Evidence Based Birth®

Every pregnant person deserves the information—and support—they need to make truly informed decisions about labor induction. In this episode, Dr. Rebecca Dekker talks with Dr. Ann Peralta and Kari Radoff, CNM, co-creators of Partner to Decide, a nonprofit initiative improving decision-making in perinatal care. They discuss the creation of their free, multilingual decision aid that supports families in understanding their options around routine induction of labor—and empowers them to advocate for their 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! 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 today's episode, we're diving into the evidence on perineal tears and the importance of avoiding episiotomies during childbirth. We'll talk about what perineal tears are, the different types that can occur, and the potential health consequences that can follow. You'll also hear about the various factors that may increase or decrease the risk of tearing during birth. Finally, we'll cover why it's so important to avoid an episiotomy during childbirth.

Content warning: Discussion of perineal tears during childbirth, severe tears, episiotomy, and obstetric violence related to cutting episiotomies without consent.

(05:58) Understanding Perineal Tears (09:15 Midwife Care Reduces Birth Tears (13:06) Risk Factors for Severe Birth Tears (16:08) Postpartum Tear Impact Study Findings (21:59) Episiotomy History and Controversy (24:02) Episiotomy Study on Routine vs. Restricted Use (28:02) Episiotomy Risks vs. Natural Tears (31:39) Episiotomy Awareness and Informed Consent Resources

• For the full list of references, visit the EBB website here.
• To watch the EBB YouTube video with visual props, visit here.
• View graphics from the Mayo Clinic that show the different types of tears here.
• Read Dr. Klein's story here.

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.

Navigating a neonatal intensive care unit (NICU) experience can be overwhelming and emotionally taxing. In this episode, Dr. Rebecca Dekker talks with Mary Farrelly, a certified NICU nurse, doula nurse educator, and founder of The NICU Translator. With over a decade of experience in a Level 4 NICU, Mary shares how families can find empowerment and confidence in the NICU. Mary discusses the importance of emotional, social, and informational support for families, and how NICU-informed doulas can play a critical role in bridging the gap between parents and medical teams. From understanding the different levels of NICU care to navigating postpartum challenges, Mary offers compassionate and practical guidance. Learn how early preparation, trauma-informed care, and advocacy can make a difference in the NICU experience. Plus, Mary provides actionable tips for doulas supporting families through this journey. (03:18) Discovering the Path to NICU Nursing (06:16) Emotional Impact of NICU Nursing and Family Connections (11:25) Understanding NICU Levels of Care and Medical Needs (17:57) Staffing Shortages and Challenges in NICU Care (21:48) Families' Most Common Questions: "When Can My Baby Go Home?" (25:02) Transitioning from NICU to Home and Navigating Anxiety (29:11) Parental Mental Health and PTSD After a NICU Stay (33:14) The Role of NICU-Informed Doulas in Supporting Families (39:08) Effective Support Strategies for NICU Families (45:52) Resources for NICU Families and Doulas Resources:

• Connect with Mary Farrelly on Instagram: @thenicutranslator
• Visit The NICU Translator website: www.thenicutranslator.com
• Download the free NICU Birth Plan template: www.thenicutranslator.myflodesk.com/birthplan

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 can art serve as a powerful way to honor pregnancy, birth, and parenting experiences—especially for families who are often underrepresented in birth spaces? In this episode, Dr. Rebecca Dekker explores this question with Lauren J. Turner, a Baltimore-based artist, birth worker, and founder of Birth Nerds. Lauren shares how her own home birth experiences, her journey with postpartum and neurodivergence, and a diagnosis of multiple sclerosis shaped her path into birth work and fine art. Together, Rebecca and Lauren explore how art can be a healing, meditative process for birthing families, and a meaningful tool for birth workers to honor their clients' journeys. Lauren opens up about creating paintings that reflect diverse parenting experiences—from lactation to the NICU—and how she uses bold colors and imagery to bring visibility to Black and Brown families in maternal health. (03:44) Lauren's First Home Birth Experience and the Impact of Midwives (06:28) A Challenging Second Birth and the Role of Trust and Teamwork (11:19) Starting Over with Doula Training and the Importance of Comprehensive Education (12:27) Living with Multiple Sclerosis and Being Dismissed by the Healthcare System (19:29) Redefining Rest through Art and Creativity (27:51) Exploring Themes in Maternal Health and Parenting Art (28:34) How Parents and Birth Workers Can Use Art to Process Birth (35:41) The Beauty of the Placenta in Art (37:10) Fiber Arts in Birth Work and Creative Expression (40:21) Uplifting Lactation Through Art and Community Resources

• Explore Lauren's art: laurenjturnerfineart.com
• Follow Lauren on Instagram: @birthnerds
• Shop prints, shirts, and stickers: birthnerds.com
• Learn more about Mamatoto Village: mamatotovillage.org
• EBB 92 – Impacts of the Community Birth Worker Model with Aza Nedhari
• Discover MamAmor Dolls: mamamordolls.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.

Dr. Rebecca Dekker is joined by Camilla Costa Goetz, a graduate of the EBB Childbirth Class, to share her story of advocating for herself during labor. Camilla, a former fashion student turned full-time mom, opens up about navigating pregnancy with POTS (Postural Orthostatic Tachycardia Syndrome), preparing for birth while her husband was away at Army Ranger School, and making the bold decision to push back against hospital norms to have the birth she wanted. Tune in as Camilla and Rebecca discuss why self-advocacy is crucial in birth, how hospital policies can conflict with evidence-based care, and how standing firm can make all the difference in your birth experience. Learn tips for preparing your birth team, confidently saying no to interventions you don't want, and making sure your birth preferences are honored—even in a hospital setting. (02:11) How Camilla Discovered Evidence Based Birth® and Her Pregnancy Challenges (05:11) Navigating Pregnancy with POTS and Health Concerns (10:27) Preparing for Birth Without Her Husband by Her Side (17:31) Planning for an Unmedicated Birth and Overcoming Fear of Hospitals (23:06) The Problem with Hospital Birth Policies and Misinformed Providers (26:13) How Camilla Switched Hospitals to Avoid an Unwanted C-Section (34:26) The Surprising Lack of Support for Unmedicated Birth in the Hospital (39:50) How Camilla Stood Her Ground in the Delivery Room (45:57) Her Husband's Emotional Reaction to Missing the Birth (51:06) Postpartum Challenges, Military Life, and the Strength of 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.

In this mini Q&A, Dr. Rebecca Dekker digs into the evidence on three important questions submitted by EBB Pro Members. Tune in as we explore:

• The evidence on peanut balls during early and active labor—do they really shorten labor and increase vaginal birth rates?
• Whether induction at 39 weeks is necessary for IVF pregnancies—what does the research actually say?
• Dysphoric Milk Ejection Reflex (D-MER)—what is it, what causes it, and how can parents cope?

(02:30) How to Join the EBB Pro Membership & Submit Questions (04:15) (Q1) Peanut Balls in Labor – What does the research say about their use in early labor vs. active labor? (06:50) Key studies on peanut ball use—impact on labor duration, mode of birth, and satisfaction (13:30) (Q2) Induction at 39 Weeks for IVF Pregnancies (16:40) SMFM recommendations, lack of randomized trials, and shared decision-making in IVF pregnancies (20:00) (Q3) Dysphoric Milk Ejection Reflex (D-MER) (22:45) Hormonal theories behind D-MER, coping strategies, and available research (30:00) Recap & How to Find More Evidence-Based Resources For the full list of references and resources, visit the EBB website here! 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.

Dr. Shilpa Babbar, a double board-certified maternal-fetal medicine specialist and OB/GYN, joins Dr. Rebecca Dekker to discuss the role of integrative obstetrics in pregnancy and birth. Dr. Babbar shares her journey into maternal-fetal medicine, how she became interested in yoga and breathing techniques, and the growing body of research on prenatal yoga. They discuss how breathwork can support pregnant individuals, the physiological effects of deep breathing, and how birth workers can incorporate these techniques into prenatal care. Dr. Babbar also shares her experience using alternate nostril breathing to manage blood pressure during pregnancy and her vision for making integrative therapies a standard part of obstetric care. (01:41) Dr. Babbar's Journey into Maternal-Fetal Medicine (04:16) How Yoga and Prenatal Yoga Research Began (09:37) Studying the Effects of Prenatal Yoga on Pregnancy (12:46) Yoga's Impact on Labor Duration (14:33) The Role of Breathwork in Pregnancy (17:48) How Dr. Babbar Used Breathing Techniques for Her Own Pregnancy (22:30) The Science Behind Alternate Nostril Breathing (28:52) Guided Demonstration of Deep Breathing Techniques (35:10) Applying Breathwork During Pregnancy and Labor (39:08) The Future of Integrative Obstetric Care Resources Learn more about Dr. Shilpa Babbar's work at drshilpababbar.com Follow the Integrative Obstetric Care Conference on Instagram: @IOBCare 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.

Madi van Tonder is a birth photographer, doula, and educator based in the Netherlands. Originally from South Africa, Madi has lived in multiple countries and brings a unique perspective to birth work, particularly for families navigating new healthcare systems. Join Dr. Dekker and Madi as she shares insights into the Dutch maternity care system, where midwives play a central role, home birth is considered a national heritage, and postpartum families receive in-home support through the Kraamzorg system. We explore how Dutch birth culture prioritizes physiological birth, minimizes unnecessary interventions, and encourages parents to trust in their bodies. Madi also highlights the challenges faced by immigrant families and the importance of informed decision-making, regardless of where you give birth. (00:03:16) Overview of the Dutch Maternity Care System: Midwife-Led Model (00:05:52) Home Birth as National Heritage: Dutch Birth Culture & Trends (00:06:54) Role of Doulas in the Netherlands & Their Place in the System (00:10:33) Dutch Approach to Birth Interventions & Cesarean Rates (00:12:46) Pain Management Options: Non-Medicated Comfort Measures First (00:16:18) Early Hospital Discharge & the Kraamzorg Postpartum Care System (00:20:01) Dutch Parental Leave Policies & Family-Friendly Work Culture (00:22:54) Challenges in the System: Protocols, Immigration, & Language Barriers (00:28:47) Lessons from the Dutch Birth Model: Autonomy, Education & Low-Intervention Birth (00:31:08) Madi's Advice for Expecting Parents & Birth Professionals Resources

• Learn more about Madi van Tonder and her work at Meraki Madi.

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.

EBB Childbirth Class graduate Krista DeYoung joins us from her hospital room to share her journey through a high-risk pregnancy, an extended antepartum hospital stay for partial placental abruption, and preparing for a scheduled Cesarean at 37 weeks. Krista opens up about the challenges of long-term hospitalization, advocating for herself in a complex medical system, and the emotional toll of being away from her family. Dr. Rebecca Dekker walks Krista through creating a Cesarean birth plan, covering topics like delayed cord clamping, optimizing the operating room experience, and postpartum recovery expectations and strategies. (00:03:01) High-Risk Pregnancy & Partial Placental Abruption Diagnosis (00:07:35) Managing an Antepartum Hospital Stay: Challenges & Coping Strategies (00:12:09) Navigating Medical Information & Self-Advocacy in the Hospital (00:26:53) Mental Health Strategies & Staying Positive in a Prolonged Hospital Stay (00:31:36) Preparing for a Cesarean Birth: Creating a Birth Preferences Plan (00:36:28) Discussing Delayed Cord Clamping & Other Cesarean Options (00:45:17) What to Expect Physically & Emotionally During a Cesarean (00:48:52) Postpartum Recovery: Healing, Movement, and Emotional Processing (00:53:29) Building a Postpartum Support Plan Resources

• EBB 304 – Q & A on PPD/Pitocin, Delayed Cord Clamping, Nubain, and Placental encapsulation
• EBB 305 – A High-Risk Pregnancy and Miraculous Birth with Krista and John DeYoung, EBB Childbirth Class Graduates
• EBB 343 – Top Ten Evidence-Based Strategies for Lowering the Risk of Cesarean

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 is joined by Trish Ware, Registered Nurse, childbirth educator, and host of The Birth Experience with Labor Nurse Mama. With 16 years of labor and delivery nursing experience, Trish shares her journey from feeling disempowered during her first birth to becoming an advocate for changing the birth culture one birth at a time. Tune in as Trish and Rebecca discuss how to effectively advocate for yourself during labor, overcome fears of being "that patient," and navigate common labor scenarios like refusing unnecessary interventions. Learn tips for building a strong birth team, empowering your partner to advocate for you, and ensuring your voice is heard in the delivery room. (01:31) Trish's Journey to Becoming a Labor and Delivery Nurse (05:42) Early Birth Experiences and the Importance of Advocacy (10:59) The Power of Human Dignity During C-Sections (13:38) Why Parents Struggle to Advocate for Themselves (17:07) Changing the Power Dynamic in the Labor Room (20:43) Thinking Outside the Bed: Encouraging Movement in Labor (25:43) Advocating for Yourself with Simple, Firm Responses (34:57) Protecting Yourself Against Unwanted Interventions (38:59) Empowering Birth Partners to Advocate Effectively (43:31) Building Strong Birth Teams with Nurses and Doulas Resources

• Join the virtual EBB Conference here.
• Explore birth classes and the Mama Membership at Labor Nurse Mama.
• Listen to The Birth Experience with Labor Nurse Mama podcast here.
• Follow Trish on Instagram for educational content and reels: @LaborNurseMama.
• Learn about induction and informed consent with the Induction Pocket Guide here.

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.