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, 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.
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.
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Do we use ‘cookies’?
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California Online Privacy Protection Act
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Does our site allow third party behavioral tracking?
It’s also important to note that we do not allow third party behavioral tracking
COPPA (Children Online Privacy Protection Act)
When it comes to the collection of personal information from children under 13, the Children’s Online Privacy Protection Act (COPPA) puts parents in control. The Federal Trade Commission, the nation’s consumer protection agency, enforces the COPPA Rule, which spells out what operators of websites and online services must do to protect children’s privacy and safety online.
We do not specifically market to children under 13.
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In order to be in line with Fair Information Practices we will take the following responsive action, should a data breach occur:
We will notify the users via email within 7 business days.
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Evidence Based Birth®
P.O. Box 4962
Lexington, KY 40544
Last Edited on 2016-07-13