Advice & resources for an evidence-based birth

When I was pregnant with our daughter, I started researching standard of care practices in prenatal care as well as labor and delivery. My research started with curiosity about ultrasounds, and from there, I really started questioning everything. Into my second pregnancy, I’m still doing research and finding new information all the time. My biggest takeaways from the experience are:

  1. Quite a few care practices, even ones that I assumed were perfectly fine, are considered controversial because of the health outcomes for mom and/or baby. I realized really quickly that my most important job as a pregnant mama was doing my homework so that I could make educated decisions. Knowledge is power.
  2. You have the right to decline care. Regardless of how information is presented to you, you have the final say. Fight for your rights, and enlist your loved ones and/or birth worker to advocate for you.
  3. Once you decide which care practices you are and aren’t comfortable with, find the best providers that align with your vision. Not everyone has a ton of options based on location, insurance and other resources, but try to make the most of what’s available to you. You’ll find so many differences doctor by doctor, practice by practice and state by state. For instance, during my first pregnancy, we lived in California, and I was put under an enormous amount of pressure to do prenatal testing….and they made us jump through hoops to opt out. In Georgia where we live now, prenatal testing is more of an opt-in approach.

In terms of care practices to research, I recommend starting with:

  • Ultrasounds, particularly the 20-week anatomy scan 
  • Glucose test during the third trimester to test for gestational diabetes (There are alternatives to the typical formula; my midwife gave me grape juice.)
  • Daily baby aspirin (81 mg) for birthers over 35 years old
  • RhoGAM shot during pregnancy for people with a negative blood type
  • Methods for inducing labor
  • Medications given during labor such as epidurals and Pitocin
  • Episiotomy
  • Delayed umbilical cord clamping
  • Hepatitis B vaccine for newborns, administered immediately after birth
  • Vitamin K shot for newborns, administered immediately after birth, and the alternative oral Vitamin K treatment
  • Antibiotic eye ointment for newborns, administered immediately after birth

This list is by no means exhaustive, but I hope that it illustrates the point: you have the right to question what goes into your body and the body of your baby, particularly if your gut instinct says “no.” For instance, my OBGYN told me at the end of my first trimester to start taking Baby Aspirin every day because I was considered geriatric at 35 years old. She said that it has been shown to decrease the risk of preeclampsia. Preeclampsia is a very serious condition, but one that I don’t fit the risk profile for. And as someone who rarely takes medicine when I’m not pregnant, the idea of taking medicine every single day for my last two trimesters made me very uneasy.  I followed her advice and began taking it but stopped after a couple of months because I had a nagging feeling in my body that it wasn’t the right thing for me. Listen to that voice and find resources that help you make informed decisions that are right for you.

Doing your homework is critical, regardless of whether or not you follow medical advice. One decision that was especially complicated for me was the  20-week anatomy scan. Ultimately, the uneasiness about exposing the baby to the ultrasound outweighed any benefits of the scan for me. It was a difficult decision. In fact, I scheduled and then canceled multiple appointments. I was torn because at that point in my pregnancy, the birth center where I wanted to deliver couldn’t take me as a patient unless I agreed to the 20-week anatomy scan. (The birth center made it very clear that their requirements were set by the state, and that in most cases, not evidence based). Knowing that one decision would change my entire birth plan made it especially complicated. (You can read my birth story here.) Make sure you know those details in advance so that you can make tradeoffs for yourself. 


My midwife recommended the website Evidence Based Birth, and I found it incredibly balanced and helpful. I’ve also started listening to their podcast.

Natural birth books are another really great resource to find out more information on your care options, the pros and cons of each and alternatives to standard practices. Whether you plan to have a medicated or unmedicated birth, you will learn so much about all aspects of birth, pain management and how to feel empowered throughout your pregnancy. My favorites are listed here. They’re super informative and non-judgmental.

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