Evidence Based Birth®

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.