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Month March 2014

Spotlight on Rebecca Dekker and Evidence Based Birth™

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Working through the multitude of childbirth care options and decisions during pregnancy and labor can be a daunting task.   Pregnant women and their families can often be overwhelmed when faced with some of the various tests, suggested procedures or interventions that are offered or recommended to them prenatally or while laboring.

Rebecca Dekker, PhD, RN, APRN is one of those women whose first time through the gate left her feeling uneasy, so she started asking questions and seeking answers.  Rebecca felt that some of the restrictions that were in place during the birth of her daughter had not worked in her favor. She began to wonder if they had truly been needed.  Was it really imperative that she not be allowed to eat or drink during labor? Was the risk of cord prolapse great enough to justify the bed rest that kept her from being more upright and active during labor? Being a researcher and a nurse herself, Rebecca set to work investigating the basis for some of the recommendations that she took for granted were based on clear evidence. It turns out that the evidence was scant for some of the policies and procedures she had assumed were necessary and that realization prompted her to do things differently with her second child.

Armed with new information based on the all of the good quality research she could get her hands on, in her second pregnancy, Rebecca placed herself firmly in the driver’s seat and sought out care that was supported by medical evidence. After her son’s birth, she felt the opposite of uneasy, and instead, she felt she could do anything!  She followed her gut and turned her newfound bursts of inspiration into something that would help others gain information to more easily navigate the birth care maze. Rebecca’s story is not uncommon. Many women have their minds and hearts jostled a bit during their first birth experience when things either don’t go as planned, or the overall experience is not what they had envisioned. As a long time postpartum support group facilitator, I have personally seen countless new mothers do a lot of rethinking of the choices they made, especially in regard to interventions or care they felt they had no choice about or did not quite understand the real risks or advantages of.

All of this questioning and examination usually yields good results.  And, fortunately, for all of us out there who care about improving maternity care and providing pregnant women with quality information to help make decisions about their care, Rebecca used her experience, skills and research and took big action. Her website, Evidence Based Birth™ , is a virtual treasure trove of birth related research, distilled down into forms that the non-researcher can easily understand and utilize.

The EBB website offers, a long list of articles in Q & A blog format, printable documents, video-based online classes that include continuing education credits and a newsletter. Subjects are well organized and can be accessed using an alphabetized topic list.

I had the opportunity to speak with Rebecca on the phone and was able to ask her a few questions about her new venture, which has garnered a fair amount of attention in a short amount of time since she launched the site in 2012. Some of the recent or upcoming topics she is working on which include Vitamin K for newborns, moxibustion for turning a breech baby and the oft cited ‘failure to progress’ as a reason for birth interventions.

When asked what she felt was one of the best things a pregnant woman could do with the content available on her website as far as taking action, Rebecca said that using the data and information to choose a care provider that they feel will provide evidence-based care was at the top of the list. I agree wholeheartedly with this because a woman who exercises her power to purposefully choose a care provider that supports the vision she has for her birth is a key element to a positive experience.  In addition to birthing women, Rebecca’s EBB website resources are highly desirable and useful to childbirth educators, doulas and other birth and medical professionals in the work they do with clients prenatally, during birth and postpartum.

With less than stellar maternal and infant mortality rates here in the US, there is much discussion in the birth world about finding ways to improve these results. It is challenging finding a balance between expecting the maternity care system to take responsibility for ensuring, quality, evidence-based care for all while simultaneously urging pregnant women to take responsibility for learning as much as they can in order to make informed decisions about who and how they are cared for when they give birth. Both of these things are important.  I love that Rebecca has made it easier for all of us to access and understand the research that is out there in order to get a clearer picture of the path that seems best for a woman in her own unique situation.  So if you are trying to find your way (or help others) to the birth you desire and feel lost and uncertain about which way to go, bring your questions to Evidence Based Birth™

and you may just find the answers you are looking for.

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Note: My interview with Rebecca was the inspiration for an article I recently wrote for Peggy O’Mara’s website about evidence based medicine as it relates to birth.  Click here to read it.  As the long time editor of Mothering magazine and founder of mothering.com, Peggy has been a tireless advocate for women and families as well as the author of several wonderful books. At her new self-titled website, she continues to curate and create great content about natural family living, social justice and making healthy choices. I highly recommend this site as a place to spend time reading about and digging into issues that are near and dear to all of us who want to live well and support positive change in the world.