Hello! My name is Rebecca Dekker, and I am a nurse with my PhD and the founder of Evidence Based Birth®.
For decades, the vast majority of birth research evidence has been locked away in medical journals. I believe in putting the evidence back in the hands of the people who need it the most: birthing people and their and families.
In 2012, I embarked on a mission to create a trusted, non-biased source for the most current, evidence-based information on pregnancy and childbirth. This project came to be known as Evidence Based Birth®.
When my first daughter was born, I went into childbirth with rose-colored glasses. My husband and I didn’t prepare much beyond taking the standard hospital childbirth class. Having practiced as a cardiovascular nurse, I trusted that the nurses and care providers at my hospital would take excellent care of me during the labor and delivery process.
Imagine my surprise when I showed up at the hospital in labor, and I was treated as if I was one of my own heart failure patients! I was told I could not eat or drink, get out of bed, or use the bathroom. I then had a host of interventions that were done to me—none of which were medically necessary—and some of which led to complications that made my recovery and first weeks as a mother very difficult.
While I was in labor, I assumed that this care was being done in my best interests, but, still, something about the whole experience just felt a little “off” to me. I was healthy and strong—so why was I being treated like I was sick?
How was it that I’d entered the hospital healthy and confident, and left quite the opposite—and this was a “normal” experience?
As a nurse researcher and nursing professor, I already knew that evidence-based practice was the gold standard in medicine and nursing. But I began to wonder… was the care that I had received evidence based? What was the evidence for everything that happened in the delivery room?
So I made a list of everything that was done to me in the hospital, and I set out on a quest to learn about the research evidence behind every practice and complication that I had encountered during my daughter’s birth.
When I started looking into the evidence, I was shocked. Almost all of the care I had received has been shown by high-quality research evidence to be harmful to healthy women who are giving birth. What’s more, I found out that the type of care I had received was “routine” all across the U.S.—and that model has been copied in places all over the world!
When I got pregnant again, I wanted my next birth to be different. I wanted my baby’s birth to be evidence based.
After my son was born—an incredibly empowering experience in which I received evidence-based care—I felt an intense drive to share what I had learned with others. I had compiled so much research evidence on birth—what if other people could benefit from it?
And so in 2012, Evidence Based Birth® was born.
I began by posting summaries of the research evidence that I had found. The response from the public was nothing short of astounding. Traffic to Evidence Based Birth® grew rapidly (3,500% in the first year alone!), and within months I began receiving requests to speak at health organizations all around the world.
Our vision is to ensure that one day every pregnant person around the world will experience only the highest standard, most respectful and empowering childbirth care possible.
Our mission is to raise the quality of childbirth care globally, by putting accurate,
Use of Inclusive Language
Evidence Based Birth® incorporates gender neutral language in the materials that we produce, in keeping with national health care initiatives. We affirm and respect that some pregnant and birthing people do not gender identify as women and we strive to accurately reflect this diversity in the language that we use. We also acknowledge that the vast majority of people giving birth do gender identify as women, and for this reason we have retained gender-specific language as well. We hope that you find our use of language to be both balanced and inclusive.
Structure of Evidence Based Birth®
Today, Evidence Based Birth® has grown beyond my wildest dreams. We are now an independent organization with a total of 7 staff team members who work relentlessly to make research evidence on childbirth freely accessible to the public.
The EBB website and our team are entirely funded by our continuing education programs (the EBB Professional Membership and EBB Instructor program), sales from our Online Store, sales from Dr. Dekker’s book, and speaking engagements.
So that we can remain entirely free from conflicts of interest, EBB does not accept funding, such as advertising or sponsorships, outside of these programs and product sales. EBB also does not provide or sell any customer data to any other organization.
We are not a non-profit, but instead we are a “for purpose” company. We continually invest the money we earn from our hard work back into improving the articles and other free resources we offer to the public. This structure has allowed us to remain nimble and continue to expand our ability to affect change worldwide.
Through all these years, I continually remain grateful to you—my readers—for helping me decide which topics to cover, for patiently awaiting new articles, and for encouraging me, supporting me, and sharing the website with your friends.
We have resources
Methods in full detail
This site began in April 2012 as a way for me to document the evidence I found as I researched various birth practices. In June 2012, this site became widely read on an international level. Based on the sheer numbers of people who were reading my articles, I made a conscious decision to increase my standards for Evidence Based Birth® articles.
Importantly, in August 2012, I made a commitment to publish high-quality evidence-based articles that include as little personal bias as possible. I decided to simply report the evidence and leave out my personal opinions. If the research points strongly in one direction or another, I will make concluding statements such as, “This evidence shows that this test is preferred over that test,” or “There is not enough evidence to recommend routine use of _____,” or “The risks and benefits of these options are…” However, I try to ensure that these concluding statements are based on solid research evidence and not my personal opinion.
In the interest of transparency, here is the process that is followed before each evidence-based article is published. We began using this process formally in August 2012.
- A topic is chosen, and we ask ourselves and our audience a series of questions about that topic.
- We write down our own personal feelings about that topic. This helps us be aware of our biases, which hopefully helps lessen bias during the writing process.
- We conduct a literature review using PubMed, the search engine for the National Institutes of Health and the U.S. National Library of Medicine. We choose specific key words that will best help us find the articles that we are looking for.
- First, we search for meta-analyses, which are considered the highest level of evidence on a topic. We also search for systematic reviews, randomized controlled trials, observational studies, quality control papers, and case reports as appropriate.
- We read through the titles and abstracts (also known as summaries) to determine whether each article is relevant to my search. If an article is relevant, we download the article and read it in its entirety. We read the reference list from each downloaded paper to make sure we did not miss any relevant articles that have been published.
- We add each article that I read into my EndNote file, which is a referencing software.
- Based on the amount of evidence available, we may or may not include time limits in our search. For example, we may limit my search to research studies that have been conducted in the past 10 years. However, sometimes “classic” studies were carried out many years ago and are still relevant today. If we include an older study, we mention in the article if it is considered a “classic,” landmark, or ground-breaking study.
- We read about the topic using other sources, including multiple obstetric textbooks, UpToDate (a subscription service that publishes up to date evidence-based summaries of almost every medical topic imaginable), and practice guidelines from various organizations.
- We begin writing the article, making sure to include a reference for each factual statement that we make.
- We add links to each of the references so that readers can read the research summaries or full-text articles for themselves on PubMed.
- Once the evidence-based article is drafted, we email it to multiple volunteer reviewers. One of our reviewers is a non-medical professional whose primary purpose is to make sure that we have eliminated as much bias as possible from the article and that we only present the evidence. The other reviewers are healthcare professionals (OBs, midwives, and family physicians) who practice in the obstetrics field and review the content for accuracy, clinical relevancy, and bias. We also contact research experts in that specific field and ask them to review the content and suggest revisions. Finally, we send the article to a medical editor to make sure we do not have any typographical errors.
- The reviewers suggest revisions. We make the recommended changes and send it back to the reviewers and medical editors for a final check.
- The article is published.
- We strive to update Signature Articles at least once every three years, conducting a systematic literature search prior to the update. We note the most recent update date at the beginning of each article.
By accessing, using, downloading, and/or browsing information on this website and blog, and by subscribing to newsletters and downloading other products offered by Evidence Based Birth® on this website and blog, you acknowledge your understanding and agreement to all the following:
The Evidence Based Birth® website and blog content only provides general information that may or may not apply to your personal health condition or circumstances. The opinions expressed on this website and blog by Rebecca Dekker, PhD, RN, APRN or any other Evidence Based Birth® team members or volunteers on behalf of Evidence Based Birth® are strictly their own personal opinions and not the opinions or policies of any third party, including any health care provider, employer, educational or medical institution, professional association or charitable organization. Nothing on the Evidence Based Birth® website or blog constitutes or shall be construed as constituting medical advice of any kind whatsoever, whether from a licensed medical professional or otherwise; nor is it a substitute for professional medical advice, diagnosis and treatment.
There is no substitute for the relationship between a medical professional and his or her patient. See your treating physician, osteopath, nurse practitioner, midwife or other qualified health care provider regarding any questions you have about your personal health and any medical condition you may have, including a pregnancy. No information found on this website or blog should be relied or acted upon by you without first consulting your own treating healthcare provider. NEVER disregard professional medical advice or delay seeking it because of something you have read on Evidence Based Birth.® If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance upon any information provided on the Evidence Based Birth® website or blog is solely at your own risk.
The information on the Evidence Based Birth® website and blog is provided on an “AS IS” basis. To the fullest extent provided by law, Evidence Based Birth® disclaims all warranties, whether express, implied, statutory or otherwise, including but not limited to the implied warranties of merchantability, non-infringement of third parties’ rights, and fitness for a particular purpose with respect to all Evidence Based Birth® content. Without limiting the foregoing, Evidence Based Birth® makes no representations or warranties that the content, software, text, graphics, links or communications provided on or through the use of this website and blog is: (i) accurate, reliable, complete, or current/up-to-date; or (ii) satisfies any government regulations requiring disclosure of information on healthcare or prescription drug products. Further, the content of this website and blog is transmitted over a medium that at times may be beyond the control of Evidence Based Birth.® Accordingly, Evidence Based Birth® assumes no liability for or related to the delay, failure, interruption, or corruption of any data or other information transmitted in connection with the website and blog.
Reliance upon any information provided on the Evidence Based Birth® website or blog is solely at your own risk. Evidence Based Birth® reserves the right to make alterations or deletions to the content or format of the website or blog at any time without notice. Evidence Based Birth® does not recommend or endorse any specific tests, physicians, medical facilities, products, procedures, opinions, or other information that may be mentioned on the Evidence Based Birth® blog as safe, appropriate, or effective for you. In no event shall Evidence Based Birth, LLC, its members, officers, representatives, agents, authors, employees, volunteers or any third parties who contribute to the website or blog content or who are mentioned on the website or blog, be liable for any damages of any kind or nature, including, without limitation, compensatory, incidental and/or consequential damages, arising from or at all related to the use of, reliance upon, or inability to use any Evidence Based Birth website or blog content, regardless of whether such damages are based on warranty, contract, tort, or any other legal theory. Your sole and exclusive remedy for dissatisfaction with this website and blog is to stop using it.
Effective date: May 22, 2018
Evidence Based Birth (“us”, “we”, or “our”) operates the websites: https://evidencebasedbirth.com, https://evidencebasedbirthacademy.com, and https://evidence-based-birth.myshopify.com (the “Service”).
This page informs you of our policies regarding the collection, use, and disclosure of personal data when you use our Service and the choices you have associated with that data.
- Service: Service is the https://evidencebasedbirth.com, https://evidencebasedbirthacademy.com, https://evidence-based-birth.myshopify.com websites operated by Evidence Based Birth
- Personal Data: Personal Data means data about a living individual who can be identified from those data (or from those and other information either in our possession or likely to come into our possession).
- Usage Data: Usage Data is data collected automatically either generated by the use of the Service or from the Service infrastructure itself (for example, the duration of a page visit).
- Cookies: Cookies are small pieces of data stored on your device (computer or mobile device).
- Data Processors (or Service Providers): Data Processor (or Service Provider) means any natural or legal person who processes the data on behalf of the Data Controller. We may use the services of various Service Providers in order to process your data more effectively.
- Data Subject (or User): Data Subject is any living individual who is using our Service and is the subject of Personal Data.
Information Collection And Use
We collect several different types of information for various purposes to provide and improve our Service to you.
Types of Data Collected
While using our Service, we may ask you to provide us with certain personally identifiable information that can be used to contact or identify you (“Personal Data”). Personally identifiable information may include, but is not limited to:
- Email address
- First name and last name
- Address, State, Province, ZIP/Postal code, City
- Profession or role in the health care system
- Cookies and Usage Data
We may use your Personal Data to contact you with newsletters, marketing or promotional materials and other information that may be of interest to you. You may opt out of receiving any, or all, of these communications from us by following the unsubscribe link or instructions provided in any email we send or by contacting us.
We may also collect information how the Service is accessed and used (“Usage Data”). This Usage Data may include information such as your computer’s Internet Protocol address (e.g. IP address), browser type, browser version, the pages of our Service that you visit, the time and date of your visit, the time spent on those pages, unique device identifiers and other diagnostic data.
Tracking Cookies Data
Cookies are files with small amount of data which may include an anonymous unique identifier. Cookies are sent to your browser from a website and stored on your device. Tracking technologies also used are beacons, tags, and scripts to collect and track information and to improve and analyze our Service.
You can instruct your browser to refuse all cookies or to indicate when a cookie is being sent. However, if you do not accept cookies, you may not be able to use some portions of our Service.
Examples of Cookies we use:
- Session Cookies. We use Session Cookies to operate our Service.
- Preference Cookies. We use Preference Cookies to remember your preferences and various settings.
- Security Cookies. We use Security Cookies for security purposes.
Use of Data
Evidence Based Birth uses the collected data for various purposes:
- To provide and maintain our Service
- To notify you about changes to our Service
- To allow you to participate in interactive features of our Service when you choose to do so
- To provide customer support
- To gather analysis or valuable information so that we can improve our Service
- To monitor the usage of our Service
- To detect, prevent and address technical issues
- To provide you with news, special offers and general information about other goods, services and events which we offer that are similar to those that you have already purchased or enquired about unless you have opted not to receive such information
Legal Basis for Processing Personal Data Under General Data Protection Regulation (GDPR)
Evidence Based Birth may process your Personal Data because:
- We need to perform a contract with you
- You have given us permission to do so
- The processing is in our legitimate interests and it’s not overridden by your rights
- For payment processing purposes
- To comply with the law
Retention of Data
Evidence Based Birth will also retain Usage Data for internal analysis purposes. Usage Data is generally retained for a shorter period of time, except when this data is used to strengthen the security or to improve the functionality of our Service, or we are legally obligated to retain this data for longer time periods.
Transfer Of Data
Your information, including Personal Data, may be transferred to — and maintained on — computers located outside of your state, province, country or other governmental jurisdiction where the data protection laws may differ than those from your jurisdiction.
If you are located outside United States and choose to provide information to us, please note that we transfer the data, including Personal Data, to United States and process it there.
Disclosure Of Data
Disclosure for Law Enforcement
Under certain circumstances, Evidence Based Birth may be required to disclose your Personal Data if required to do so by law or in response to valid requests by public authorities (e.g. a court or a government agency).
Evidence Based Birth may disclose your Personal Data in the good faith belief that such action is necessary to:
- To comply with a legal obligation
- To protect and defend the rights or property of Evidence Based Birth
- To prevent or investigate possible wrongdoing in connection with the Service
- To protect the personal safety of users of the Service or the public
- To protect against legal liability
Security Of Data
The security of your data is important to us, but remember that no method of transmission over the Internet, or method of electronic storage is 100% secure. While we strive to use commercially acceptable means to protect your Personal Data, we cannot guarantee its absolute security.
“Do Not Track” Signals
We do not support Do Not Track (“DNT”). Do Not Track is a preference you can set in your web browser to inform websites that you do not want to be tracked.
You can enable or disable Do Not Track by visiting the Preferences or Settings page of your web browser.
Your Data Protection Rights Under General Data Protection Regulation (GDPR)
If you are a resident of the European Economic Area (EEA), you have certain data protection rights. Evidence Based Birth aims to take reasonable steps to allow you to correct, amend, delete, or limit the use of your Personal Data.
If you wish to be informed what Personal Data we hold about you and if you want it to be removed from our systems, please contact us.
In certain circumstances, you have the following data protection rights:
The right to access, update or to delete the information we have on you. Please contact us to assist you in accessing, updating, or deleting your information.
The right of rectification. You have the right to have your information rectified if that information is inaccurate or incomplete.
The right to object. You have the right to object to our processing of your Personal Data.
The right of restriction. You have the right to request that we restrict the processing of your personal information.
The right to data portability. You have the right to be provided with a copy of the information we have on you in a structured, machine-readable and commonly used format.
The right to withdraw consent. You also have the right to withdraw your consent at any time where Evidence Based Birth relied on your consent to process your personal information.
Please note that we may ask you to verify your identity before responding to such requests.
You have the right to complain to a Data Protection Authority about our collection and use of your Personal Data. For more information, please contact your local data protection authority in the European Economic Area (EEA).
We may employ third party companies and individuals to facilitate our Service (“Service Providers”), to provide the Service on our behalf, to perform Service-related services or to assist us in analyzing how our Service is used.
These third parties have access to your Personal Data only to perform these tasks on our behalf and are obligated not to disclose or use it for any other purpose.
We may use third-party Service Providers to monitor and analyze the use of our Service.
Google Analytics is a web analytics service offered by Google that tracks and reports website traffic. Google uses the data collected to track and monitor the use of our Service. This data is shared with other Google services. Google may use the collected data to contextualize and personalize the ads of its own advertising network.
For more information on the privacy practices of Google, please visit the Google Privacy Terms web page: http://www.google.com/intl/en/policies/privacy/
Facebook remarketing service is provided by Facebook Inc.
You can learn more about interest-based advertising from Facebook by visiting this page: https://www.facebook.com/help/164968693837950
To opt-out from Facebook’s interest-based ads follow these instructions from Facebook: https://www.facebook.com/help/568137493302217
Facebook adheres to the Self-Regulatory Principles for Online Behavioral Advertising established by the Digital Advertising Alliance. You can also opt-out from Facebook and other participating companies through the Digital Advertising Alliance in the USA http://www.aboutads.info/choices/, the Digital Advertising Alliance of Canada in Canada http://youradchoices.ca/ or the European Interactive Digital Advertising Alliance in Europe http://www.youronlinechoices.eu/, or opt-out using your mobile device settings.
For more information on the privacy practices of Facebook, please visit Facebook’s Data Policy: https://www.facebook.com/privacy/explanation
We may provide paid products and/or services within the Service. In that case, we use third-party services for payment processing (e.g. payment processors).
The payment processors we work with are:
Links To Other Sites
We have no control over and assume no responsibility for the content, privacy policies or practices of any third party sites or services.
Our Service does not address anyone under the age of 18 (“Children”).
We do not knowingly collect personally identifiable information from anyone under the age of 18. If you are a parent or guardian and you are aware that your Children has provided us with Personal Data, please contact us. If we become aware that we have collected Personal Data from children without verification of parental consent, we take steps to remove that information from our servers.
- By email: firstname.lastname@example.org
- By mail: P.O. Box 4962, Lexington, KY 40544