Evidence Based Birth®

Even when caring for similar patient populations, some hospitals have significantly higher Cesarean rates than others, and factors like teamwork, psychological safety, leadership, staffing, and beliefs about childbirth can affect outcomes. In this episode, Dr. Rebecca Dekker talks with family physician and researcher Dr. Emily White VanGompel about how the culture of labor and delivery units can shape decision-making and influence the birth experience for families.
 
Dr. White VanGompel explains the NTSV (nulliparous, term, singleton, vertex) Cesarean rate, why it is used as a quality measure, how hospitals have successfully reduced unnecessary Cesareans, and what families can look for when choosing a birth setting that supports vaginal birth. Plus, learn about the Labor Culture Survey (LCS), Dr. White VanGompel's research on the impact of the ARRIVE Trial on provider attitudes, and why conversations about reducing Cesarean overuse are important from a public health perspective.
 
(01:58) Growing up around home birth and discovering differences in birth culture during medical training
(09:05) How family medicine influences perspectives on childbirth, postpartum care, and long-term family health
(12:46) What NTSV Cesarean rates are and why they are used as a quality measure
(16:19) Defining labor and delivery unit culture and how it affects Cesarean decision-making
(19:23) Lessons from hospitals that successfully reduced Cesarean rates
(23:50) Real-world examples of hospitals that transformed their birth culture and lowered Cesarean rates
(29:36) Common attitudes and beliefs associated with higher Cesarean rates
(32:32) The Labor Culture Survey
(35:44) The ARRIVE Trial, provider attitudes toward induction, and shifting birth culture
(43:01) How families can evaluate hospitals and providers when seeking support for vaginal birth
(48:24) Midwifery models of care and their potential role in supporting vaginal birth
(52:40) How personal birth experiences influence clinician attitudes toward Cesarean and vaginal birth
 
Resources
View the original validation study that explains the creation of the LCS: https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12406
See how the first statewide use of the LCS found an association between labor culture and hospital-level cesarean rates: https://onlinelibrary.wiley.com/doi/full/10.1111/1475-6773.13123
Deep-dive into this qualitative study about how hospitals that lowered their cesarean rates changed their cultures: SpringerAccess research journals, articles, books and more | Springer Nature Linkarticle/10.1186/s12913-024-12108-3
See how this study used the Labor Culture Survey (LCS) to compare clinician beliefs and attitudes about induction of labor before and after the publication of the ARRIVE Trial: Sciencedirectsciencedirect.com
science/article/abs/pii/S0884217522003914
 
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.

This summer, join Dr. Rebecca Dekker and the EBB Research Team for a four-part live series on "How to Read Research," starting June 30.
Get access to the full Summer School Series by joining the Quarterly EBB Pro Membership at a special summer rate!
Plus, enroll by June 28 and receive a free digital EBB Pocket Guide to Labor Induction!
Learn more and save your seat in our virtual classroom: ebbirth.com/summer

The way we move during labor shapes far more than our comfort. It helps determine how a baby navigates through the pelvis, and whether a birth can unfold with fewer interventions!
In this replay episode, Dr. Rebecca Dekker talks with Brittany Sharpe McCollum, a childbirth educator, doula, lactation counselor, and pelvic biomechanics educator. Brittany explains how the bones of the pelvis move during labor, why that movement matters for fetal positioning, and how everyone can benefit from intentional position changes during labor-- whether you're planning an unmedicated birth or not!
They explore the three planes of the pelvis, why opening the pelvic inlet and outlet require opposite movements, and how to match specific positions to where the baby is located in the pelvis. Brittany also shares her 5-4-3 rule for position changes, practical tips for inductions and epidurals, the power of asymmetrical positioning, and why movement is one of the few birth tools that carries benefit without risk.
(06:25) Exploring movement in childbirth
(10:19) Understanding baby's position in labor
(13:03) Benefits of movement during labor
(17:31) Subtle pelvic movements in labor
(23:05) Partner role during contractions
(25:17) Managing rectal pressure during labor
(27:57) Movement during labor
(32:21) Importance of prenatal education
(37:35) Understanding racism in obstetrics
Resources
EBB Signature Article on the Evidence on Birthing Positions: ebbirth.com/birthingpositions
Learn more about Brittany: blossomingbelliesbirth.com
"Baby Got VBAC: An Inspiring Collection of Wisdom for Better Births After a Cesarean"
Connect with Brittany on Instagram: @blossomingbelliesbirth
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.

The ways we feed and care for babies are shaped not only by research, but also by family traditions, cultural values, and generations of shared wisdom.
 
In this episode, Dr. Rebecca Dekker talks with Yogyata Wadhwa, an IBCLC, childbirth educator, birth doula, sleep consultant, and infant feeding specialist based in India. Drawing on her experience supporting more than 10,000 families, Yogyata shares how parents can honor cultural traditions while making informed decisions about breastfeeding, introducing solids, and navigating the postpartum period.
 
They explore common breastfeeding challenges, cultural beliefs surrounding infant feeding, and how parents can balance evidence-based recommendations with meaningful family customs. Yogyata also shares postpartum traditions in India, including the Jappa period, family caregiving practices, and the cultural significance of introducing a baby's first foods.
 
(00:00) Introduction and overview of cultural perspectives on breastfeeding and infant feeding in India
(05:34) How Yogyata became a childbirth educator, IBCLC, doula, and infant feeding specialist
(08:38) Common breastfeeding challenges: milk supply concerns, latch difficulties, and tongue ties
(10:24) Cultural beliefs that influence breastfeeding
(16:18) Traditional infant feeding practices in India and the Annaprasan ceremony
(21:32) First foods for babies and introducing solids
(23:45) What baby-led feeding looks like
(28:04) Signs that a baby is ready to start solids
(33:41) Maternity leave, workplace accommodations, and postpartum support systems in India
(36:20) The Jappa period and postpartum recovery practices
(39:09) Balancing evidence-based recommendations with cultural expectations
(43:43) Advice for Indian families living abroad and navigating feeding without traditional support systems
(47:04) Yogyata's final advice for first-time parents
 
Resources
Connect with Yogyata on Instagram: @thebirth.life
Learn more about The Birth Life: thebirthlife.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.

Research shows that queer and trans parents face significantly higher rates of perinatal depression and anxiety, but affirming and community-centered support can make a big difference. In this episode, clinical psychologist and researcher Leiszle Lapping-Carr joins Dr. Rebecca Dekker to talk about the unique mental health challenges 2SLGBTQ+ parents may experience during pregnancy and postpartum and what providers, birth workers, and communities can do to create safer, more supportive care. Dr. Lapping-Carr shares how stigma, discrimination, isolation, and lack of affirming healthcare spaces can affect mental health outcomes for queer and trans parents. She also explains how evidence-based approaches like cognitive behavioral therapy can be adapted to better support 2SLGBTQ+ families, especially when distress is rooted in experiences of discrimination and loss of safety. Learn how protective factors that support mental health, chosen family and community, and inclusive healthcare providers can make perinatal spaces more affirming for all parents.
 
(01:43) Dr. Leiszle Lapping-Carr's background and research journey
(04:31) Perinatal depression rates among queer and trans parents
(07:19) Minority stress, discrimination, and mental health risks
(11:08) Protective factors and the importance of community support
(12:52) What is the Mothers and Babies intervention?
(15:17) Adapting Cognitive Behavioral Therapy (CBT) for queer and trans parents
(20:09) Common thought patterns and challenges for LGBTQ+ parents
(22:57) Behavioral strategies and "pleasant activities" for mental health
(28:58) Barriers to affirming perinatal mental healthcare
(32:42) The role of doulas and community recommendations
(37:33) Common mistakes providers make when caring for queer and trans parents
 
Resources
Learn more about Dr. Lapping-Carr and her research: feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=49272
Postpartum Support International Online Support Groups: postpartum.net/get-help/psi-online-support-meetings/
Mothers and Babies preventive perinatal depression intervention: mothersandbabiesprogram.org/providers/
 
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.