasons, Smallify, Support, and Spirit. This episode is a heartfelt invitation to anyone holding space for others while feeling the weight of burnout.   (04:27) Grace and Ihotu’s Birth Work Journey (07:54) The Roots of Burnout in Maternity Care (13:19) Presence, Boundaries, and the Burnout Cycle (18:33) Symptoms and Signs of Burnout (27:06) The “Four S’s”

From ICU to birth center, Liz Carr’s story is a reminder that midwives come to this work through many paths, and each journey holds wisdom for the future of maternal care.   In this episode, Dr. Rebecca Dekker reconnects with former nursing student turned certified nurse midwife, Liz Carr. Liz shares her unique trajectory: from critical care nursing to catching babies, from witnessing obstetric violence as a student to providing trauma-informed, evidence-based midwifery care. Liz and Rebecca explore the impact of diverse clinical experiences, the challenges of navigating midwifery school without labor and delivery experience, and the transformative power of reproductive justice. Liz also opens up about working in abortion care before and after the fall of Roe v. Wade, how she centers consent and autonomy in every interaction, and why investing in the education of future physicians is one of her biggest hopes for change.   Content Note: This episode contains discussion of obstetric violence (non-consented

Carson Meyer, doula, certified nutrition consultant, and author of Growing Together, joins Dr. Rebecca Dekker for a conversation about reclaiming the sacred, intuitive, and evidence-based aspects of pregnancy, birth, and postpartum. Carson shares how she stepped into birth work at a young age, driven by a desire to transform a system that can leave parents disempowered and unsupported. She opens up about her own home birth experience, the spiritual preparation that carried her through, and the tools she now teaches others through her virtual Growing Together Circles. Together, Carson and Dr. Dekker discuss the importance of informed choice and the emotional, physical, and environmental foundations of holistic care.   (04:57) Carson’s Path to Becoming a Doula (07:24) Growing Together Circles and Virtual Doula Support (09:39) Carson’s Home Birth Story (13:23) Holistic Practices for Pregnancy and Labor (17:33) Four Pillars of Postpartum Healing (21:15) Nourishment and Hydration During Postpartum (25:20)

Curious how to actually prevent perineal tears during childbirth? In this episode, Dr. Rebecca Dekker breaks down the latest research on three of the most talked-about methods: 1) using warm compresses, 2) provider “hands on” techniques, 3) provider “hands off” techniques, and how these approaches measure up when it comes to protecting your perineum. You’ll learn surprising facts, like how a simple warm washcloth can significantly lower your risk of severe tears (and even ease pain!), plus what the evidence really says about whether a provider should help “guard” the perineum or just keep their hands off you during the actual birth.   Content note: Discussion of perineal tears during childbirth, severe tears, and episiotomy.   (02:55) What is the Perineum? (05:33) Warm Compresses Reduce Birth Tears (08:51) Warm Compresses Reduce Birth Complications (12:27) Hands On vs. Hands Off (18:07) Hands-On vs. Hands-Off Perineal Techniques (19:38) Perineal Support Training Reduces Tearing (22:47) Hands-On

Most parents are told their baby is either a boy or a girl. But what happens when a baby is born with intersex traits—and how can birth workers and clinicians respond with compassion, accuracy, and care? In this episode, Dr. Rebecca Dekker speaks with Niki Khanna, MA, MFT, and Dr. Catherine Clune-Taylor, co-presidents of InterACT, about how to support families when a baby’s physical sex characteristics don’t fit binary expectations. Together, they explore how often this occurs, what parents are typically told in the hospital, and why rushed decisions about infant genital surgery can cause lasting harm. They also share powerful insights on how to provide affirming care, connect families with community, and ensure every baby is welcomed with dignity.   (05:43) What Does “Intersex” Mean and How Common Is It? (09:05) Why Many Intersex Traits Aren’t Identified at Birth (13:36) Understanding CAH and Newborn Screening (17:24) The History of Infant Surgeries and Gonadectomies (19:49) What Parents Are Told—And

Struggling with low milk supply can feel overwhelming, isolating, and confusing. In this episode, Dr. Rebecca Dekker talks with midwife and International Board Certified Lactation Consultant Katie James to demystify the realities of low milk supply. Together, they explore the hormonal, medical, and systemic factors that can affect lactation, as well as the critical importance of early postpartum support. Katie shares how birth interventions, lack of education, and misinformation can interfere with lactation—and how reclaiming knowledge, honoring instinct, and receiving timely help can make all the difference.   (07:21) How Birth Interventions Impact Breastfeeding (09:30) Prolactin, Oxytocin, and the Critical First 3 Days (11:18) What is Low Milk Supply—and Can it Be Prevented? (14:58) Medical Conditions That Can Affect Milk Production (19:27) Gestational Diabetes, Cesarean Birth, and Milk Supply (23:42) The Trap of “Perceived” Low Supply (28:48) Why Judgment-Free Support Matters (36:56) When and How