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Evidence Based Birth®

Rebecca Dekker, PhD, RN
Evidence Based Birth®
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  • EBB 373 - How to Confront Tokophobia and Clear Fears about Childbirth with Alexia Leachman, Author and Podcast Host of "Fear Free Childbirth"
    For some, the thought of pregnancy and birth fills them with a visceral panic they can’t explain. In this episode, Dr. Rebecca Dekker's talking tokophobia—the fear of pregnancy and birth—with Alexia Leachman, founder of Fearless Birthing and host of the Fear Free Childbirth Podcast. Alexia shares her personal journey of discovering and healing her own tokophobia, how she developed her unique “Head Trash Clearance” method, and why tokophobia is often misunderstood as simple anxiety. She explains the root causes of this condition, including reproductive trauma and lack of control, and offers insight on how both expectant parents and healthcare providers can better recognize and respond to it.   Content Note: This episode includes discussion of miscarriage, pregnancy termination, and birth trauma. Please take care of yourself while listening.   (01:39) Alexia's experience with tokophobia (04:05) Developing her own method to overcome fears and preparing for birth (07:51) Discovering the root cause: birth trauma and early experiences (10:28) How media, social media, and negative birth stories fuel fear in younger people (13:40) Why the term tokophobia may be misleading (19:05) The paradox of control in pregnancy and birth (24:55) Common signs and symptoms of tokophobia (29:31) Can partners experience tokophobia? (30:50) The role of healthcare providers: language, attitudes, and trauma-informed care (34:16) Steps for healing: support groups, timing, and making the decision to face fears (41:07) Alexia’s five-step process for clearing fears   Resources Learn more about Fearless Birthing: fearless-birthing.com Listen to Alexia's podcast, Fear Free Childbirth: fearfreechildbirth.com/podcast   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.
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  • EBB 372 - Comfort Measures and a 41-Week Induction with Hopey Fink and Ben Levin, EBB Childbirth Class Graduates
    At 41 weeks, Hopey Fink and Ben Levin's birth plans shifted after elevated blood pressure readings led to an induction conversation. But, with the support of their doula, care team, and each other, the Evidence Based Birth Childbirth Class graduates navigated every twist with confidence. In this episode, Hopey and Ben reflect on preparing for a low-intervention birth, the role of comfort measures, how advocacy shaped their decisions in the hospital, and what it meant to welcome their daughter with joy and strength. They also share advice for expectant families on building flexibility into birth plans, communicating with your partner, and finding empowerment in telling your birth story.   (03:07) Planning a Low-Intervention Birth in the Hospital (06:38) Lessons from the Evidence Based Birth Childbirth Class (09:03) Navigating the Emotional Wait at 41 Weeks (12:52) Elevated Blood Pressure and the Induction Conversation (18:00) Advocating Around Pitocin and Weighing Risks (23:31) A Long Night with the Foley Balloon (30:16) When Progress Stalled and the Epidural Became a Tool (34:30) Rest, Progress, and a Smooth Pushing Stage (41:17) Advice for Expecting Parents: Flexibility, Partnership, and Storytelling   Resources Get the digital guide to comfort measures: ebbirth.com/pocket-guides   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.
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  • REPLAY: EBB 283 - How Colonialism, Environmental Instability, & Politics Impact Birth in Puerto Rico with EBB Instructors, Tania Silva Meléndez and Tamara Trinidad González, CPM
    In today’s episode, I’m revisiting a deeply important conversation with Tania Silva Meléndez and Tamara Trinidad González, two inspiring birth workers and Evidence Based Birth® Instructors based in Puerto Rico. Tania and Tamara share their personal journeys into birth work and what led them to become changemakers in Puerto Rico’s birth community. They speak candidly about the immense challenges families face, from one of the world’s highest cesarean rates to the ongoing impacts of colonialism and systemic barriers within maternal health care. You’ll hear what it’s like to provide midwifery services in an environment where midwives aren’t officially recognized, and the impact this has on those seeking safe, respectful, and dignified care.   We also dive into the powerful grassroots and community-led efforts Tania and Tamara are leading, including legislative advocacy, innovative education, and direct, compassionate support for families striving to improve birth outcomes and claim reproductive rights on the island. Together, we explore both the heartbreak and the hope shaping Puerto Rico’s current birth landscape, and highlight meaningful ways listeners can join in solidarity with these efforts.   Content note: obstetric violence, colonialism, infant death, abortion, poor outcomes, maternal health deserts, gender based violence (03:03) Midwifery Leadership and Collaboration (07:27) Journey to Home Birth Choices (12:32) Puerto Rico Birth Control Campaign Impact (13:57) Obstetric Violence and Doula Integration (17:36) Midwife-Doctor Collaborative Care Solutions (20:04) Hospital System Communication Challenges (23:48) Puerto Rico: A Modern Colony (27:46) Puerto Rico Investment Gentrification Issue (33:30) Community-Led Family Support Initiative (34:50) Youth Engagement Through Visual Education (38:46) Puerto Rico Midwives Day Law (44:14) Birth Summit Collaboration in Puerto Rico (46:05) Midwife-EMT Collaboration Curriculum (51:19) Puerto Rico Birth Rate & Hospital Crisis (53:50) Supporting Midwifery and Access in Puerto Rico   Resources If you are interested in joining with Tania and Tamara and volunteering your time or skills to help them reform the maternal health system in Puerto Rico, they are currently looking for volunteers with experience in law, public relations, funding, data collection, research, and writing. OR if you have resources, or access to connections that could help fund their work, please email [email protected]. Learn more about Caderamen, a nonprofit organization that has a service program that is called SePARE, which offers education and doula services, midwifery services and naturopathic medicine services, social workers, mental health by clicking here. Learn more about the Asociación de Parteras of Puerto Rico here. Learn more about Alimentación Segura Infantil, a community-based organization born after the impacts of Hurricanes Irma and Maria in 2017 to support breastfeeding and chestfeeding families in their lactation journeys by clicking here.  Learn more about Observatorio de Violencia Obstétrica in Puerto Rico here. Learn more about Las Mingas de Aborto, an abortion doula collective that offers free support in Puerto Rico here. Check out the work by Puerto Rican journalist Biana Graulau here. Read more about the history of Puerto Rico:  How to Hide an Empire by Daniel Immerwahr  Puerto Rico: What Everyone Needs to Know by Jorge Duany For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.
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  • EBB 371 - Reclaiming Black Midwifery in the South with Dr. Nikia Grayson, Chief Clinical Officer of CHOICES in Memphis
    Dr. Nikia Grayson, nurse midwife, family nurse practitioner, and anthropologist, joins us to share how she's helping reclaim and restore Black midwifery in the South. As Chief Clinical Officer at CHOICES Center for Reproductive Health in Memphis, TN, Dr. Grayson has led groundbreaking efforts to open Memphis’ first and only birth center, launch the nation’s first Black Midwifery Fellowship, and provide full-spectrum, justice-centered reproductive care. In this episode, Dr. Grayson reflects on the challenges of dismantling systemic racism in health care, the impact of the Dobbs decision on abortion access in the South, and the importance of investing in doulas, midwives, and community-based care. Dr. Grayson also offers advice for birth workers on building new systems rooted in justice, joy, and liberation. Content note: Discussion of infant mortality disparities as well as difficulties in accessing abortion care post-Dobbs decision. (02:33) The Vision Behind CHOICES (04:44) Obstetric Racism and Health Care Barriers in Memphis (07:21) Building Memphis’ First Birth Center (10:34) A Calling to Midwifery and Restoring Black Traditions (13:41) Early Work in Home Birth and Community Care (15:19) Growing a Midwifery Team in Memphis (17:57) Launching the Black Midwifery Fellowship (20:11) Pivoting Care After the Dobbs Decision (24:26) Sustaining Joy and Practicing Self-Care in Justice Work (30:51) Partnering with Doulas and Growing Community Support (34:27) Investing in Workforce Development and Training (35:41) Advice for Birth Workers: Build Boldly, Do It Afraid   Resources Learn more about CHOICES: www.yourchoices.org | @yourchoicesclinics Explore the Black Midwifery Fellowship: www.yourchoices.org/fellowship-for-black-midwives   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.
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  • EBB 370 - Updated Evidence on Diagnosing Gestational Diabetes
    Gestational diabetes (GDM) is one of the most common health issues during pregnancy, and diagnosing it is more complicated than you might think. In this episode, Dr. Dekker is joined by EBB Research Team member Dr. Morgan Richardson Cayama to cover the newly updated evidence on how GDM is diagnosed. They walk through the physiology behind GDM, current testing methods, and why there’s still international disagreement about how to screen. Together, they examine the results of large randomized trials comparing the one-step and two-step screening methods, the research on early screening with hemoglobin A1C, and the evidence on alternatives to the Glucola drink, including candy and home blood sugar monitoring. They also review the risks of skipping screening entirely, and how weight bias and other systemic factors can impact diagnosis and care.   (02:28) What is Gestational Diabetes and Why Is It So Common? (06:30) Risk Factors, Size Bias, and the Role of Race and Ethnicity (10:40) Why We Screen and the Origins of the Controversy (13:17) Comparing the One-Step and Two-Step Methods (19:55) What New Research Says About Health Outcomes (23:45) Should We Screen for GDM Earlier in Pregnancy? (28:11) Can Hemoglobin A1C Replace the Glucola Drink? (32:44) Alternatives: Candy, Food, and Home Monitoring (40:04) What International Guidelines Recommend (43:07) Declining GDM Testing: What the Evidence Shows (47:47) Is Sperm Linked to Gestational Diabetes Risk? (51:29) Takeaways and the Future of GDM Diagnosis   Resources Download the free two-page handout in English or Spanish [NEED LINK] Explore Real Food for Gestational Diabetes by Lily Nichols: realfoodforgd.com For a full list of resources, visit ebbirth.com/inducinggdm For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.
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About Evidence Based Birth®

In the Evidence Based Birth® podcast, we cover the research evidence on hot topics about pregnancy and childbirth! Our mission is to help birth workers build the evidence based knowledge, skills, and power they need to protect families' ability to give birth with empowerment. The work we do has a huge impact on parents who are searching for accurate information to empower their prenatal, birth, and postpartum experiences!
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