Evidence Based Birth®

The impact of epidurals on the second stage of labor has sparked a lot of discussion. Research suggests that epidurals can prolong this stage... and a prolonged second stage can be associated with increased risks of infection, severe tears and the need for interventions like forceps-assisted delivery or Cesarean. But does an epidural mean that you are higher risk for complications during the second stage of labor, or are there ways to lessen your risks? In this episode, Dr. Dekker explores the physiological effects of epidurals (and how they impact your body's birthing reflexes), the correlation between epidurals and the duration of the second stage of labor, and nuanced perspectives from professional guidelines worldwide— including a brief discussion of "laboring down" (aka delayed pushing). References:

• To access all the scientific references that go along with this episode, visit our blog article here.
• Access the rest of our EBB Pain Management series go to this page and click on "Pain Management Series."
• Check out the EBB Pocket Guide to Comfort Measures here.
• Find an EBB Childbirth Class near you here.

For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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.

Dr. Rebecca Dekker's joined by Debra Pascali-Bonaro, host of the Orgasmic Birth podcast, to explore the connections between love, intimacy, and childbirth. A world-renowned speaker and doula trainer, and the creative force behind the documentary "Orgasmic Birth: The Best-Kept Secret," Debra shares her origins into the world of childbirth education and her groundbreaking work. Debra and Dr. Dekker delve into how intimacy can enhance the birthing experience by promoting relaxation, reducing fear, and allowing for a more joyous and fulfilling labor. Learn how the power of pleasure and joy can transform the birth experience, and hear compelling stories that challenge conventional perceptions of labor and delivery.

Resources:

• Learn about Debra's 5 Essential Tools to Enhance Pleasure Centered Birth here.
• Follow Debra on Instagram!

For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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.

Dr. Liz Nutter, a retired Lieutenant Colonel with over 20 years of nursing and healthcare leadership experience, is bringing her expertise as a board-certified nurse midwife and national expert in waterbirth and hydrotherapy evidence-based practice. Dr. Nutter shares her journey from serving in the United States Army to becoming an assistant professor at St. Martin's University in Washington State. She discusses her pivotal role in advocating for waterbirth practices within the military healthcare system and maternal health rights within the military, including extending maternity leave to 12 weeks and providing support for service members experiencing pregnancy loss. From overcoming misconceptions to championing evidence-based protocols, she reminds us of the transformative power of waterbirth for birthing families and healthcare providers alike.

Check out Waterbirth Works, Dr. Nutter's online, evidence-based waterbirth continuing education program here!

Follow Waterbirth Works on Facebook here.

To view the Evidence articles that were mentioned in the episode, click on either link below:

• The Evidence on: Waterbirth (updated in 2024!)
• The Evidence on: Fetal Monitoring

For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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.

Today, we're sharing a replay of our podcast episode with EBB Childbirth Class parent, Angela Jones, about having an uncomplicated pregnancy and birth when labeled as high risk.

Angela is a macro-level social worker, wife to her husband, Tony, and mom to her son, Allister, and their cats, Pumpernickel and Lion-O. Angela and Tony graduated from the Evidence Based Birth Childbirth Class with EBB instructor, Victoria Michonski. Both Victoria and Heather McCullough, who is also an EBB instructor, were Angela and Tony's doulas for Allister's birth.

In today's replay, we talk about Angela's birth story and her experience having an easy, uncomplicated pregnancy and birth despite being labeled as high risk for multiple reasons. We also talk about data birth outcomes for people who have multiple high-risk labels.

Three years later, Angela shared this thoughtful update as she reflected on her birth story.

Update from Angela: When I am having difficult moments, I sometimes look back at the video of myself giving birth to Allister and feel such peace. Allister turned 3 this year, and recently he has been asking about how he came into this world. My husband and I have been showing him the video of him being born and when he sees it, he looks at me, almost in awe, with a big smile. He now requests to see it at least once per week. Going into my birthing time, I never imagined that I would have 41 hours of active labor. I still credit the EBB course and my amazing doulas with having prepared me well in understanding all of the tools that were available to me when, after 30 hours of not being able to tolerate any food or water, I decided that I wanted to depart from my original birth plan. Getting an epidural allowed me to eat, drink, sleep and then ultimately push my son out gently in the position of my choosing. This was the exact birth experience that I wanted. I still encourage women, especially those who are afraid (in particular, those who are afraid due to multiple "high risk" labels) to not settle for a care team that is anything less than supportive, safe, and empowering.

Content note: We talk about ectopic pregnancy, pregnancy losses, high-risk pregnancy complications, and perinatal morbidity.

Resources:

• Learn more about EBB Instructor, Victoria Michonski, here. Follow Victoria on Instagram and Facebook.
• Learn more about EBB Instructor, Heather McCullough, here. Follow Heather on Instagram and Facebook.
• Sheen, J. J., Wright, J. D., Goffman, D., et al. (2018). Maternal age and risk for adverse outcomes. Am J Obstet Gynecol. 2018 Oct;219(4):390.e1-390.e15. Click here.

For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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.

Have you ever wondered what the evidence is on epidurals for pain management during labor? Join us on today's podcast as we discuss most recent evidence on epidurals, spinals, and combined spinal-epidurals! We'll begin with some background on these methods, including how common they are in the U.S. and around the world, before moving on to the effectiveness, benefits, and risks for use during labor. We'll also talk about alternative methods of pain relief during labor, and share recommendations from professional healthcare organizations. [Bonus addition to the podcast at 20:00: We talk about the study on epidurals out of Scotland [Kearns et al. 2024] that is generating lots of news headlines!] Join us to learn more about pain relief options during labor! Content Note: Topics related to epidural use, how they're provided (including needles and catheters), and the benefits and risks of this intervention. Discussion of assisted vaginal delivery (forceps and vacuum deliveries), severe maternal complications, surgery, perineal tears, and postpartum depression. References:

• To access all the scientific references that go along with this episode, visit our blog article here.
• Access the rest of our EBB Pain Management series go to this page and click on "Pain Management Series."
• Check out the EBB Pocket Guide to Comfort Measures here.
• Find an EBB Childbirth Class near you here.

For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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.

Brandie Bishop, CEO of the National Black Doulas Association (NBDA), joins us to explore the vital role of doulas in supporting pregnant individuals and families within Black and Brown communities. From her early experiences working with refugee families to her passion for advocating for marginalized populations, Brandie's unique journey into birth work led to her role today— continuing NBDA's mission of training the next generation of Black doulas. Through comprehensive trainings and mentorship programs, NBDA aims to empower doulas to make a meaningful impact in reducing maternal mortality rates and ensuring equitable access to compassionate care for all birthing people. Join us as we celebrate the principles, values, and ancestral knowledge driving the NBDA's vision for the future of doula care.

Learn more about the National Black Doulas Association here.

Check out Your Tribe Family Services here.

For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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. Dekker's joined by Gena Jaffe, an LGBTQ+ activist, attorney, and founder of Connecting Rainbows©️. Gena shares her personal story of embarking on reciprocal IVF with her wife and the legal hurdles they faced as a lesbian couple. From navigating complex parental rights to accessing inclusive healthcare, Gena sheds light on the challenges faced by some LGBTQ+ individuals and families on their path to parenthood.

Gena's experience led her to creating Connecting Rainbows©️, a groundbreaking organization offering free legal and fertility resources tailored to the LGBTQ+ community. Tune in for an empowering conversation celebrating diversity, resilience, and the journey of building loving, inclusive families.

Resources:

• Learn more about Connecting Rainbows©️ here!
• Follow Connecting Rainbows©️ on Instagram.
• Find support from Fertility Out Loud here.
• Learn more about the Family Equality Council here.
• EBB 227 – Amplifying the Need for Intersectional Birth Support for QTBIPOC Birthing People with Xian Brooks of the Dandy Doula
• EBB 182 – Black-led Queer and Trans Birth Work with Mystique Hargrove, Kortney Lapeyrolerie, and Nadine Ashby
• EBB 180 – Trauma-Informed Care and Consent with Feminist Midwife, Stephanie Tillman
• EBB 179 – An Empowering and Transformative Home Birth Experience with Trish and Mimi Ang
• EBB 160 – Introducing Mystique Hargrove: EBB Featured Instructor

For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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 about the world of babywearing, including its impact on infant development, digestion, and sleep with Whitney Dula, a maternal child health advocate and founder of The Mama's Dula. Whitney shares her personal journey into babywearing, the rich cultural history of babywearing, its role in community-based child-rearing practices, and practical tips for parents. From fostering a close bond between caregivers and babies to being an affordable alternative to expensive baby carriers, learn how this practice could benefit you and your child.

Learn more about Whitney and The Mama's Dula here.

Follow Whitney on Instragram, TikTok and Facebook.

Check out the baby wraps and carriers mentioned in this episode:

1. Moby Wrap®

2. Tula®

3. Ergobaby®

4. Boba®

For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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, EBB Childbirth Class graduates Melissa and Brendon Smyles' share their experiences preparing for an unmedicated birth while embracing flexibility in their birthing plan. From the unexpected premature rupture of membranes to the decision to use fentanyl for rest during labor, Melissa and Brendon tell their birth story, emphasizing the importance of informed choices and personalized support. Join us as they reflect on the transformative power of evidence-based education and the profound impact of tailored guidance and informed decision making in achieving a positive birth outcome. Resources:

• Get the Evidence on Injectable Opioids for Pain Management during Labor here.
• And learn about it on YouTube, here!
• Learn more about their doula, Alycia, here!
• EBB 267 - Debunking the Myths about Fundal Massage with Barbie Christianson, RN
• EBB 256 – Top 3 Recommendations for Preventing Pelvic Floor Dysfunction after Birth with Dr. Sarah Duvall, Founder of Core Exercise Solutions
• Find an EBB Childbirth Class here.
• Check out Melissa's pelvic floor therapist, The Pelvis Pro, here.

For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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.

Were you aware that beyond the standard epidural, there is an additional medication option for managing pain during childbirth? Today, Dr. Dekker discusses another common option, intravenous (IV) or intramuscular (IM) opioids. Dr. Dekker explains the different types of injectable opioids available during labor, how they work, and the current evidence that you need to know to make an informed decision. Plus, learn about the benefits and risks of IV opioids for pain relief labor and an in-depth look at one opioid in particular: Remifentanil, which is commonly given through a "Patient-Controlled Analgesia" or PCA pump.

• EBB Pocket Guide to Interventions (https://ebbirth.com/shop)
• EBB Pocket Guide to Comfort Measures (https://ebbirth.com/shop)
• More YouTube videos mentioning IV Opioids among other options:
  • Pain Management During Labor, Regional Anesthesia - Maternity Nursing
  • Anesthesia Options for Labor & Delivery
• Prescribing Guidelines for Pregnant Patients with Opioid Use Disorder
• Narcotics for Pain During Childbirth

For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! 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.

References:

• To access all the scientific references that go along with this episode, visit our blog post here.