When Holly and Nathan Miller learned their baby was breech late in pregnancy, the unmedicated vaginal birth they had been preparing for suddenly felt out of reach. Living in rural South Georgia, they explored their options, including finding a provider experienced in vaginal breech birth, but ultimately faced limited choices close to home.

In this episode, EBB Childbirth Class graduates Holly and Nathan share how they shifted their focus from the birth they had originally envisioned to creating a family-centered Cesarean experience. They talk about advocating for a clear drape and immediate skin-to-skin, navigating conflicting information from providers, and finding ways to remain active participants in their baby's birth. They also reflect on Cesarean recovery, the importance of partner support, and what they learned about speaking up for their preferences even when circumstances were outside their control.

(01:27) Finding Evidence Based Birth® and Preparing for an Unmedicated Birth

(03:33) When Birth Plans Began to Change

(05:03) Navigating Birth Options in Rural South Georgia

(07:51) Exploring ECV, Vaginal Breech Birth, and Cesarean

(10:24) Shifting Toward a Family-Centered Cesarean

(12:50) Advocating for a Clear Drape and Immediate Skin-to-Skin

(15:10) Holly and Nathan's Cesarean Birth Story

(17:43) What a Cesarean Felt Like Physically and Emotionally

(22:03) Meeting Eliana and Beginning Skin-to-Skin

(25:31) Breastfeeding and Recovering from a Cesarean

(28:53) Partner Support During Postpartum Recovery

(30:09) Advice for Navigating Breech Birth and Unexpected Changes

(31:53) Looking Ahead to a Future VBAC

Resources

• EBB 256 – Top 3 Recommendations for Preventing Pelvic Floor Dysfunction after Birth with Dr. Sarah Duvall, Founder of Core Exercise Solutions

All About Breach

• EBB 299 – A Breech Vaginal Birth Story with EBB Parents Naoma Kleisner, RN, MSN and Mohamed Koraichi
• EBB 298 – Overcoming Barriers to Breech Vaginal Birth with Dr. Emiliano Chavira, OB/GYN and Maternal Fetal Medicine Specialist
• EBB 297 – Frequently Asked Questions about Breech with Dr. Rebecca Dekker and Sara Ailshire, MA
• EBB 296 – Evidence on Breech Birth with Dr. Rebecca Dekker and Sara Ailshire, MA
• EBB 173 - Evidence on External Cephalic Version for Breech Positioned Babies
• EBB 172 – Breech Vaginal Birth with Dr. Rixa Freeze and Dr. David Hayes
• EBB 171 – The Experience of a Unique Vaginal Breech Birth with Janae and Andrew Rick
• EBB 111 – Positioning Breech Babies with Dr. Elliot Berlin

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.

In this episode, Dr. Rebecca Dekker and Dr. Sara Ailshire examine the available evidence on planned unassisted birth, also known as freebirth, defined as intentionally giving birth without a qualified midwife or physician present.

They explore why some people choose a planned unassisted birth, including previous trauma, distrust of the medical system, barriers to preferred care, and a desire for greater autonomy. Dr. Dekker and Dr. Ailshire also explain how freebirth differs from midwife-attended home birth, what research shows about planned community birth, and the safeguards a trained birth attendant can provide during pregnancy, labor, birth, and the newborn period. Finally, they discuss investigative reporting concerning the Free Birth Society, including allegations of misinformation and preventable harm associated with its community.

Content Note: This episode includes discussions of stillbirth, maternal death, newborn death, birth trauma, and serious complications related to planned unassisted birth.

(00:03:20) What Is Freebirth? (00:07:41) Prenatal Care, Wild Pregnancy, and Freebirth (00:10:30) How Common Is Freebirth? (00:14:27) The History and Origins of Freebirth (00:22:16) Why Do Some People Choose Freebirth? (00:26:14) What Do We Know About the Risks of Freebirth? (00:34:42) The Role of Skilled Midwives in Home Birth Safety (00:42:28) Free Birth Society Controversy (00:53:49) Lessons from the Free Birth Society (00:55:44) Warning Signs of Controlling Group Dynamics and Influencer Manipulation (01:01:50) Final Takeaways on Freebirth, Safety, and Informed Decision-Making

View the full transcript for this episode at evidencebasedbirth.com.

ResourcesEBB 23 – Home Birth Midwives EBB 110 – Inside an Unplanned, Unassisted Home Birth with Parent Sabrina Tran EBB 122 – Home birth during the pandemic with Vicki Penwell EBB 292 – Confronting the Unknowns in Childbirth with Liesel Teen of the Mommy Labor Nurse EBB 130 – Home Birth in the Black Community with Isis Rose Count the Kicks: https://countthekicks.org/ PUSH Pregnancy: https://www.pushpregnancy.org/ Star Legacy Foundation: https://starlegacyfoundation.org/ Healthy Birth Day: https://healthybirthday.org/ CDC Stillbirth resources: https://www.cdc.gov/stillbirth/communication-resources/index.html Share Pregnancy and Infant Loss Support: https://nationalshare.org/ Stillbirth and infant loss support communities: https://postpartum.net/group/stillbirth-and-infant-loss-support-for-parents/

Works Cited

1. Birthplace in England Collaborative Group (BECG). (2011). "Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study." BMJ 343: d7400. https://pubmed.ncbi.nlm.nih.gov/22117057/
2. Biesele, M. (1997). "An Ideal of Unassisted Birth: Hunting, Healing, and Transformation among the Kalahari Ju/'hoansi." In Childbirth and Authoritative Knowledge. Cross-Cultural Perspectives. Davis-Floyd, R. & C.F. Sargent (eds), Childbirth and Authoritative Knowledge. Cross-Cultural Perspectives, Berkeley: University of California Press, pp. 474-92.
3. Bjellmo, S. & Iversen, J. K. (2025). "Unassisted home births in Norway: A growing concern." Acta Obstet Gynecol Scand 104(8): 1418-1419. https://pubmed.ncbi.nlm.nih.gov/40536244/
4. Boodman, S. G. (2007). "Do-it-yourself Delivery." The Washington Post. July 31. https://www.washingtonpost.com/wp-dyn/content/article/2007/07/27/AR2007072702164.html
5. Bovbjerg, M. L., Cheyney, M., Hoehn-Velasco, L., et al. (2024). "Planned Home Births in the United States Have Outcomes Comparable to Planned Birth Center Births for Low-Risk Birthing Individuals." Med Care 62(12): 820-829. https://pubmed.ncbi.nlm.nih.gov/39514513/
6. Boushra, M., Stone, A., & Rathbun, K. M. (2023). "Umbilical Cord Prolapse." In StatPearls. Treasure Island: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK542241/
7. Brandt, J. S. & Ananth, C. V. (2023). "Placental abruption at near-term and term gestations: pathophysiology, epidemiology, diagnosis, and management." Am J Obstet Gynecol 228(5S): S1313-S1329. https://pmc.ncbi.nlm.nih.gov/articles/PMC10176440/
8. Carlson, K. & Vadakekut, E. S. (2026). "Amniotic Fluid Embolism." In StatPearls. Treasure Island: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559107/
9. Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Natality on CDC WONDER Online Database. (2026). Data are from the Natality Records 2016-2024, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/natality-expanded-current.html on Jul 29, 2026.
10. Cheyney, M., Bovbjerg, M., Everson, C., et al. (2014). "Outcomes of care for 16,924 planned home births in the United States: the Midwives Alliance of North America Statistics Project, 2004 to 2009." J Midwifery Womens Health 59(1): 17-27. https://pubmed.ncbi.nlm.nih.gov/24479690/
11. Dahlen, H., Kumar-Hazard, B., & Schmied, V. (2020). Birthing Outside the System: The Canary in the Coal Mine. Edited Volume. London: Routledge.
12. Dahlen, H. G., Jackson, M., & Stevens, J. (2011). "Homebirth, freebirth and doulas: casualty and consequences of a broken maternity system." Women Birth 24(1): 47-50. https://pubmed.ncbi.nlm.nih.gov/21163719/
13. Davey, M. (2026). "Stacey Warnecke died after choosing a birth free of all medical help. An inquest wants to know why." The Guardian. June 19. https://www.theguardian.com/australia-news/2026/jun/20/stacey-warnecke-melbourne-influencer-died-freebirth-inquest-ntwnfb
14. Davis-Floyd, R. & Cheyney, M. (2019). Birth in Eight Cultures. Edited Volume. Waveland Press.
15. Einerson, B. D., Gilner, J. B., & Zuckerwise, L. C. (2023). "Placenta Accreta Spectrum." Obstet Gynecol 142(1): 31-50.https://pmc.ncbi.nlm.nih.gov/articles/PMC10491415/
16. Feeley, C. & Thomson, G. (2016). "Tensions and conflicts in 'choice': Womens' experiences of freebirthing in the UK." Midwifery 41: 16-21. https://pubmed.ncbi.nlm.nih.gov/27498184/
17. Feeley, C. & Thomson, G. (2016). "Why do some women choose to freebirth in the UK? An interpretative phenomenological study." BMC Pregnancy Childbirth 16: 59. https://pubmed.ncbi.nlm.nih.gov/27000100/
18. Greenfield, M., Payne-Gifford, S., McKenzie, G. (2021). "Between a Rock and a Hard Place: Considering "Freebirth" During Covid-19." Front Glob Womens Health 2: 603744. https://pubmed.ncbi.nlm.nih.gov/34816178/
19. Hutton, E. K., Cappelletti, A., Reitsma, A. H., et al. (2016). "Outcomes associated with planned place of birth among women with low-risk pregnancies." CMAJ 188(5): E80-E90. https://pubmed.ncbi.nlm.nih.gov/26696622/
20. Iceland Monitor. (2024). "How do you know this woman had this child." Iceland Monitor. May 9. https://icelandmonitor.mbl.is/news/news/2024/05/09/how_do_you_know_this_woman_had_this_child/
21. Johansson, M., Jansson, O., Lilja, F., et al. (2023). "Freebirth, the only option for women who do not fit into common practice- A Swedish national interview study." Sex Reprod Healthc 37: 100866. https://pubmed.ncbi.nlm.nih.gov/37295181/
22. Johnston, K. & MacDougall, C. (2026). "Toward Conceptual Clarity: Out-of-Hospital Birth Practices and Freebirth Entrepreneurialism." Atlantis: Critical Studies in Gender, Culture, & Social Justice. 47(1): 44–57. https://atlantisjournal.ca/atlantis/en/article/view/5920
23. Kale, S. & Osborne, L. (2025). "Influencers made millions pushing 'wild' births – now the Free Birth Society is linked to baby deaths around the world." The Guardian. November 22. https://www.theguardian.com/world/ng-interactive/2025/nov/22/free-birth-society-linked-to-babies-deaths-investigation
24. Kale, S. & Davey, M. (2026). "A US champion of 'freebirthing' always claimed there had been no maternal deaths linked to the movement. Is Stacey Warnecke the first?" The Guardian. June 29. https://www.theguardian.com/world/2026/jun/30/freebirth-wellness-influencer-stacey-warnecke-death-ntwnfb
25. Lou, S., Dahlen, H. G., Gefke Hansen, S., et al. (2022). "Why freebirth in a maternity system with free midwifery care? A qualitative study of Danish women's motivations and preparations for freebirth." Sex Reprod Healthc 34: 100789. https://pubmed.ncbi.nlm.nih.gov/36332498/
26. Mackeen, D. (2026). "She wanted a `free birth.' It put her and her baby in grave danger." The New York Times. April 22. https://www.nytimes.com/2026/04/22/science/free-birth-wild-pregancy-risks-home-birth.html
27. McKenzie, G., Robert, G., & Montgomery, E. (2020). "Exploring the conceptualisation and study of freebirthing as a historical and social phenomenon: a meta-narrative review of diverse research traditions." Med Humanit 46(4): 512-524. https://pubmed.ncbi.nlm.nih.gov/32361690/
28. Miller, J. F. (2020). "Solitary and Kin-Assisted Rarámuri Birth: Ideals and realities." In Birthing Models on the Human Rights Frontier. Daviss, B. & Davis-Floyd, R., eds. Routledge: London.
29. Payne, E. (2025). "Officials 'strongly advise' against freebirths after cluster of stillbirths in Ontario." Ottawa Citizen. January 15. https://ottawacitizen.com/news/local-news/officials-advise-against-freebirths-after-stillbirths-ontario
30. Pillai, S., Cheyney, M., Everson, C. L., et al. (2020). "Fetal macrosomia in home and birth center births in the United States: Maternal, fetal, and newborn outcomes." Birth 47(4):409-417. https://pmc.ncbi.nlm.nih.gov/articles/PMC8923081/
31. Rosenberg, K. & Trevathan, W. (1995). " Bipedalism and human birth: The obstetrical dilemma revisited." Evolutionary Anthropology 4(5): 161-168. https://doi.org/10.1002/evan.1360040506Sargent, C. (1982).
32. "The Implications of Role Expectations for Birth Assistance among Bariba." Soc Sci Med 16(16): 1483-1489. https://pubmed.ncbi.nlm.nih.gov/7135022/
33. Shorey, S., Jarašiūnaitė-Fedosejeva, G., Akik, B. K., et al. (2023). "Trends and motivations for freebirth: A scoping review." Birth 50(1): 16-31. https://pubmed.ncbi.nlm.nih.gov/36598288/
34. Shostak, M. (1981). Nisa: The Life and Words of a !Kung Woman. Cambridge: Harvard University Press.
35. Snowden, J. M., Tilden, E. L., Snyder, J., et al. (2015). "Planned Out-of-Hospital Birth and Birth Outcomes." N Engl J Med 373(27): 2642-2653. https://pubmed.ncbi.nlm.nih.gov/26716916/
36. Sperlich, M. & Gabriel, C. (2022). ""I got to catch my own baby": a qualitative study of out of hospital birth." Reprod Health 19(1): 43. https://pubmed.ncbi.nlm.nih.gov/35164785/
37. Togioka, B. M. & Tonismae, T. (2023). "Uterine Rupture." In StatPearls. Treasure Island: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559209/
38. Uda, E. (2026). "Facing rural realities and mistrust in hospitals, these women turned to home births." CBC Radio. April 26. https://www.cbc.ca/radio/thecurrent/freebirthing-rural-maternal-medicine-9.7172199

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 the exhaustion that once made her consider leaving birth work altogether, and the changes that helped her build a more sustainable career. She discusses how recognizing the root causes of burnout, diversifying income, creating intentional seasons of work and rest, and building supportive relationships with other doulas keep her going.

(02:05) Katie's journey from teacher to birth doula

(04:55) Early lessons in business, fees, and communication

(07:21) Setting healthy boundaries with clients

(11:40) Navigating childcare and the on-call doula lifestyle

(14:02) Preparing for long births and using backup support

(19:53) Recognizing and addressing doula burnout

(25:45) Saying no and making space for rest

(27:05) Growing The Iowa Baby Ladies

(33:41) Advice for new doulas getting started

(37:02) Overcoming imposter syndrome through education and experience

(43:13) Advice for building a lasting doula career

Resources

• Learn more about the EBB Instructor Program: https://evidencebasedbirth.com/become-an-evidence-based-birth-instructor/
• Find an EBB Instructor: https://evidencebasedbirth.com/find-an-instructor-parents/
• Follow Katie on Instagram: https://www.instagram.com/theiowababylady/
• Learn more about the Iowa Baby Ladies: https://theiowababylady.com/
• Evidence on: Doulas
• EBB 364 – How to Prevent and Heal Birthworker Burnout with Doctoral Student Ihotu Ali and Grace Flannery, Certified Professional Midwife

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.

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, and what makes perinatal mental health distinct from other forms of mental illness.

They discuss the myths that keep parents suffering in silence, the real impact of mental health on babies and families, and how therapy and support groups, including free resources from Postpartum Support International, can empower families on the path to healing.

Content Warning: This episode includes discussions of perinatal mental health disorders, including postpartum depression, anxiety, OCD, and psychosis. Sensitive topics such as intrusive thoughts, stigma, feelings of guilt and shame, and the potential for harm to self or others are addressed. Listener discretion is advised, and we encourage anyone who may be affected by these topics to reach out for support through Postpartum Support International or a trusted healthcare provider.

(00:07:28) Unique Challenges in Perinatal Mental Health (00:11:05) Caregivers' Mental Health and Bonding Challenges (00:16:32) Parental Isolation Stemming from Anxiety and Depression (00:21:53) Emergent Postpartum Psychosis Symptoms (00:27:08) Overcoming Stigma in Perinatal Mental Health (00:31:54) Thought and Behavior Change Therapy for Depression (00:36:56) Perinatal Mental Health Challenges and Support

Resoureces

• EBB 197 – Addressing Perinatal Mental Health for Communities of Color with the Co-Founders of the Perinatal Mental Health Alliance for People of Color, Divya Kumar, Jabina Coleman, and Desirée Israel
• Postpartum Support International
• The Mom & Mind Podcast
• The Pregnancy Workbook: Manage Anxiety and Worry with CBT and Mindfulness Techniques

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? 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.

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 transformed the way she practices medicine and deepened her understanding of the physical, emotional, and identity-related transitions into parenthood. Plus, get practical guidance for changing providers, asking informed questions after a prior Cesarean, and navigating the overwhelming, and sometimes unreliable, health information found through social media and artificial intelligence.

(00:02:03) Dr. Vernon's journey into obstetrics and the influence of midwifery (00:05:47) Understanding matrescence and the transition into parenthood (00:07:14) What integrative medicine looks like in pregnancy and postpartum care (00:09:59) Bringing perinatal mental health and integrative medicine into obstetric practice (00:12:19) Gaps in traditional perinatal care and the need for individualized support (00:16:59) Supporting parents after infertility, pregnancy loss, birth trauma, or a difficult postpartum experience (00:21:32) Why it is okay to change providers (00:24:31) How infertility and pregnancy loss can shape a subsequent pregnancy (00:27:25) Practicing evidence-based, person-centered care that protects patient autonomy (00:29:02) Finding trustworthy pregnancy information online (00:32:27) Balancing medical evidence with personal intuition and individual circumstances

Resources

Connect with Dr. Vernon and learn more about her 1:1 perinatal coaching: https://www.drjessicavernon.com/

Follow Dr. Vernon on Instagram: https://www.instagram.com/dr.jessicavernon/

Then Comes Baby: An Honest Conversation About Birth, Postpartum, and the Complex Transition to Parenthood by Dr. Jessica Vernon: https://www.bloomsbury.com/us/then-comes-baby-9781538195925/

Matrescence: On Pregnancy, Childbirth, and Motherhood by Lucy Jones: https://www.penguinrandomhouse.com/books/714054/matrescence-by-lucy-jones/

Free Postpartum Support International online support groups: https://postpartum.net/get-help/psi-online-support-meetings/

PSI Perinatal Mental Health Provider Directory: https://postpartum.net/get-help/provider-directory/

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.

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. She and Dr. Dekker discuss what it was like to advocate for herself through multiple diagnoses, switch care providers late in pregnancy, and prepare for a hospital birth while still hoping for an unmedicated labor. Heidi also shares the surprising series of events that led to spontaneous labor before her scheduled induction, and how she welcomed her baby after a fast, nine-hour labor. (01:36) Overcoming a lifelong fear of pregnancy and choosing parenthood (05:13) Navigating migraines, gestational diabetes, and changing providers (08:52) Risking out of birth center care and finding the right hospital (11:11) Understanding a rare umbilical vein varix diagnosis (17:47) Building confidence through education, advocacy, and a supportive birth team (21:59) Preparing for birth with physical therapy, acupuncture, and evidence-based resources (25:50) Spontaneous labor begins weeks before a scheduled induction (32:02) Coping strategies for a fast, unmedicated labor (37:19) Postpartum recovery and breastfeeding (40:42) Heidi's advice on informed decision-making and birth preferences (43:06) Using anxiety and pain-coping techniques during labor Resources Find an EBB Childbirth Class: evidencebasedbirth.com/parentclasses/ Diagnosing Gestational Diabetes and the Glucola Test Evidence on: Induction for Gestational Diabetes Listen to EBB's Natural Induction Series on Acupuncture, Raspberry Red Leaf Tea, and Nipple Stimulation: evidencebasedbirth.com/category/series/natural-labor-induction-series/ EBB 304 – Q & A on PPD/Pitocin, Delayed Cord Clamping, Nubain, and Placental encapsulation: evidencebasedbirth.com/ebb-304-q-and-a-on-ppd-pitocin-delayed-cord-clamping-nubain-and-placental-encapsulation/ Read the research on Umbilical Chord Varix

• Fetal intra-abdominal umbilical vein varix: retrospective cohort study and systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/28876490/
• Isolated fetal umbilical vein varix and the association with intrauterine fetal death and fetal growth restriction: A systematic review, meta-analysis, and nested retrospective cohort study: https://pubmed.ncbi.nlm.nih.gov/38502055/
• The Development of the Umbilical Vein and Its Anatomical and Clinical Significance: https://pmc.ncbi.nlm.nih.gov/articles/PMC11954436/

Learn more about Spinning Babies®: spinningbabies.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.

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 learn what CMV is, how it spreads during pregnancy, evidence-informed prevention strategies, newborn screening and treatment, and why informed consent and narrative medicine matter for families navigating pregnancy and birth.

(02:01) Megan's journey into motherhood and how Anna's diagnosis led her to write the book (07:04) What congenital CMV is and why so few families know about it (10:26) Why CMV prevention isn't routinely discussed during pregnancy (15:40) Megan's illness during pregnancy and the missed opportunities for diagnosis (18:00) Antiviral treatment for newborns with congenital CMV (22:50) Steps pregnant families can take to reduce CMV exposure (25:55) Newborn screening for CMV and the current landscape of universal testing (32:16) Hearing screening, progressive hearing loss, and why early diagnosis matters (34:05) Parenting a child with developmental delays and what Anna has taught their family (40:11) Finding her voice, self-advocacy, and overcoming the culture of silence (46:41) Megan's final advice for pregnant families and where to learn more

Resources Get your copy of "Remedies for Sorrow": penguinrandomhouse.com/books/704982/remedies-for-sorrow-by-megan-nix/ Learn more about the National CMV Foundation: nationalcmv.org/ EBB 185 – The History of Narrative Medicine and Childbirth with Tyler Jean Dukes 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.

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 postpartum hemorrhage, and walks through what the evidence actually shows about each approach. She also shares trauma-informed scripts that nurses and providers can use to explain what they are doing and obtain informed consent, even in urgent, fast moving situations. Learn how unit culture, staffing, and fear based practice patterns can affect whether an unnecessary intervention becomes the default standard of care, and how to speak up and advocate for respectful care.

(02:40) Barbie's path from special education to labor and delivery nurse (04:36) Witnessing obstetric violence as a new nurse and learning the term (10:52) Defining fundal assessment versus fundal massage (18:06) When uterine massage is actually medically necessary (22:07) Recap: fundal assessment, routine massage, and massage for active hemorrhage (23:01) What the research says about routine fundal massage (26:04) How forceful and painful routine massage can be without consent (30:35) Misinformation about fundal massage on social media (34:11) Scripts for advocating for yourself if massage is done without medical need (37:00) How to assess and massage your own fundus after birth (39:26) What your uterus should feel like in the days after birth (44:35) A message to nurses who want to change their practice (45:11) Trauma-informed scripts for when massage is medically necessary (53:30) Unit culture and unaddressed trauma among nurses and providers

Resources

The Evidence on Pitocin During the Thrird Stage of Labor: ebbirth.com/thirdstage

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 a Pocket Guide, the My Doula Visit Workbook, 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 waitlist for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

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.