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 our wildest dreams. We are now an independent organization with a total of 11 virtual 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 programs (the EBB Professional Membership and EBB Instructor program), sales from our Online Shop, proceeds from the EBB Childbirth Class workbook, 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 our own 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, we continually remain grateful to you—our readers—for helping us decide which topics to cover, for patiently awaiting new articles, and for encouraging us, supporting us, 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.