EBB 3 - Why Is It So Hard to Get Evidence Based Care?

Evidence Based Birth®

Rebecca Dekker

Kids & Family, Medicine, Parenting, Health & Fitness

4.3 • 1.1K Ratings

🗓️ 17 December 2025

⏱️ 30 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

In this episode, Dr. Rebecca Dekker dives into the evidence-practice gap, the disconnect between what research tells us is best during childbirth and what is actually happening in labor and delivery units around the world. She walks through the latest statistics on Cesarean rates, VBAC access, and the widespread use of non–evidence-based interventions, as well as the persistent underuse of practices proven to improve outcomes, like doulas, midwifery care, and birthing positions that support physiologic labor.

Dr. Dekker also unpacks the systemic forces driving these gaps, including the role of paternalism, hierarchical power structures in healthcare, legal pressures, and the phenomenon of horizontal violence among healthcare workers. She explores how overlapping forms of oppression shape the experiences of both patients and providers.

(02:40) Why research takes so long to become routine care

(03:42) A look at U.S. cesarean rates and what's driving them

(05:38) The rise and fall of VBAC access and why families struggle to get support

(08:01) The "bait and switch" problem in maternity care

(09:34) Interventions that are overused vs. underused during labor

(11:47) How paternalism and medical hierarchy fuel the evidence gap

(16:39) Horizontal violence among nurses, midwives, and doulas

(19:11) Trauma and burnout across the maternity care workforce

(23:04) Real signs of progress and positive change in birth settings

Resources

EBB 1 - Intro to Evidence Based Birth

EBB 2 – What is Evidence Based Care?

Listening to Mothers in California (Sakala et al., 2018)

Basile Ibrahim et al. (2020) study on VBAC access and barriers

Register for the EBB Course: How to Help Families Get Evidence-Based Care: evidencebasedbirthacademy.com/register/course-how-to-help-families-get-evidence-based-care/

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.

Transcript

Click on a timestamp to play from that location

0:00.0	Did you know that all evidence-based birth products and programs that we offer for sale go to support the free research we published on our website and right here on the podcast?
0:09.0	This allows us to avoid having outside advertisers and helps us remain free of conflicts of interest.
0:15.2	So if you support EBB, I wanted to let you know about a fun event happening on December 29 through 31. We will be having
0:22.2	three days of flash sales. So every 24 hours, there will be a different product or program
0:28.0	on sale at an amazing price. Stay tuned for next week when I will release a special bonus podcast
0:34.5	episode to announce those deals available on December 29, December 30, and
0:39.8	December 31. I know that a lot of you will want to mark your calendars for the exact day so you
0:45.3	can snag a specific item or program that's on sale for 24 hours only. So we'll announce
0:51.8	more details next week. And now let's turn to today's episode. In this
0:56.6	podcast, we're going to talk about the evidence practice gap and why it's so hard to get
1:01.7	evidence-based care. Welcome to the evidence-based birth podcast. My name is Rebecca Decker,
1:10.7	and I'm a nurse with my PhD and the founder of evidence-based birth.
1:15.1	Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world.
1:23.1	As a reminder, this information is not medical advice.
1:26.6	See eBbirth.com slash disclaimer for more details.
1:32.1	So in the very first episode of the evidence-based birth podcast, I talked about my personal journey
1:37.2	and why I started evidence-based birth. Then in episode number two, we talked about the definition
1:43.1	of evidence-based care and how it's like a three-legged stool, including, number one, research-based information to help you make decisions.
1:52.5	Number two, having an experienced health care provider who can help you apply that evidence-based information.
1:59.0	And number three, when the health care team actively
2:01.9	asks about and honors the patient's values, goals, and preferences. Now, today we're going to
2:08.7	talk about the evidence practice gap and why it can be so difficult to get evidence-based
	...

Please login to see the full transcript.

Previous episode | Next episode

Disclaimer: The podcast and artwork embedded on this page are from Rebecca Dekker, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of Rebecca Dekker and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.