Many pregnant women have these questions, but the conversation does not always flow with the OBGYN. Women may end up going along with hospital policy because they just feel expected to. That’s where Rebecca Dekker comes in.
Rebecca is a PhD, RN, APRN, and a board-certified clinical nurse specialist. But this summer she decided to play the role of birth detective. She created the blog “Evidence Based Birth” as a resource for women to become more empowered with knowledge for their birth experience.
After a negative hospital experience with the birth of her first child, Rebecca opted to give birth to her second child at home with a midwife. She started speaking to nursing students and doctors about natural birth, home birth and using hypnosis for pain control during birth.
“I felt like I was able to give these groups an interesting perspective, because I had experienced a high-intervention hospital birth with an obstetrician, and a low-intervention home birth with a midwife,” Rebecca said.
A group of doctors showed interest in scientific articles to support birthing practices, so Rebecca started reviewing and summarizing articles. She had the idea that this same information could be used by female consumers, and the blog was born.
Rebecca tackles topics that are routine hospital policies and procedures for birthing women, and uncovers the scientific evidence behind them. Some hospital policies that women face in labor are not firmly backed by research, and Rebecca lets women know their options.
“At first I wanted to find out the evidence for the things that had been done to me while I was in the hospital giving birth, like not being allowed to eat or drink, receiving IV fluids, and being told I was not allowed to get up out of bed — even to use the restroom,” Rebecca said. “Now I have expanded my topics to include anything that my readers ask me to look at — from water immersion during birth to routine screening for gestational diabetes.”
Although her research was originally intended for medical professionals, Rebecca makes her writing accessible to all women. You don’t need a medical degree to follow the research she publishes.
“I think another advantage I have is that I teach nursing students, so I am used to taking complex medical topics and teaching them to beginners who have little or no experience with healthcare,” she said. “I approach each topic from two perspectives: first, I write an article about a birth topic so that any regular person can read it. Then I edit the article so that it is tailored for medical professionals.”
Bookstores may have shelves overflowing with material on pregnancy and labor. But with science moving at such a rapid pace, those books quickly become outdated. Rebecca’s medical background may be in cardiovascular nursing, but that experience gives her an edge over many baby book authors — she knows how to critically evaluate research studies.
“I actually go to the research study reports and read them from top to bottom, then critique and summarize the study results for my readers,” Rebecca said. “So with my blog, my hope is that you get a really current perspective on what the evidence is for birthing practices from someone who is qualified to evaluate the scientific evidence.”
Rebecca’s articles are informative, but also resources for moms who may be hesitant to approach their doctor about changing the usual hospital plan.
For mothers who are intimidated of starting that conversation with their OB, Rebecca offers “printable practice bulletins.” Moms can print these off and use them to discuss various birth interventions with their care providers.
“For example, say a mom really wants the freedom to eat and drink during labor, but she knows that she will face resistance from her care provider,” she said. “She can print off the practice bulletin and use it to initiate discussion with her doctor, midwife or nurse.”
Despite being a nurse herself and taking the hospital childbirth class, Rebecca felt she was still uneducated about birth with her first child. By learning the evidence behind birth practices, mothers can take control of their birth plans and choose what they think is best — not just what is routine.
“By reading and learning about these topics, women can be empowered to either give informed consent or informed refusal to various procedures,” she said. “It takes on average 20-25 years for scientific evidence to make its way into hospital practice. So women need to empower themselves with evidence and request evidence-based care from their maternity care providers.”
Rebecca L. Dekker, PhD, RN, APRN, is a Lexington mother of two and a nursing professor. She teaches pathophysiology and pharmacology to nursing students, and she conducts research on the link between depression and heart disease. She is a board-certified clinical nurse specialist.
Readers can comment on any of the blog articles at www.evidencebasedbirth.com to reach Rebecca, or email her directly at firstname.lastname@example.org.