Methods

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.

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.

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