Evidence Based Birth®

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.
 
Resources
EBB 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
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/
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.
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/
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
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/
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/
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/
Carlson, K. & Vadakekut, E. S. (2026). "Amniotic Fluid Embolism." In StatPearls. Treasure Island: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559107/
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.
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/
Dahlen, H., Kumar-Hazard, B., & Schmied, V. (2020). Birthing Outside the System: The Canary in the Coal Mine. Edited Volume. London: Routledge.
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/
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
Davis-Floyd, R. & Cheyney, M. (2019). Birth in Eight Cultures. Edited Volume. Waveland Press.
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/
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/
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/
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/
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/
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/
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/
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
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
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
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/
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
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/
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.
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
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/
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).
"The Implications of Role Expectations for Birth Assistance among Bariba." Soc Sci Med 16(16): 1483-1489. https://pubmed.ncbi.nlm.nih.gov/7135022/
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/
Shostak, M. (1981). Nisa: The Life and Words of a !Kung Woman. Cambridge: Harvard University Press.
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/
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/
Togioka, B. M. & Tonismae, T. (2023). "Uterine Rupture." In StatPearls. Treasure Island: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559209/
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

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.