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In this episode, I interview Evidence Based Birth®®️ Instructor Tara Thompson. Tara is a certified birth doula with CAPPA, a Lamaze certified childbirth educator, and a licensed massage therapist specializing in pregnancy and postpartum. She has taught classes to expecting couples for more than ten years at a women’s center in Atlanta, Georgia. She’s also been teaching privately for over three years. Tara teaches the Evidence Based Birth®®️ Childbirth Class online, and has also taught the EBB Comfort Measures Workshop for L&D nurses. She recently facilitated a training to more than 250 birth professionals at a large hospital to help lower the Cesarean birth rate, and educate staff on comfort measures during labor.

We talk about Tara’s unique insights into hospital birth, policies, and culture, as well as the impact and importance of childbirth education. She and I also talk about the beginnings of Evidence Based Birth®️®.

Resources

Connect with Tara on her website (https://www.tarasbirthservices.com/about-me), Facebook (https://www.facebook.com/tarasbirthservices) or Instagram (https://www.instagram.com/taradthompson.co/).

Click here (https://tarasbirthservices.com) to access the Evidence Based Birth®®️ classes taught by EBB Instructor Tara Thompson.

Click here (https://evidencebasedbirth.com/resources-for-parents/) for a list of Evidence Based Birth®®️ resources for parents. 

Click here (https://evidencebasedbirth.com/childbirth-class/) for information on the Evidence Based Birth®®️ Childbirth Class. 

 

Transcript

Rebecca Dekker:
Hi everyone. On today’s podcast we’re going to talk with Tara Thompson about giving birth in Atlanta. Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Dekker and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not a medical advice. See ebbirth.com/disclaimer for more details.

Hi, everyone. Today, I’m so excited to welcome Tara Thompson to the Evidence Based Birth® podcast. Tara is a certified birth doula with CAPPA, a Lamaze-certified childbirth educator and an Evidence Based Birth® instructor.
She’s also a licensed massage therapist specializing in pregnancy and postpartum Tara has taught education classes to expecting couples for more than 10 years at a Women’s Center in Atlanta, Georgia. She’s also been teaching privately the past three years. Tara teaches the Evidence Based Birth® childbirth class online and she’s also taught the Comfort Measures Workshop for Labor & Delivering Nurses. She was also recently the facilitator of a training to more than 250 birth professionals to help lower the cesarean birth rate and educate staff on comfort measures during labor at a large hospital. Tara, welcome to the Evidence Based Birth® Podcast.

Tara Thompson:
Thank you. Thank you for having me. Excited to be here.

Rebecca Dekker:
How did you end up working in a large hospital teaching childbirth classes? What brought you to this point?

Tara Thompson:
I started in birth work first because I’m a massage therapist. I was a massage therapist first. I didn’t know anything about birth work as far as the classes and teaching and different things like that. I do have three children of my own, but when I was pregnant with my children, sad to say, I actually didn’t take any classes or anything like that. Unfortunately, where I grew up, as far as childbirth classes and different things like that, that was more for other people, not really for us, so we really didn’t have that type of information or education for that brought to us.

Rebecca Dekker:
You felt like you didn’t have culturally safe or congruent type of education in your community.

Tara Thompson:
Exactly. I knew absolutely nothing. Absolutely nothing when I started having children. Fortunately, I actually did it without an epidural, not any medications or anything like that, but it wasn’t because of the education. It was because of more of fear of the side effect. When I was and I’ll start, I’m sorry, the story, but when I was 15 years old, I had a neighbor that was braiding my hair and we were sitting outside on the step and she said, “It’s about to rain,” and I’m looking up and I’m like, “There’s no clouds in the sky. What are you talking about?” She said, “I can tell it’s going to rain from the spot where had the epidural?” Now, her child was four years old and she’s telling me at four years later after she had a baby, that she can tell when it’s going to rain because of a spot in her back, and for some reason, that just stuck with me.

Tara Thompson:
When I got pregnant at 22 with my first child, I was like, “I am not getting the epidural. I don’t know anything else, but I know for sure I do not want the epidural.” I said, “This is one day. I can do this for one day as opposed to I don’t know how long she’s going to have this pain and this was four years later.” That’s basically where I was driven as far as not having an epidural or anything like that. That was from that, from fear of it. Then, I became a massage therapist years later and then I took … I always love children, so I became an infant massage instructor and then moved down here. This was all in New York. This is where I grew up.

Then, we moved down to Atlanta in 2005 and I worked at a spa. There was a massage therapist that came in for a service and she was actually a teacher or she was an instructor for the hospital. As we got to talking, she was like, “Would you like to take over?” because she was opening a practice, a pregnancy massage practice, so she had to leave the hospital teaching the classes. She asked me if I wanted to do it. I said, “Sure,” and I was new to Atlanta. That’s how I actually got started working in that hospital. It was from another massage therapist that I’m actually good friends with.

Rebecca Dekker:
They recommended that you take this position as a childbirth educator, and then, I’m assuming you had to go and get training to do that?

Tara Thompson:
Exactly, because I actually started because of the infant massage instruction, because that was part of … It’s called Mother’s First and that’s the program that teaches the classes. That was one of the classes that they taught and that was infant massage. That’s how I got in.

Rebecca Dekker:
At this point, did you already have all three of your kids?

Tara Thompson:
Yes.

Rebecca Dekker:
How did your second and third births go?

Tara Thompson:
They were hard, but I knew I wasn’t going to get the epidural. Like I said, that was one thing that I said, “No matter what happens, I’m not getting an epidural.”

Rebecca Dekker:
You were determined not to get one out of fear.

Tara Thompson:
Exactly.

Rebecca Dekker:
Were you able to use any other techniques to stay comfortable during labor without the epidural?

Tara Thompson:
Well, with my first, it was a really good pregnancy, and then, I started having contractions at night. I went to sleep, and then, it woke me up at about 7:00 in the morning. I remember going to the hospital at 10:00 AM, and then, they sent me home. Again, not having any education or anything and I’m like, “Okay.” I was just around the house, just doing everyday things, just normal things. Then when you had to stop, you stopped, you’d bent over, but I was still moving. It was just, I guess, instinct that just told me to keep moving because again, I didn’t have any education for this. Then, I remember my mother tried to bring me a sandwich. It was a peanut butter and jelly sandwich. Then, I just threw up. She was like, “No, you’re going back to the hospital.”

We went back to the hospital, and when we got there, they said, “Why did you wait so long?” They just took me right into labor and delivery because they had like triage first. They took me right into labor and delivery and she was born within about 20 minutes after me getting there.

Rebecca Dekker:
They sent you home because it was too early and then, they chastised you when you come back and they said it’s too late.

Tara Thompson:
They said I waited too long. Yes.

Rebecca Dekker:
But it sounds like you’re able to stay pretty comfortable at home then, moving around.

Tara Thompson:
It was uncomfortable, of course, but again, just moving and it’s just like instinct just told me to move like, “Don’t lay there.” I wasn’t comfortable laying down. That’s for sure. I just got up and moved. With learning everything from becoming a massage therapist, to becoming a doula and an educator, I was like, “If I would have known all these things before when I had my kids, oh, my gosh, it would have been so much easier.” That’s what really brought me in to birth work. I was like, “I have to give people this information,” especially where I came from. I wish I was still in my neighborhood where I was and helping young women.

Rebecca Dekker:
In New York or in Atlanta?

Tara Thompson:
In New York. Yeah, in New York, but I said, “I just have to get this out to anybody I can,” and that’s where as far as the education portion of it, I love, love, love doing that because a lot of people don’t know, and for one, they just think that your doctor supposed to know everything and that’s what I thought like, “I don’t need to know anything because my doctor will tell me what to do.”

Rebecca Dekker:
What is that like then when you work with couples? Can you see them just becoming empowered through educating themselves?

Tara Thompson:
Absolutely. One of the reasons, like I said, I started at that hospital, I started 2007, I started working at that hospital. That hospital actually has a bad reputation in Atlanta for their C-section rates and different things like that. Becoming a doula … Because I became a doula in 2010, so becoming a doula and different things and being different networks, you hear, “Why are you working there? Why are you there? You can leave and you can go there.” I stayed around for a little while because I felt that I can actually help people because they’re coming in for, one, I used to ask in the beginning of classes, “What brought you here?” Then, I would get a lot of, “Well, my doctor told me to come.” That was like, “Okay, so they don’t have the education either. They just think that their doctor is going to do everything.”

Fortunately, the doctor did tell them to come to a class. Then, I felt if I can just help one couple in this class, then I will be making a difference. Again, because the C-section rates are so high, the epidural rates is about 90-something percent for epidural rates at this hospital. If I can just help one couple and make a difference, this is why I’m here.

Rebecca Dekker:
What was the C-section rate while you were teaching there?

Tara Thompson:
In the beginning, it started off in the 30s. Of course, now, they’re not putting any numbers out or anything like that, but I know it did get pretty high and I believe it was close to 40% recently, like the last we heard of it, but of course, they’re not putting any numbers out or anything like that.

Rebecca Dekker:
Are you still working there or have you moved-

Tara Thompson:
I am still working there. I did leave. I left in … Oh gosh, I can’t remember what year, I think 2016 or ’17, I left and I actually went back. I said, “I am supposed to be here,” because my supervisor that was there at the time and I had gotten really close. She is actually the one that told me to go get my Lamaze Certification. Another reason, like I said, why I’m there, everything happens for a reason. I was an instructor as far as the infant massage and I also started teaching pregnancy for massage and labor. This was a class that we taught to couples and it helped … It’s basically a comfort measures class and it was showing massage techniques and different things to help for comfort measures while they were in labor. That’s a class I started to teach.

She’s the one that actually told me to go get my Lamaze certification. I was like, “How am I going to do that?” because at this hospital, the only instructors are RNs. I was the only instructor that was not an RN at this hospital, still to this day, and they said they’re not hiring anyone else, but I am the only one there that’s not an RN that teaches the childbirth classes.

Rebecca Dekker:
We know that nursing and childbirth education are very white fields. Are you the only Black educator at the hospital as well or are there others?

Tara Thompson:
I am. Yeah, I’m the only one. Yes. Again, I felt that I’m supposed to be there for a reason. A majority of the couples there, I guess about 85% of them are white. It’s a small portion that are Black when they come in, more that I get in my classes, I should say. Again, just me being there, I’m like, “I’m there for a reason.” I actually went back to the hospital again and started teaching there again. Unfortunately, that supervisor that was there is no longer there anymore because we were really trying to do things to make changes and trying to make things happen and she’s not there anymore. The new supervisor that’s there, she’s again new, so she’s not too familiar with the staff and the higher up, people higher up that she can pull some strings and get things in there.

Tara Thompson:
It’s going to take some time. Then of course, this whole pandemic started because I was actually supposed to be teaching some of the nurses there, the comfort measures class. Then again, the whole pandemic started, so everything fell to the side.

Rebecca Dekker:
I’ve heard that with a lot of hospitals instead of switching to virtual classes, they just canceled all the classes. Unfortunately, that’s what happened at the hospital you were teaching, but you’ve been teaching privately for the past three years and you recently started teaching the Evidence Based Birth® childbirth class online. Can you tell us a little bit about what that experience has been like?

Tara Thompson:
I love Evidence Based Birth® for one. I am so glad. I’m trying to think of how I heard about it. I guess just scrolling one day and I saw some information I think that you guys were about to start one of the courses or whatever. Scrolling and I saw it and I looked into it. Then, I saw and detailed how research based it was. I was like, “Oh, my gosh. This is what we need.” Again to give people information because I have been a Lamaze instructor for a few years, but it felt to me like you teach them and you give them information. It’s like, “Okay, now go off and just go have a baby or go learn some more stuff,” but it was nothing to point them in a direction, “Go here to learn this,” or, “Go there to learn this.”

I feel that Evidence Based Birth® has that where you can give them more information and just guide them into where to go like, “This is not the end. There’s still more after this,” because they’re still pregnant and they haven’t had the baby. Even after the pregnancy, I love the fact that Evidence Based Birth® has the newborn care section and everything else that has it. With teaching the Evidence Based Birth® classes, I also love that you stay on top of everything as far as … You were 80% online even before this whole pandemic started. That was just something that the childbirth classes offered, and then, that’s what I noticed was a problem because at one point of time at the hospital, they noticed that the numbers started getting low. They were, I guess, trying to figure out, doing census to see why the numbers started going low.

Rebecca Dekker:
For classes you mean like fewer people come into classes?

Tara Thompson:
For classes, right, for classes. The number started dropping and they were saying that people are getting information offline now. They’re not coming to childbirth classes. They are getting Dr. Google or YouTube or wherever and they felt that that was enough between their doctors and just the information they can get online, that was enough, and even as far as the time, it was just a lot. I actually stopped teaching. Lamaze, you can have an all-day class at the hospital because the hospital classes are Lamaze based and you can have an all-day class which was eight hours. I actually stopped teaching that class. When I came back to the hospital, I didn’t want to teach the full class anymore because I felt that was too much information at one time.

Again, I love the fact that EBB breaks it down and let them learn it the way they need to learn it and when they need to learn it. Not just, “Come here on a Saturday from 9:00 to 5:00. We sit here all day,” because after lunch, all the dads are asleep. I have to keep them moving and do different things to try to get them up. I do love the fact that EBB has that information where they can learn. It’s more mentoring, not just me standing in the front of room with a PowerPoint going over everything.

Rebecca Dekker:
I think that is a big part of the class that we try to build into is that your role as the educator is to be more of a mentor and a guide and the parents are on a self-learning journey and you’re just helping, debrief with them and discuss things with them.

Tara Thompson:
Exactly, so they’re finding out more. That’s the type of learner I am like. If I sit in the classroom and somebody just spouts things at me, just yells, it will go in one ear and out the other. After about an hour, I can’t remember anything that they said, but if you sort of break it down or if I’m going to find the information myself, then that helps me to retain it a little more. I think that’s really what drew me to EBB also, just to type, because it helps different learners where it has visual, it has audio and it has that … The kinetics part of it is gone because you can’t really touch, but just helping, but I do love that about EBB also.

Rebecca Dekker:
What struggles do you think that parents are facing in the Atlanta area in terms of birth?

Tara Thompson:
For one, if you just move down to Atlanta, a lot of times you come into the area and it’s like, “Okay, now you’re pregnant. Where do I have my baby?” Of course, the number one hospital where they named it the baby factory will pop up, “This is where you should have your baby,” and that’s-

Rebecca Dekker:
Based on marketing.

Tara Thompson:
Exactly. Marketing and just their numbers in general. The largest hospital in Atlanta, they have 42 labor and delivery rooms, whereas other hospitals may have six labor and delivery rooms, 13 labor and delivery rooms. That one again, like I said, has 42 labor and delivery rooms. They do have a Women’s Center where it’s specific just this one part of the hospital is only labor and delivery and postpartum. You never going to go into the main hospital at all to have a baby.

Rebecca Dekker:
But it’s called the baby factory or I guess that’s what people call it in the community?

Tara Thompson:
Yeah, they call it the baby factory. Then after looking and being in different hospitals and then seeing, you go in and it’s like, “Wow, it looks like a factory,” because it’s like bright lights and just the rooms and just certain things, where you go into other hospitals and it’s more cozy feeling. The lights are dimmer. The furniture is darker. The floors. It just brings a different vibe or a different feeling as opposed to, again, go into this place that’s more open. It is very family oriented. You don’t even need visitors passes or anything like that. Well, it used it before the pandemic, of course, but people can just go in there. You can be in there and somebody just come in. It doesn’t matter. The only time that someone would not be able to find someone is if they were put down as the Jane Doe or something like you didn’t want to be listed at all. That’s the only time. Any other time, people can just kind of come in.

Rebecca Dekker:
What you’re saying is a large impersonal institution, but yet, it’s the place where most people go to have their baby.

Tara Thompson:
Exactly.

Rebecca Dekker:
Why do you think that is?

Tara Thompson:
For one, I’m just going to point out, if you are high risk or needing some sort of just anything, high risk or anything like that, that is definitely the place you should be. They’re very good at what they do as far as the anesthesiologists and their surgeons are very good. People have come from other states. They have people coming from Tennessee. They have people coming from Alabama to give birth there because of that. I think maybe just because of that, and like I said, if you’re not educated or you don’t know and you just think that, “Okay, I’ll just listen to my doctor,” they have a lot of doctors there, a lot of different practices that deliver there, so they’re going to just go there.

When you hear about it and saying, “This is the number one,” you have to really dig deep and see why is this number one because for, one, and it’s sad like millennials started and if they wanted this microwave thing, everything right now, they don’t want to wait. I’ve had a lot of people even in the classes that started off when they were like, “No, I’m just going to have my epidural. Basically, I want the anesthesiologist waiting in the room for me when I get there, so I can just have my epidural and have the baby,” or-

Rebecca Dekker:
If that’s kind of birth you want, then it’s a popular option.

Tara Thompson:
Exactly, but that’s the thing. They weren’t educated. They didn’t know the difference because one of the things in the classes and this is why I say I had to be there and why I’m still there for so many years, one of the things in the classes, I always start off and ask, “Okay, who plans to have the epidural?” just feel around the see and everybody’s raising their hand. Nine out of 10 of the couples always raise their hand, “Yes, I’m going to have the epidural. I wanted it as soon as I can.” At the end of the class, when it ended, I then asked, “Okay, who plans to have the epidural?”

They may still have a lot, but at least they’re going to give their bodies a chance. They’re not going to just go in and want the epidural as soon as they walk into the door because now they’ve been educated and now they know the effects. Whereas you just hear, “Epidural is going to take your pain away and contractions cause pain, well, then I’m going to get the epidural,” but everything in between, nothing is taught to them. Of course, your doctors are not going to explain it to you.

Rebecca Dekker:
I have a question too about … Because I know Atlanta is considered by many people to be the Black Mecca of the United States and more than half the population is Black. Do the nursing staff in that hospital reflect the population of the City of Atlanta or are the nursing staff primarily white nurses in labor and delivery?

Tara Thompson:
That hospital specifically, they’re primarily white nurses. Yeah, the RNs, the ones that aren’t going to be there. Now as far as maybe the techs or the transporters or other workers in there, they may have a lot of large Black population in there for other workers, but as far as the RNs and the ones that’s in their labor and delivery, those are primarily white nurses.

Rebecca Dekker:
I know which hospital you’re talking at and I went to the AWHONN Conference last year which is the Association of Women’s Health, Obstetric and Neonatal Nurses and they had a speaker from that hospital on a panel about maternal mortality. I was shocked when that speaker said, “We don’t know why Black women are dying at higher rates than white women.” I was so shocked that I had to write letters and I talked to people about it and I talked about to our pro member Facebook group that this person was a person in a position of authority at a hospital in Atlanta and had no idea that racism was the cause of systemic disparities. It was just jarring and shocking and horrifying.

Tara Thompson:
We actually had a, I forgot what it was called, it was some type of meeting that we had. Each one of the instructors had to present a different topic. I presented EBB to bring it into the hospital or to educate them about it. It was a roomful of the instructors. Then, there was my supervisor, the coordinating supervisor, her supervisor. There was like three or four levels there. When I-

Rebecca Dekker:
What a hierarchy, four supervisors.

Tara Thompson:
[crosstalk 00:21:39] When I presented and gave the information, this was the first time that they have ever heard this and this is even instructors that have been there for years and some of the instructors they actually were labor and delivery nurses that have come over to be instructors now.

Rebecca Dekker:
You mean they’d never heard of Evidence Based Birth® is what you’re saying?

Tara Thompson:
They’ve never heard of the Evidence Based Birth® or the information that I’ve presented before them as far as the numbers in African American, just the mortality numbers and everything.

Rebecca Dekker:
They didn’t even know that there were disparities?

Tara Thompson:
Exactly.

Rebecca Dekker:
Wow.
Tara Thompson:

Exactly. You in this … I want to say maybe like for lack of a better word in this bubble, you’re in here and it’s like Lalalalalala Land. You’re just coming and you’re just helping, and then, that’s it. I’m sure they know what’s happening, what’s going on, but not really paying attention to it or not even caring.

Rebecca Dekker:
Or not thinking it applies to them maybe.

Tara Thompson:
Exactly.

Rebecca Dekker:
“Well, that’s not in our facility,” or, “That’s on our problem.”

Tara Thompson:
Exactly. When you’re on the labor and delivery floor, not all of the nurses follow over to, “Okay, now we have to move to a C-section,” or, “Now, we have to go with it.” They don’t know what happens after they leave here because you’re stuck on this side.

Rebecca Dekker:
Like nurses don’t even know their own statistics, right?

Tara Thompson:
Exactly.

Rebecca Dekker:
I’ve read there’s research showing that individual nurses have their own cesarean rates, but you’re saying a lot of the nurses don’t even know the outcomes of the people they took care of.

Tara Thompson:
Yes, or following it because even if it happens postpartum, they’re not going to know about it and a lot of things that were happening, they’re happening postpartum after the C-section. Of course, if there’s a nurse in the labor and delivery, she’s not going to do research or not even care about it because they don’t see anything wrong.

Rebecca Dekker:
Now, I remember when you gave that presentation about Evidence Based Birth® and also we’re going to share with them statistics and some research information. I remember you were prepping to do that presentation. Did you feel like that made an impact? Did that end up being a successful strategy to give that presentation?

Tara Thompson:
Yes, absolutely. That’s what I said like. Because I had some of the instructors saying, “Oh, my goodness, Tara. I didn’t know.” Unfortunately, I was in tears when I was presenting, of course and just the fact that, for one, I’m the only one that’s not a nurse and here I am presenting this information and the reason why I’m here and doing this and I had to explain to them like, “My 26-year-old, she’s an African American having a baby in the State of Georgia. To me, that was terrifying.”

Rebecca Dekker:
This is personal because this is your family’s health and life.

Tara Thompson:
Exactly. Here we are, we’ve moved to Atlanta. Here we are in the State of Georgia and the state, not only in the US are the numbers worst for African American, they’re the worst in the State of Georgia. We’re like the 48th to 47th to 48th state doing the worst out of all the other states in the US. Again, I have a daughter that’s about to have a baby. It was yeah, but definitely with presenting, I’m so glad I did, so thank you everyone for helping me, to helping me present, but I’m so glad I did because it presented that information. It was my supervisor that was retiring and then the current supervisor coming on. They were both there.

I was able to give that information and a supervisor that had retired, she was explaining to her what we were trying to do moving forward. That did help the current supervisor help me and get me in there, which I did like. Again, like I said, things were happening and we had another meeting where I was presenting to the labor and delivery, the clinicians, and then, the whole pandemic started.

Rebecca Dekker:
It’s put a pause on a lot of education.

Tara Thompson:
Exactly.

Rebecca Dekker:
I remember another reason I was shocked with such a lack of awareness that hospital is like you were saying, Georgia has the highest rate of maternal mortality in the entire United States. It’s the home of the Centers for Disease Control and it’s the home of all these universities.

Tara Thompson:
Exactly.

Rebecca Dekker:
The very staff who are caring for these women don’t even know that they have the highest maternal mortality rate and that racism is contributing to that for Black women.

Tara Thompson:
About maybe seven years ago, maybe five to seven years ago, at the hospital, there were a couple of midwives that were, again, losing clients, losing patients and they were like, “What’s going on? Why are we losing patience?” and it was because there were two hospitals that were doing water births, and then, it was the talk of the birth center coming. That’s when people started getting educated and learning more about what’s happening.

Rebecca Dekker:
Because there’s more options, and there’s competition, and so then, people are like, “Oh, wait. We better educate ourselves on these options.”

Tara Thompson:
So they weren’t losing patients. That’s when they bought together this whole, it was called Strategies for Optimizing Birth. It was the two midwives from different practices, and then, it was a head clinician and myself as a doula. Let’s see midwives, clinician and then myself as a doula. What they did was they had each one of us present, and then, they broke off into smaller groups where we went into the actual labor and delivery rooms and then we taught hands on. That was like, I want to say over time like … We did it for a couple of years. I want to say we’ve reached out to maybe about 250 nurses at least.

During that time, things were getting a little better. That’s where I really heard like the nurses themselves. One was a new nurse and she said, “Oh, my goodness. I never even learned this stuff in school.” Then, there was an older nurse and said, “Of course, I’m not doing this.” You can hear the differences. Some not even educated or even know what it’s about, what you’re supposed to do and then some that are just stuck in their ways and they’re not changing no matter what, but they’re setting this position. They are comfortable.

Rebecca Dekker:
“I’ve been doing this for 30 years and I’m not changing.”

Tara Thompson:
Exactly, exactly. I think it starts with the schools. The schools need to be … As far as different fields that you want to be and as far as the nursing, it needs to help you and educate you a little more. That’s why when you started talking about teaching in the schools, I was like, “Oh, my gosh. I need to do that. That’s where I need to be too because that’s where it starts.” Like I said, I was very fortunate with my supervisor. She let me do a lot. I like shadowed nurses at one point before I started teaching. She let me shadow the nurses. One thing I was like, “I do not want to be a nurse,” because they just wasn’t there. They weren’t able to touch them. They weren’t able to do anything. It was charting, charting, charting, charting. “Okay, 50 minutes, I’ll be back,” and they have patient here, patient there and we got to leave, and then, we have to go there. Then, we have to sit and wait and chart. Then, we have to go back to this one. We really didn’t spend time with the patient.

Rebecca Dekker:
That’s probably what impressed on you the importance of doula support and partner support.

Tara Thompson:
Yes, exactly. Especially like I said, when we did those optimizing strategy classes, that was one of the things too. She was like, “Oh, my gosh. This is like the first time I’m actually touching a patient.”

Rebecca Dekker:
It must be hard for you, especially as a massage therapist where you’ve seen the power of therapeutic touch and then to see how it’s just not part of the care that’s routinely delivered?

Tara Thompson:
Yes. Then, my own experience. Like I said, I was up and able to move around. I didn’t have a massager or anything like that, but just being up and being able to move around and different things like that, that can help you. Here you are, stuck in a bed, you’re confined to a bed, whereas this optimizing strategies, one of the things was getting out of the bed. That’s why I was really excited about because it was opening their eyes to … Because they were trying to lower the C-section rates, of course, but it was really trying to open their eyes to, “Don’t just have them come in and strap them to a monitor and put them in a bed for hours. Have them get up. Move around.”

We were showing different things to do, where they can still be on a monitor if they have to be, but let them be on the ball. You can’t just turn the world in one day. You have to take baby steps. It wasn’t like we were just going to come in there and I’m like, “Okay, everybody’s going to be on the wireless monitors and everybody …” No, definitely had to be baby steps but at least it was a start. “Put them on the ball with the monitors on. Let them walk around and then come back to the monitors.”

Rebecca Dekker:
It sounds like just like with parents, you’re finding that education is empowering for nurses too, especially newer nurses.

Tara Thompson:
Yes, absolutely. Because like I said, some of them, when they’re older and they’re set in their ways, they’re just set in their ways. You’re really not going to … No matter what you do, it’s not going to be. They’re really not going to change.

Rebecca Dekker:
Do you feel in the past few years birth options have expanded for families in the Atlanta area?

Tara Thompson:
Yeah, absolutely because the birth center came and I was a volunteer with that with helping with the birth center also. When they had their gala and different things, I was down there. Let me see what year was that. Sorry, I cannot remember what year. Everything is like … I don’t remember the years when the birth center came, but that came a few years ago. Absolutely, things have definitely changed again with the water birth, those options and even as far as insurance allowing different things. Even now, some people, if they decide to have a home birth, they can still have maybe like their prenatals covered by the insurance at a doctor’s office and then the actual birth by the home birth midwife.

Rebecca Dekker:
Can CPMs practice legally in Georgia?

Tara Thompson:
No.

Rebecca Dekker:
That’s a fight, still a problem there.

Tara Thompson:
Yeah, that’s a fight. I have a friend, she has a nonprofit and she’s down at legislation. She was down there. Even before the pandemic, she was down there every day, just fighting.

Rebecca Dekker:
At the Capitol?

Tara Thompson:
Yes, trying to fight for it again. Once the pandemic hit, then it just changed a lot. Hopefully, we don’t go backwards after all of this. It’s just-

Rebecca Dekker:
That’s going to be hard for people who especially want to avoid the hospitals during the pandemic and there’s very limited options for home birth midwives because certified professional midwives can’t practice with a license.

Tara Thompson:
Yeah. That’s one of the reasons why I decided as far as doula work like going into their home. As long as they’re safe, I’m going to wear masks.

Rebecca Dekker:
You’re teaching EBB childbirth classes totally online now and you’re also providing doula services. You mentioned you’re doing a lot of work in people’s homes. Can you talk a little bit about that?

Tara Thompson:
Instead of, “Call us when you’re in active labor, we’ll meet you at the hospital or even at the home, wherever, we decided to meet you,” now I’m not going to the hospitals at all. I am strictly just going to their homes. Of course, in the beginning, as early on, you want to try to do as much as you can by yourself. You want that bonding between your support person, so with the EBB that helps with that information and education and then when it’s time say like, “Okay, it’s getting tough where dad doesn’t remember or doesn’t know what to do, then I go to the home.” I work with them at the home for as long as we can until we notice different signs and different things like, “Okay, maybe we should go to the hospital.” Then for one, they’re staying home for as long as possible, so they’re not sitting around the hospital all day long which is good and it helps them.

Again, if they decide they want to have an epidural and that’s fine too, but again, getting them to the point where, “Okay, again now you’re not just sitting around the hospital. Now you’re going to go in and get your epidural because it’s been long enough or you just can’t bear it anymore or whatever the case may be.” Again, being in hospitals like having that information and education in their background.

Rebecca Dekker:
How dilated are your clients usually when they get to the hospital and get checked?

Tara Thompson:
Well, it’s only been a couple since I’ve started this. My last one, which was an April … April or May? May. My last one she was actually nine centimeters when she got to the hospital.

Rebecca Dekker:
Wow, way to go, Tara.

Tara Thompson:
I know that was exciting when she told me, it was like, “Yes.” That’s when I really got excited. I was like, “Yes, this is what we need to do.”

Rebecca Dekker:
Tara, thank you so much for sharing your story about being an educator and doula in the Atlanta area. Are there any questions that you have for me?

Tara Thompson:
Yes. Thank you so much for EBB and starting this. It’s like, oh, my goodness. As far as with you starting EBB, was there any obstacles or anything that you faced starting it?

Rebecca Dekker:
Yeah, I would say the main obstacle in starting Evidence Based Birth® in 2012 was just it was the time in my life when at the time I had two kids. I had a three-year-old and a newborn. I was also working full time. Lack of sleep was probably.

Tara Thompson:
Oh, gosh.

Rebecca Dekker:
The thing I’m sure many of our listeners can identify with when you have little kids and babies, sleep deprivation is pretty hard, but I was so obsessed with the research on childbirth that it didn’t matter. I just spent every spare evening and weekend working on articles. Then maybe another barrier was the technical aspects of starting a website, but I just checked out a book from the library. I think it was called like Blogs for Dummies or something like that. I’ve always been a self-learner, so I just read as many books and listened to as many podcasts I could to figure out the tech part of it.

Tara Thompson:
Who was your biggest supporters? Well, besides your friends and family, who were your biggest supporters?

Rebecca Dekker:
In the beginning and even probably still today, doulas, local doulas, because I think you can probably identify with this, the doulas were really hurting like in terms of having to watch their clients go into hospitals and get poor quality care. It’s really frustrating for them. Doulas, yoga instructors, midwives, they were the ones sharing that information and telling all their friends and family about it. It started with my sister’s doula and my prenatal yoga instructor and my midwife. They told all the midwives and doulas that they knew and it just kept growing from there.

Tara Thompson:
That’s nice. That’s good. Where there any big financial obligations or anything starting? I know you said you just started with the blogs and self-learning but was there starting-

Rebecca Dekker:
Yeah, there were startup costs with Evidence Based Birth®, but in terms of starting any kind of business or organization, they were relatively small. I was trying to be really resourceful. I was teaching a nursing school at the time. One of the things I did is I went to my office at work. This was back when physical textbooks were still like a big deal. I know a lot of people moved to online textbooks, but I was always getting free textbooks from the textbook companies that were trying to get me to adopt their textbooks. I took their textbooks, brought them home and I had Dan put them on eBay. At the time, you could get a decent amount of money for textbooks. We sold on all of the free textbooks I got.

Tara Thompson:
Nice.

Rebecca Dekker:
We used that money to pay for like a logo and the startup costs for the website and a few other things.

Tara Thompson:
Wow, [inaudible 00:36:51].

Rebecca Dekker:
I don’t think you can do that anymore. Then shortly after that, eBay stopped letting you sell textbooks on there. I think we used a website called half.com or something and it got more complicated, but it worked. We were able to squeeze some dollars out of the … It’s so funny because I always used to be annoyed by like, “Oh, they’re giving me another textbook. I don’t even want this in my office.”

Tara Thompson:
See, everything happens for a reason that you had all those textbooks. Wow. Was there anything that caught you by surprise like something that maybe said, “Maybe I’m not doing the right thing,” or setbacks, anything like that, anything you didn’t expect?

Rebecca Dekker:
I didn’t expect people to get upset about when I wrote about Group B Strep with antibiotics and when I wrote about vitamin K. I think that’s when I began to realize that there were a lot of people who had a certain ideology or belief that interventions were always bad. It was interesting to be like, “Well, sometimes interventions like aren’t necessarily bad thing. There’s benefits and risks and these are tools that we have.” I think I was surprised though by some of the lash back, especially for vitamin K. I had no idea, but it did teach me a lot in terms of expecting lash back whenever I write about something controversial. So that fed into like, for example, when we released the circumcision article in 2019. We’ve learned a lot from the vitamin K experience. We were able to do a lot more preparation for people being triggered by the topic, which I think was important, just like preparation is half the battle.

Tara Thompson:
If you had to do it all over again, is there anything that you would do differently?

Rebecca Dekker:
I don’t think so. That’s a good question. I feel like, like you said, everything happens for a reason. I felt like that along the way like, “I wish there was some things I’ve learned faster,” but I feel like any mistakes I made were good and that they helped me learn for the future. I tend not to be a super self-critical person, which I think helps when you’re writing or starting a blog or anything like that because when things happen, I can improve on or one of our team members can improve on. I see it more as a learning opportunity rather than like, “This is the end.” That’s how I approach life. I see everything as a learning opportunity and I’m not too hard on myself. I think I would just do it the same way.

I don’t know. Maybe I won’t be able to say that forever. I’ll probably make some mistakes and I’m like, “Man, I wish I hadn’t done that,” but I’m glad that I started Evidence Based Birth®. I never anticipated that I would. It was not something that I planned to do. It reminds me of almost like an unplanned pregnancy that affects the rest of your life because I meant to just start Evidence Based Birth® as a little place where I could write, do literature reviews for my own benefit. Maybe it might help other people, but mostly I was just interested in collecting information and learning about different topics because I was hoping to make that my new field of research. I was like, “Maybe this will be helpful for other people,” but mostly, this will just force me to get into the literature and do these literature reviews. I had no idea it was going to turn into what I did, so yeah.

I call it jokingly like my fourth baby. I have three babies. This is like a fourth. It felt like that a lot in terms of the lack of sleep and all the attention I needed. Instead of having a fourth kid, I just had a blog.

Tara Thompson:
That’s good. That’s awesome. Oh, my goodness. Wow. Well, I’m so glad you did. Thank you so much.

Rebecca Dekker:
We’re super thankful you’re part of our community. We love having you as part of the instructor program and help people check out your classes because you’re going to be teaching for the rest of the pandemic hopefully online. Anybody can hire you. There’s no geographic barrier anymore.

Tara Thompson:
That’s good.

Rebecca Dekker:
All right. Well, thank you everyone for listening to this podcast with Tara. Tara is one of our superstar Instructors, and you can find her EBB Childbirth Classes at https://tarasbirthservices.com. She’s also on Facebook as Taras Birth Services and she’s also on Instagram as Taradthompson. Tara, thank you so much for coming on the podcast!

Tara Thompson:
Thank you for having me.

Rebecca Dekker:
Today’s podcast was brought to you by the Evidence Based Birth® Professional Membership. The free articles and podcasts we provide to the public are supported by our Professional Membership Program at Evidence Based Birth®. Our members are professionals in the childbirth field who are committed to being change agents in their community. Professional members at EBB get access to continuing education courses with up to 23 contact hours, live monthly training sessions, an exclusive library of printer-friendly PDFs to share with your clients and a supportive community for asking questions and sharing challenges, struggles and success stories. We offer monthly and annual plans as well as scholarships for students and for people of color. To learn more, visit ebbirth.com/membership.

Listening to this podcast is an Australian College of Midwives CPD Recognised Activity.

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