February 1, 2023
Dr. Rebecca Dekker:

Hello, everybody. In at the moment’s episode, we’re going to evaluation all of the analysis we revealed at Proof Primarily based Start® in 2022 and stay up for 2023.

Hello, everybody, and welcome to at the moment’s episode of the Proof Primarily based Start® podcast. My identify is Dr. Rebecca Dekker. My pronouns are she/her, and I will likely be your host for at the moment’s episode. At this time we’re going to speak about 2022, a yr in evaluation. We’re going to look ahead to 2023. However earlier than we get began, I need to let you recognize that we’re providing a particular yr finish sale on the Proof Primarily based Start® Professional membership. So in the event you be part of on the annual subscription between now and December 31, you not solely get a improbable low cost off the Professional membership, however you’ll additionally obtain a bodily copy of our latest intervention pocket information. It retails at $50 and it’s at the moment offered out within the store.

That is additionally a improbable means in the event you personal your personal beginning enterprise in america to get a tax deduction earlier than the top of the yr. To be taught extra and be part of at the moment, go to ebbirth.com/membership. And keep in mind, you’ve got till midnight on Saturday, December 31 to benefit from this chance. So in at the moment’s episode, I’m going to concentrate on the analysis that we publish in 2022 and allow you to all know in regards to the totally different assets which can be obtainable to our podcasts listeners. After which on the very finish of this podcast, we’ll transfer on and we’ll provide you with a sneak peek as to what we’re engaged on for 2023. All proper, you able to get began? Let’s go. So right here at Proof Primarily based Start  this yr we labored actually exhausting on updating 4 of our research-based signature articles in 2022, the proof on birthing positions, the proof on consuming and ingesting and labor, the proof on IV fluids and proof on Friedman’s Curve and failure to progress.

We additionally revealed one new handout for you all, the debunking pelvic shapes handout. So let’s begin with the proof on birthing positions first. This text was initially revealed in 2012. That was the landmark yr that I began publishing at Proof Primarily based Start®. And we had up to date it previously, however we up to date it in 2022. So the total size peer reviewed signature article was up to date, in addition to the one web page handout that goes together with that article. We additionally launched a number of podcasts about birthing positions. So in episode 196, we talked about pelvic biomechanics and motion in labor with the particular visitor speaker, Brittany Sharp McCollum. After which in episode 221, we talked in regards to the proof on birthing positions and tried and true midwifery strategies for shielding the perineum. In truth, that was an enormous collection we did within the first half of this yr right here at Proof Primarily based Start®, all about defending the perineum and stopping tears.

So we narrowed in and targeted on birthing positions and the way these defend the perineum throughout the pushing part. After which in episode 241 of the Proof Primarily based Start® podcast, I am going into element about all the newest analysis on birthing positions and precisely which updates we made to the signature article on this subject. In order we’ve mentioned right here earlier than within the Proof Primarily based Start® podcast, giving beginning in upright positions is useful for a number of physiologic causes, and physiologic signifies that it’s useful for sustaining a standard beginning. So upright birthing positions use gravity to assist deliver the infant down and out. There’s much less danger of compressing the aorta, which is the massive blood vessel that brings oxygenated blood to your physique and to your child. However uterus can contract extra strongly and effectively, the fetus may be in a greater place to go by the pelvis and analysis reveals it’s much less painful while you use upright birthing positions, it’s a lot much less painful than mendacity in your again.

We additionally speak about how MRI research have proven that the pelvic outlet turns into wider while you’re utilizing squatting or kneeling as in comparison with mendacity in your again. And researchers have additionally discovered that upright birthing positions elevated satisfaction and result in extra constructive birthing experiences. Nonetheless, regardless of all these advantages, most individuals who give beginning in lots of hospitals world wide don’t use upright positions and as a substitute they’re coached to push on their backs, 68% in america, or in a semi sitting mendacity place the place the pinnacle of the mattress is raised up, you’re form of nonetheless in mattress, leaning again, that’s 23% of individuals giving beginning in america. And solely a small variety of individuals birthing in US hospitals use different positions like sideline, which though it’s not upright, it’s sacrum versatile.

So it permits the pelvis to develop for the beginning of the infant. That’s used to solely 3% of births in america. And solely 4% of individuals giving beginning in hospitals in america push and ship whereas squatting or utilizing a beginning stool. And just one% push and ship in a arms and knees place. That is in distinction to analysis on dwelling beginning and freestanding beginning facilities the place most individuals have given the selection will push and provides beginning in a extra upright place the place the pelvis may be versatile. Analysis is persistently proven that while you take the load off the sacrum and the coccyx that enables the pelvis to develop, makes spontaneous beginning extra doubtless, that means it makes beginning with out using surgical procedure, forceps or vacuum extra doubtless. And we added a pc modeling analysis research to the 2022 replace that reveals that when the coccyx is allowed to maneuver freely, it will possibly transfer virtually 16 levels.

And when non versatile sacrum positions are used, that means you’re semi-sitting in mattress or mendacity in mattress within the lithotomy place, the coccyx can solely transfer about 4 levels. If you wish to be taught extra in regards to the up to date analysis on birthing positions, I strongly suggest that you simply return and take heed to a abstract of what’s new in Proof Primarily based Start® podcast 241, the up to date proof on birthing positions. In that we give definitions, we clarify what the coccyx is, we speak about why individuals give births on their backs. We’ve got a fairly robust part all about why persons are pressured into again line or semi sitting positions. We added analysis from nations all around the world. I’ve a brand new part that features myths about defending the perineum and a brand new part in regards to the symbolic significance of the hospital mattress. There’s a model new systematic evaluation that makes up the proof part on giving beginning and upright positions with out epidurals.

We wrote the part on birthing positions with epidurals. We added information about how the lithotomy place, which is mendacity in your again together with your ft in stirrups, the way it’s really actually dangerous, particularly in case you have an epidural. And we gave instance language of how some docs, nurses, and even midwives, would possibly use stress or coercion to get somebody to lie in a again line place for the supply. We wrote new motion statements for nurses, doulas, childbirth educators and fogeys, added tons of assets and hyperlinks and up to date the one web page handout. And you will get all of this data at free by going to ebbirth.com/birthingpositions.

Subsequent up, let’s discuss in regards to the up to date proof on consuming and ingesting in labor. The EBB signature article on consuming and ingesting throughout labor was initially revealed in 2013. It was up to date in 2017 after which we up to date all of it once more in 2022.

I really like writing and educating about this subject as a result of this is likely one of the issues that led me to start out Proof Primarily based Start®. One of many issues that bothered me most about my first time giving beginning was that I used to be not allowed to eat or drink something for twenty-four hours throughout the beginning of my first child. And that led me down the trail of questioning all the pieces that occurred to me. So we coated the general proof on consuming and ingesting throughout labor in episode 198 of the podcast. After which in episode 233, we go into element in regards to the updates on the analysis on consuming throughout labor. The newest knowledge that we have now reveals that, people who find themselves giving beginning in US hospitals, 60% don’t drink any oral fluids and 80% don’t eat something throughout labor. Nonetheless, just like birthing positions, when persons are free to eat and drink at beginning facilities and at dwelling births, only a few select to not.

Solely 5% of individuals giving beginning at dwelling select to not eat throughout labor or possibly don’t have an opportunity, as a result of labor goes so quick. Little or no analysis has been revealed on dietary wants throughout labor, however analysis in sports activities diet has discovered that taking in carbohydrates throughout train improves your efficiency and protects in opposition to fatigue. And through occasions of hunger or carbohydrate restriction, your physique has to show to burning fats for power, which leads to the discharge of ketones. Some individuals might select to eat a keto weight-reduction plan at sure occasions of their life, however we don’t actually have any analysis on whether or not ketosis throughout labor is regular or innocent. Researchers within the discipline of diet and power efficiency and consuming throughout labor say that your calorie wants throughout labor are just like these of marathon runners. Some recommendation on-line for marathon runners is to purpose for about three grams of carbohydrates per kilogram of your physique weight earlier than the race.

What we do know is that analysis reveals that persons are dissatisfied and infrequently anxious and pressured after they’re advised they’re not allowed to eat throughout labor. So in our up to date article on consuming and ingesting, we selected to refocus this text to concentrate on the truth that it’s regular to eat throughout labor. It’s good on your physique to keep up your physique with diet. To this point we don’t have any analysis proof on particular meals or drinks that may be really useful for consumption throughout labor, however doulas on our group right here at Proof Primarily based Start® recommend that you simply eat meals which can be reasonably priced and culturally grounded for you. We additionally generally hear doulas suggest coconut water and honey sticks. Our doulas right here at EBB added these suggestions, roasted okra, tortillas with honey or tahini unfold, tostones, and fried plantain bites and lightweight oil, together with different solutions that you could find in our article.

We additionally determined to make use of this text as an opportunity to name out when docs or nurses understand some meals as being, quote, unquote, “unhealthy” for individuals in labor, saying that they’re robust smelling, spicy, heavy, greasy. All of us who’ve attended births right here at Crew EBB have seen healthcare employees actually on their faces make disgusted facial expressions or make remarks after they see a affected person consuming meals that the healthcare employee disapproves of. We’ve additionally witnessed labor and supply employees make judgmental and classist statements about individuals who prefer to eat quick meals throughout labor. In our up to date article, we urged nurses, docs, and midwives, to handle their very own implicit biases about meals and query their assumptions about what makes one thing wholesome or unhealthy to eat throughout being pregnant and labor. I believe one actually helpful a part of the up to date article on consuming and ingesting is that we summarize and hyperlink to all the totally different skilled tips round consuming and ingesting throughout labor.

So there are organizations that suggest that you simply eat or drink as desired throughout labor, together with the World Well being Group, the American Faculty of Nurse Midwives, the NICE scientific steering in the UK and the Society of Obstetricians and Gynecologists of Canada. There are solely a few organizations that I do know of which have suggestions written in English that suggest that folks keep away from stable meals throughout labor, however be, quote, “free” to drink clear liquids, and that features the American Faculty of Obstetricians and Gynecologists, and the American Society of Anesthesiologists. The American Society of Anesthesiologists, or ASA, says, quote, “There’s inadequate proof to attract conclusions in regards to the relationship between fasting occasions for clear liquids or solids and the chance of aspiration throughout supply.” So what are they speaking about with aspiration? Properly, the explanation many obstetricians and anesthesiologists suggest that you simply be nothing by mouth throughout labor. These insurance policies happened within the early to mid 1900s when anesthesiology strategies had been crude and unsafe.

There’s really been a number of main modifications since these insurance policies had been created. Again then virtually all people who was giving beginning in a hospital was knocked out with normal anesthesia throughout their beginning, whether or not or not they had been giving beginning vaginally or by C-section, they put a masks with fuel onto their face and put them underneath normal anesthesia. While you go underneath normal anesthesia, you may not defend your personal airway. In order that’s what they had been nervous about, that you simply would possibly vomit unintentionally when you’re asleep and aspirate down the unsuitable tube. Properly, at the moment we have now correct anesthesiology instruments to guard the airway. They do one thing referred to as intubation, and that tube protects your airway together with different instruments and expertise. Additionally, normal anesthesia isn’t utilized in beginning anymore. It’s sometimes solely utilized in emergency cesareans or cesareans the place it’s not secure to make use of an epidural. A Cochrane evaluation of 5 randomized trials didn’t discover any proof of harms when low danger individuals had been consuming or ingesting throughout labor.

A bigger more moderen evaluation discovered that laboring individuals underneath much less restrictive consuming and ingesting insurance policies had barely shorter labors and no different variations in well being outcomes. Different analysis has proven that affected person satisfaction is way increased while you’re, quote, unquote, “allowed” to eat throughout labor. We additionally added information in regards to the security of consuming, whether or not you’ve got an epidural or not, which is commonly used, by the best way, as an excuse to inform individuals they can’t eat. After which it’s additionally value noting that usually they are saying low danger individuals can eat throughout labor, however not excessive danger individuals. And generally individuals who have a physique mass index of 30 to 40, or higher, are talked about within the analysis as being at excessive danger for aspiration. So this time round after we had been updating this text, we had been curious if this was proof basedor as a result of fats phobia. We can’t discover any analysis that plus-size persons are extra prone to expertise aspiration throughout childbirth.

And analysis has proven there’s no substantial distinction within the problem of intubating somebody based mostly on their physique measurement to guard their airway throughout surgical procedure. And we discuss extra about that within the article. So with regards to the proof on consuming and ingesting, you’d assume within the yr 2022, we wouldn’t have to speak about this anymore, however each time I train a childbirth class or discuss to oldsters, I run into this concern, the place possibly they’re advised, “Yeah, you may eat and drink throughout labor, however you may’t in case you have an epidural, you may’t in the event you’re having an induction, be sure you eat earlier than you come to the hospital since you’re, quote, ‘not allowed when you get right here.’” Finish of quote. And it drives me loopy as a result of the analysis doesn’t help fasting throughout labor. And right here at Proof Primarily based Start®, we’re making an attempt to offer you all of the instruments that you can also assist educate others in regards to the proof on consuming throughout labor and that it’s a human proper to eat and drink fluids throughout labor in the event you want to.

So up subsequent, the proof on IV fluids, which is intently associated to the proof on consuming and ingesting throughout labor. This text was initially revealed in 2012 and the article and it’s accompanying handout had been up to date in August of 2022. I revealed our first podcast on this subject, episode 235, the Proof on IV Fluids, and it’s also possible to look again in time at episode 104 the place we speak about saline locks, which is a associated subject. In episode 208, we speak about advocating on your rights in beginning with an EBB childbirth class graduate, Cheyanne Saenz. And he or she talks about that concern of making an attempt to advocate for not having IV entry throughout beginning as a result of that was her want. In america, most individuals who give beginning in hospitals obtain IV fluids. Within the Listening to Moms III research, they discovered that 62% of individuals acquired a steady strip of IV fluids.

And in a 2020 survey of California hospital births, they discovered that IV use was about 76% of midwife attended births and 87% of obstetrician attended births. The explanation for IV fluids is due to the nothing by mouth insurance policies which can be nonetheless in place in lots of beginning settings. You must keep hydrated, in the event that they’re not going to will let you drink fluids orally, they provide them to you by IV. However simply going again to the consuming and ingesting subject that we had been simply discussing, that nothing by mouth coverage will not be proof based mostly. So the IV fluids we focus on on this article embody regular saline, which is salt water, Ringer’s lactate, which is one other answer with minerals, after which dextrose, which is a sort of sugar that can be combined into IV fluids. So there may be little or no proof evaluating IV fluids alone to oral fluids alone. And that is very telling, as a result of IV fluids have turn out to be so widespread that after they do take a look at IV fluids in randomized trials, it’s often to match one quantity of IV fluids to a different quantity.

There have solely been three trials the place they in contrast IV fluids to no IV fluids and individuals who had been free to drink oral fluids. And in each teams individuals might drink oral fluids, it’s simply that one group bought IV fluids and the opposite didn’t. Two of those research discovered that when you’ve got IV fluids, plus you’re ingesting oral fluids, that results in shorter labors by about half-hour, in comparison with the group that solely bought oral fluids. One other research in contrast three teams, people who drank oral fluids plus IV fluids, those that had oral fluids plus IV fluids that contained dextrous, the kind of sugar, and those that drank oral fluids alone. And so they discovered that the group that had IV fluids with dextrous had shorter labors by practically six hours. Now it’s attainable that shorter labors might additionally happen if laboring individuals had been inspired to drink oral fluids that comprise ample quantities of carbohydrates. However extra analysis on that is wanted and hasn’t been accomplished but.

In 2017, researchers mix the proof from seven trials with about 1200 individuals, and most of the people on this research weren’t allowed to drink oral fluids in any respect. They discovered that while you acquired the next fee of IV fluids, 250 milliliters per hour, which is a bit of over one cup of fluids per hour versus 125 milliliters per hour, which is round a half a cup of fluids per hour, discovered that those that had much less IV fluids had longer labors by about one hour and a 30% increased danger of getting a C-section. These findings recommend that in the event you’re not allowed to drink or not in a position to drink for some purpose, that you simply would possibly profit from the marginally increased fee of IV fluids, about one cup or 250 milliliters per hour. Nonetheless, the truth that they had been proscribing individuals from ingesting fluids was not proof based mostly within the first place.

There additionally may be attainable uncomfortable side effects from receiving an excessive amount of IV fluids. In 2012, researchers discovered that when individuals acquired greater than 2,500 milliliters of IV fluids in labor, their infants had been extra prone to reduce weight after beginning. It is because that fluid was additionally on board the infant’s our bodies. And so, after the infants had been born, they needed to appropriate their fluid standing, urinate off the additional fluid and that makes it appear to be they misplaced weight on the dimensions. This may result in nervousness amongst healthcare employees and fogeys, which may then result in formulation supplementation. So in the event you’re planning to solely breastfeed or chestfeed your child, IV fluids can create a bit of little bit of confusion. Researchers means that in the event you do must obtain a considerable amount of IV fluids, that you possibly can use the infant’s 24 hour weight as their baseline, or use a ten% cutoff to outline weight reduction as a substitute of the traditional 7% cutoff.

So after we’re speaking about IV fluids, I need to remind you that they’re a software which will or might not be wanted, however consuming and ingesting fluids throughout labor is regular or physiological. It’s not proof based mostly and it’s not moral to require somebody to quick throughout labor. And the principle purpose that most individuals are given IV fluids in labor is as a result of they’re not allowed to eat or drink. One other widespread purpose why they’re given IV fluids is in case you have an epidural that drops your blood stress. We discuss extra about these totally different professionals and cons and the best way to weigh the advantages and dangers within the pocket information we launched this yr on interventions. We bought plenty of actually nice feedback on social media for individuals who learn our IV fluids article or listened to the podcast. Lots of people advised us that they cherished studying in regards to the various kinds of IV fluids and why it’s essential to remain hydrated in labor.

And it’s a great reminder that IV fluids may be one good choice for staying hydrated in the event you’re not in a position to take action with oral fluids. Say you’re nauseous, or it’s simply too intense so that you can hold ingesting fluids. One among my favourite components about writing this text is that we determined to simulate an hour of labor. So I put a timer on my cellphone and I pretended like I used to be having a contraction each 5 minutes, which could possibly be like early energetic labor or late within the early part. And so, you begin the timer from one contraction to the subsequent, was 5 minutes, and I attempted taking one gulp or two sips of liquids after every pretend contraction. So throughout this frequency of contractions, one coming each 5 minutes, I used to be in a position to keep a fluid consumption of about one cup or 240 milliliters per hour.

However clearly, I used to be not vomiting. So if I used to be vomiting, I would wish to drink extra. One other means you possibly can be sure that to remain hydrated throughout labor is for a help particular person to be sure you’re ingesting one cup of liquids firstly of the hour, seeing in the event you can end it by the top of the hour. Or you possibly can have a water or fluid container that measures it in milliliters or cups. You too can watch your urine, in the event you’re commonly urinating and you’ve got clear or pale yellow urine that may let you recognize that you simply’re staying hydrated. And we discuss extra about that within the article, which you’ll entry at ebbirth.com/ivfluids. The fourth article that we up to date this yr was the Proof on Friedman’s Curve and Failure to Progress. This text was initially revealed in 2013 and up to date in 2017. And the article bought a serious replace in 2022, in addition to an up to date two web page handout.

We additionally created a brand new handout to go together with it referred to as Debunking Pelvic Shapes. If you wish to do a deep dive into the proof on failure to progress, we did publish a podcast on it, episode 224, with myself, Erin Wilson and Ihotu Ali. You too can discover a video of that podcast with all of us educating on with PowerPoint slides on our YouTube channel. Another associated podcasts embody episode 196 the place we talked with Brittany Sharpe McCollum about pelvic biomechanics and motion and labor. And episode 75, the place my mother comes on the podcast to speak about her beginning expertise with Twilight Sleep, which is what they had been doing to individuals after they created Friedman’s Curve. So failure to progress historically has been recognized when a healthcare supplier thinks that labor will not be progressing as shortly because it ought to. This may be very subjective. Failure to progress is a imprecise analysis that may imply many alternative issues to totally different healthcare suppliers.

Some suppliers have concepts of how lengthy is simply too lengthy. Different suppliers could also be extra affected person, others are impatient. We’ve heard many nurses and doulas who witness many alternative apply kinds from docs and midwives, discuss with failure to progress as generally being a failure to attend. For a few years, what we knew about failure to progress was based mostly on Friedman’s Curve, a historic research from the Fifties that also impacts birthing individuals all world wide at the moment. In 1955, Dr. Friedman of Columbia College in New York Metropolis revealed a research that described the typical period of time it takes to dilate per centimeter based mostly on his commentary of 500 white sufferers at a single hospital in New York Metropolis. The graph that he created, it was hand drawn from these individuals giving beginning for the primary time, and later in an identical research with individuals who had been giving beginning to a subsequent child, went on to turn out to be identified world wide as Friedman’s Curve.

Again then, Twilight Sleep was widespread apply for white birthing sufferers. It was often not provided to Black girls. And so mainly 96% of the individuals within the research had been sedated with medication. 31% had been deeply or excessively sedated with Demerol and scopolamine. The common size of time it took for these sedated sufferers, who had been primarily asleep, to get from zero to 4 centimeters was 8.6 hours. As soon as they reached energetic labor, labor sped up, and at that time, they dilated a mean of three centimeters per hour, which may be very quick, till they reached 9 centimeters. At 9 centimeters, there was a slight slowing down earlier than the sufferers reached 10. And the typical size of time it took to get from 4 to 10 centimeters dilated was about 5 hours. And the typical size of the pushing part, or supply, was one hour. These graphs nonetheless stay on because the partograph, which is used world wide to trace the pace of labor.

Now utilizing at the moment’s requirements for analysis, Dr. Friedman’s research could be thought-about unethical, due to the various invasive pelvic exams carried out on sedated or sleeping sufferers. The sedation might have additionally considerably sped up labor and the widespread use of forceps whereas the infant was nonetheless up within the pelvis shortened the size of the supply. Additionally, not one of the sufferers within the research had an epidural, which is understood to decelerate the method. It’s just about agreed upon by most researchers at the moment that we must always not apply this curve to labor as a result of too many issues have modified since 1955. Epidurals are commonplace, sedation will not be used, Pitocin is used rather more continuously, individuals giving beginning at the moment are older, intend to weigh extra on common, and it’s uncommon to see forceps-assisted births in some nations. Present tips are based mostly largely on a research from 2010 by Zhang et al. The place they checked out greater than 62,000 individuals in labor.

And the numbers from that research have changed the imprecise time period of failure to progress. Within the Zhang et al. Research, energetic labor started at six centimeters, not 4 centimeters like with Dr. Friedman’s research. And it was regular to have lengthy intervals with none progress in early labor. At this time, the timelines are presupposed to be longer and also you’re presupposed to have extra flexibility for components, like whether or not or not you’ve got an epidural. When you go to evidencebasedbirth.com/failuretoprogress, you’ll discover extra information on this subject. And the free two-page handout that goes together with this text has a very nice desk that reveals the typical size of labor for the totally different phases, for individuals who’ve given beginning earlier than and those that haven’t had a child earlier than. Now whereas researching this new replace on failure to progress, we had been studying a number of outdated racist details about pelvic shapes and the perceived impression of pelvic shapes on beginning.

So Ihotu Ali, one among our analysis editors at Proof Primarily based Start®, determined to create a model new handout to handle this instantly. The analysis reveals there are not any particular classes of pelvic shapes. Pelvimetry is the research of pelvis measurement and form, and this apply led to the assumption that sure individuals can’t give beginning vaginally. Digging in a bit of bit deeper, scientific racism is using flawed knowledge to, quote, unquote, “show” that there are distinct races and to justify unequal remedy of others. However this information has already been debunked. In 2015, a research out of Australia debunked the idea that there are totally different pelvic shapes, and present that there’s a nebulous cloud of variation through the use of CAT scan imaging. So in the event you go to ebbirth.com/birthjustice, you could find a hyperlink to obtain that handout, referred to as Debunking Racist Myths about Pelvic Shapes. Whereas we had been publishing all this information for the general public and likewise speaking about on our podcast, we had been that includes month-to-month trainings based mostly on the analysis for our Professional members.

A few of you will have seen our free webinar on Failure to Progress or Failure to Wait. We did a personal exhibiting for our members, the place that they had an opportunity to get all of their questions answered, identical with the proof on Pitocin, however our analysis group additionally offered different matters. And I need to give a shout out to Ihotu Ali for creating two lessons on the proof on anti-racism, half one and half two, that had been taught to our Professional members. And our applications group at Proof basedBirth additionally had the concept to do a viewing of Bringin’ in da Spirit a documentary movie. So we did that as a gaggle collectively. So I’d like to know what’s your favourite podcast episode of 2022. Go forward and tell us on social media or ship us an e-mail at [email protected] I had a very exhausting time deciding what my favourite podcast episodes had been.

I realized lots from so a lot of our company. I’m positive there’s a recency bias the place those that got here out within the second half of the yr are more moderen in my reminiscence and so I’m eager about them extra usually. When it comes to the analysis proof, I cherished our Defending the Perineum collection. It was actually enjoyable to debunk plenty of myths about that. I additionally actually loved speaking in regards to the prime 5 most shocking findings from the abortion analysis information, with doctoral candidate Tyler Jean Dukes. And publishing that mission was an enormous labor. I additionally love the training a few of our company did on points associated to reproductive justice, together with episode 217, Incapacity Justice and Start and Parenting with Stefanie Lyn Kaufman-Mthimkhulu. Episode 234, tackling Fats Phobia and Lactation with Kristin Cavuto. And episode 243, the Significance of Equipment Counting for Combating Disparities and Preventable Stillbirth, Stephaney Moody of Depend the Kicks.

When it comes to our most downloaded episodes of 2022, there’s a number of alternative ways to have a look at the statistics. We did surpass 4 million downloads this yr, which was actually thrilling. It places us within the prime 5% of all podcasts. However to make it honest, as a result of some podcasts have been out longer than others, so you may’t actually go by essentially the most downloaded this yr. We seemed on the most downloaded within the first seven days after publication. The fifth hottest podcast was 235, the Proof on IV Fluids. The fourth hottest podcast was episode 222, Navigating Induction in Being pregnant at 35 Plus with Jennifer Anderson. The third most downloaded podcast was episode 224, Failure to Progress or Failure to Wait with the EBB Analysis Crew. The second hottest podcast was Proof on Birthing Positions and Tried and True Midwifery Strategies for Defending the Perineum. And the primary most downloaded episode within the first week after publication was episode 241, the Up to date Proof on Birthing Positions.

I’ve to offer a shout out to Jen Anderson who joined our program group this fall. She was featured in that episode 222, which was actually widespread. And one other enjoyable milestone. Haley Grachico joined us on the podcast a bit of over a yr in the past in episode 202 about her quick first time beginning expertise, after taking the EBB childbirth class. And I’m proud to allow you to all know that Haley Grachico has been our podcast coordinator since this fall and he or she’s engaged on a very superb mission for you all. At first of 2023, we hope to launch a free obtain that may be a podcast listening information to the Proof Primarily based Start® podcast. Our analysis group was additionally busy with a model new pocket information that we launched this yr. Bodily and digital copies went on sale November of 2022, for our pocket Information to Consolation Measures, labor induction and our model new Pocket Information to interventions.

And so they offered out actually quick and we did a second printing run. This yr, our analysis group was persevering with our analysis on racism and maternal well being. We’ve got a model new signature article, the Proof on Anti-Racism and Healthcare and Start Work coming in 2023, is getting actually near being finalized. You’ll be able to go to ebbirth.com/birthjustice to see present assets and hyperlinks associated to reproductive justice, together with the Analysis Useful resource Information to Abortion. We additionally had been in a position to function a number of superb advocates within the discipline of racism and maternal well being and reproductive justice, together with Kimberly Seal’s hours, the place she talked about combating bias within the beginning room with the Irth app, that was episode 220. Episode 227, Amplifying the Want for Intersectional Start Help for QTBIPOC Birthing Individuals with Xian Brooks of the Dandy Doula. Episode 238 on Black Fatherhood and Combating Anti-Black Racism with Brandon Diggs Williams, Licensed Scientific Social Employee. Episode 228, Uplifting Radicalized Start Work with Anna, The Pocket Doula.

And we additionally seemed on the analysis on doulas and the group based mostly mannequin and reimbursement for doula care with our EBB analysis group in episode 229. So we’ll have all these linked to within the present notes. You too can go to evidencebasedbirth.com/podcast and that provides you with an inventory of all of our totally different episodes, from the very starting of the EBB podcast as much as at the moment. I do know that may be useful as a result of generally the podcasts begin to disappear from a few of the apps, when you attain greater than 100 podcast episode. And once more, Haley’s engaged on that obtain for you all in regards to the EBB podcast listening information, which we’re actually excited to unveil. There will likely be pathways for beginning employees and for anticipating dad and mom in order that they know the place they will begin. As a result of now we have now so many episodes, it may be a bit of bit overwhelming.

So what are our plans for 2023? We’ve got one, probably two new signature articles within the works. The primary model new signature article is the Proof on Anti-Racism in Healthcare and Start Work that’s being led by Ihotu Ali. After which we have now signature article updates which can be going to be popping out in 2023. We’re going to be first tackling the up to date proof on Group B strep and antibiotics for Group B strep. We’re additionally hoping to deal with the up to date proof all about gestational diabetes, each induction for gestational diabetes and diagnosing gestational diabetes. After which one other article that’s slated for an replace is the proof on water beginning, which is a enjoyable subject as effectively. Inside our Professional membership, we’re already planning our trainings for the primary half of the yr. We’re going to be beginning off January by having Dan, Mr. EBB, train about revenue first for beginning employees who’re working their very own small companies.

And Dr. Shannon Voogt goes to be coming in February to speak about motion steps for when there may be an emergency postpartum hemorrhage. And our spring public webinar that will likely be freely obtainable to the general public, we have now a very thrilling subject in thoughts. You all are going to like it, however I’m not going to share it simply but. After which in Could of 2023, we will likely be opening functions for the EBB Teacher program. When it comes to the podcast, we’re taking a break subsequent week after which we’re going to come back proper again with an thrilling visitor on January eleventh. And within the first week of February, we hope to launch the most recent proof on Group B strep. One last reminder, earlier than we go, that we’re providing a particular yr in sale on the annual subscription to the Proof Primarily based Start® Professional Membership.

When you be part of between now and December 31, you not solely get a big low cost on the membership, however you additionally obtain a bodily copy of our latest intervention pocket information that retails at $50 and is offered out within the retailer. And that is for US based mostly prospects solely. It is a improbable means, additionally in the event you personal your personal beginning enterprise to get a tax deduction in earlier than the top of the yr. To be taught extra and be part of earlier than the due date of December 31, go to ebbirth.com/membership. Lastly, I simply needed to want you all a contented New Yr, pleased holidays, right here from the group at Proof Primarily based Start®. We’re so grateful that you simply take heed to our podcasts, that you simply help our work by sharing phrase of mouth or being a part of our applications or simply studying our supplies, we recognize you. As is our custom. On the finish of yearly, we publish a Spotify music playlist of various songs which have impressed us whereas we’re all working for you throughout the previous yr. So you may try the present notes to get the hyperlink to our Proof Primarily based Start® music playlist for the previous yr. Thanks everybody, and we’ll see you in a pair weeks. Bye.