Rebecca just wanted the hospital staff to like her.
Her only birth plan for her first child was “Don’t make a fuss. Be a good girl. Do whatever they say.”
Rebecca, a nurse herself about to finish her PhD in Nursing, knew if you didn’t, the nurses might call you “high maintenance” behind your back.
I just didn't want to be seen as difficult.
After her water broke late one evening she and her husband went to the hospital. Once she was wheeled into a room the nurse said, “Go to the bathroom because this is your last chance to be out of bed; we're not going to let you out of bed after this.”
I remember being a little taken aback by that because I didn't realize I would be confined to bed. For the rest of the night, I labored alone in my room; there was just nobody really there to support me. It was very lonely and uncomfortable.
“Don’t make a fuss. Be a good girl.”
She ended up having a 24-hour labor, which she says “is pretty standard for a first-time mom.”
However, the staff didn’t like how long it was taking, “There was a lot of pressure to have different interventions.
“They were never happy with how quickly or how slow things were going. They kept saying I was taking abnormally long when I really wasn't. It was normal.”
Rebecca had a healthy baby girl.
And then they took her away.
I followed all of their rules and I did everything they told me I should do, but then they took my baby away to the nursery right after she was born for ‘observation’ even though her scores were normal.
I just really didn't understand.
I was stuck there in this bed and I just kept pressing my call button saying, “Can someone bring my baby to me? Can someone bring my baby to me?”
And they never would.
After three hours of pleading, they finally gave Rebecca’s daughter back to her.
At that point, she was really sleepy because we'd missed the first hour or two of life when they're wide awake and ready to bond and breastfeed.
Rebecca couldn’t get her daughter to eat and was distraught. How did this happen? How had she missed the first few hours of her daughter’s life?
“Can someone bring my baby to me?”
But she had a healthy baby. What more could she ask for? She let it go and focused on being a mother.
Except, every time she told her birth story, she would cry and feel an ache she didn’t quite understand.
She loved her daughter and was so happy about the day she came into the world. Why did she feel pain every time she told the story?
It wasn’t until years later, when I met Dr. Cheryl Beck, a world-renowned researcher on birth trauma and postpartum mood disorders, and shared my birth story with her, that I finally received the answer I was searching for.
‘Rebecca,’ she said, her eyes locked with mine. ‘That was birth trauma.’
And Rebecca, a researcher too, couldn’t help but wonder:
What’s the difference between a scary, traumatic birth, and an empowering, satisfying one? Is it luck? Is it the presence or absence of complications? Or is it something else?
I didn’t know the answers to all of these ‘why’ questions. All I knew was that I left birth feeling exhausted and disempowered, and I started parenthood that way as well.
Why did she feel pain every time she told the story?
“That's like the classic American experience.”
It wasn’t until Rebecca attended an in-person breastfeeding class that she felt empowered again. There, she met other mothers who were also struggling.
She wasn’t alone.
The indignities she’d experienced in her first few hours of motherhood started to melt away.
Eventually, motherhood became fun.
So much fun that she and her husband Dan decided to have another child after she graduated with her PhD and got a full-time job as an assistant nursing professor.
Two miscarriages later, she remembers riding to the university on her bike, crying the whole way.
In her grief, the questions she had about her first birth rose up again.
She wondered what the research said.
Because of her work as a professor she had access to a plethora of peer-reviewed research and began to spend all of her off time reading up on every study she could find on birth.
She made a list of everything that happened in her first birth (e.g. no eating, no getting up, having your child taken away) and checked the evidence, one by one.
Even though everyone who heard her story, especially labor and delivery nurses said “That's like the classic American experience,” Rebecca was shocked to find out what the research had to say about it.
“If I can do that, I can do anything!”
Almost none of what she’d experienced in her first birth was evidence-based. The more she learned, the more she understood why she’d had such a terrible experience.
Next time she wanted something different.
And thankfully, there would be a next time.
She got pregnant again and, based on everything she’d been researching, she decided to have a home birth with a midwife this time.
In the other model of care, I felt like I was in an assembly line. You have these 10-minute prenatal visits. You go to the hospital, you do as you're told.
But with the midwife, I had hour-long prenatal visits.
“These are your options. What do you want to do?”
She really spent a lot of time educating me, explaining my options. She really respected my autonomy.
That's a big feature of care for midwives; they really believe you have the right to your body and your baby and they want to support you in what you want.
Whereas at the hospital things were explained to me like, “You do this because we tell you to.”
With my midwife, it was like, “These are your options. What do you want to do?”
Rebecca birthed her second baby in the quiet and privacy of her home, in a warm bath, with the support of her husband and midwife.
While her first pushing experience took three hours plus vacuum assistance, this time Rebecca’s body began to push on its own and within 15 minutes her midwife told her to reach down and grab her baby.
“I can’t do it!” Rebecca said.
Her midwife responded: “Yes, you can. Just reach down and grab your baby.”
I reached down and lifted him up to my chest. “I did it! I did it!” I cried. I was stunned. I thought, “I did that? My body did that?
If I can do that, I can do anything!”
But later, remembering how after her first birth she was told they couldn’t bring her daughter to her because they were giving her a bath, she turned to her midwife and asked, “When do we give him a bath?”
The midwife answered: “Rebecca, honey, he's your baby. You can give him a bath whenever you want.”
It was as if something finally clicked for Rebecca: “You're right. He is my baby.”
I have the power to make all those decisions, whereas my first birth, it was like all of that power was stripped away from me.
It was very dehumanizing and disempowering.
With this birth, I really felt like from the very beginning my bond with my baby was respected.
Although I had set out to have a birth I viewed as evidence-based, I’d ended up with so much more.
I ended up with the realization that I could do anything, that I was powerful as a human being and a mother, and that more people deserved this type of empowering care. I don't care if it happens at home or in a hospital or in a birthing center, but I really felt like that kind of respect for humanity needed to be standard.
“If it helps just a few people, I’ll be happy.”
By the time her second child was born, she’d spent years reading and compiling all the research she could find on birth.
So when she was asked to speak to a group of resident doctors about her birth experiences, she made handouts synthesizing everything she’d learned, one-pagers like “What's the evidence on keeping someone in bed during labor?” and “What's the evidence on eating food during labor?”
The doctors loved them.
“Can we have more handouts?” They asked her. “These are really awesome.”
That day she came home and told her husband:
I have to start a blog.
“I was a little embarrassed and nervous.”
Once she realized even doctors struggled to get this information, she knew parents must too. And it seemed she was good at synthesizing the research. Maybe if she shared it in a blog other people would find it useful.
She bought a domain and got a Blogging for Dummies book from the library.
I thought, “Maybe 10 or 12 people will find these articles. If it helps just a few people, I’ll be happy.”
At first, she didn’t tell anyone what she was doing.
I didn't share it with anybody because I was a little embarrassed and nervous.
But after a while, once she’d written a few articles, she realized this could really be helpful to her friends and family and finally shared it on her Facebook page.
Her friends did find it useful. So useful in fact that they thought their friends would find it useful too.
My midwife shared it, my sister's doula, my prenatal yoga instructor; everybody was like, “Check this out. Check this out.” Within a couple of days, there were hundreds of people sharing it, and every month after that the traffic kept doubling.
In the beginning, it was just all word of mouth. That's when I realized I was onto something.
It turned out a lot of people in the US and around the world had experienced exactly what Rebecca had experienced in the hospital and they too were looking for something different.
There were also a lot of people who worked in hospitals who were really sick of the way things were done and were also looking for research and evidence to back up what they knew was right.
And what people really loved about Rebecca's website was that it wasn’t judgemental. Just like her midwife had done with her, she simply presented the evidence and gave those reading the power to choose what was best for them.
Rebecca didn’t advocate for one “way” over another – nor did she judge anyone for whatever they wanted to do with their birth. The whole point was to empower women with evidence and then let them decide based on their unique situation.
Rebecca says the experience felt democratizing.
As a researcher, we spend all this time doing research studies and writing papers and getting them published in peer review journals – and then maybe 30 people will read what you've written. You're lucky if 100 people download an article you spent years working on.
It was so different with blogging because as soon as I posted an article, thousands and thousands of people were coming to read it.
That's when I realized what researchers are missing.
They're not connecting with the people on the other end.
“I had to give up one.”
Rebecca’s articles were shared like crazy on Facebook.
Until the algorithm changed.
Before they changed the algorithm I was just enjoying unfettered access to my audience. I could post something and everybody who followed me would see it.
As soon as they changed their algorithm, it was just overnight, the number of people who saw my posts dropped off a cliff.
That's when I started an email list.
I created a digital handout about the history of birth in the 1950s, which sounded really bizarre, but apparently, people were really interested in it because I got 1,000 people to join my email list in the first month.
Rebecca also became certified in her state to create continuing education classes online for health care providers needing to keep up their certifications.
To create and film the courses she had to buy some technical equipment. She really hoped by teaching and selling these courses outside her day job she could also help make up for the costs she was incurring to keep the website going (and make up for the cost of the new equipment).
That was her only financial goal related to the blog – to break even.
Within the first hour of sending an email to my list about the courses, I made back my expenses, which I was really excited about.
That's when I realized that I could do more than break even; I could actually make some income.
That was an exciting thought, but at the time, in addition to writing the blog articles, Rebecca was focused on her assistant professor job, her students, her research, and raising her now three children.
She couldn’t think much more about monetizing, but the blog continued to grow in popularity – for years.
The university was also fine with her side-project and research, as long as she did it on her own time (and never said anything negative about the hospital affiliated with the university).
But eventually, Rebecca started to feel a conflict of interest. She wanted to respect her job, but she also felt a responsibility to speak openly about everything she was learning.
She was also on the edge of burnout trying to do everything, suffering from about 15 excruciating migraines every month.
But she didn’t know how to slow down: she was on the tenure-track at her job (if all went well, she’d have a guaranteed job for life), and she had more than a million people visiting her website every year.
I also had 5,000 people at least on my email list and I just really felt this responsibility to them and I knew I couldn't do both.
I had to decide, “Am I going to drop the blog or am I going to quit my job?”
I had to give up one.
“Life is really short.”
She didn’t know what to do. She loved both.
Then, one day, her supervisor called her into her office to talk about a comment Rebecca had made online years ago.
It was a comment she wrote when replying to a blog reader who had asked about a certain certification some hospitals were getting to denote more patient-centered care, and Rebecca told her that the certification isn’t always a guarantee since the hospital in her town had that certification but hadn’t given her the care the certification implied. Her comment was informational, kind, and vague – she didn’t name the hospital, the university, or even the town she lived in.
However, someone had looked up the comment, taken a screenshot, and emailed it to Rebecca’s boss; someone didn’t like what Rebecca was doing and wanted to get her in trouble.
Rebecca’s supervisor reminded her that she couldn’t say anything negative about the hospital affiliated with their university.
At first, I was like, “I'm going to quit.”
My next reaction was, “I could never quit. My whole career has been to get my PhD and be a professor.”
Rebecca couldn’t give up on her dream job – the one she’d spent over a decade working for. So many other researchers and mentors had been part of her journey too, and she didn’t want to let them down. Plus, at that point, her husband Dan had quit his job to care for their three kids full-time. She needed this job.
A few days later, she had two nightmares back to back:
In the first, I saw a nuclear explosion coming toward my house and my family. The world was about to end.
And then I immediately had a second dream where I was in my car driving and a car head-on collided with me. I died. And then I rose up and saw my body in the car.
She’d never had a graphic or a life-ending dream like that before. It shook her.
Life is really short. What would I do if I knew my life was going to be ending soon?
It was so immediately clear to me.
I wanted to be at home with my family. I needed to stop working so much. I wanted to spend as much time as possible with my kids and with Dan.
I also knew that my responsibility was not to this big institution. It was to the families all around the world who are reading my blog and the birth professionals who are depending on me.
That's who I wanted to serve.
“I couldn’t sit around and watch.”
Thinking about leaving her job and changing a life plan she’d already invested a decade of her life toward was still really hard.
Even now, I get a little chest pain thinking about it because I loved my job. It was always my dream to be a professor.
I loved the students. I had an amazing research team that I was a part of.
It was like a second family to me.
Leaving felt like divorcing someone you love.
But before she gave her notice, she decided to test the email waters and see if she could really make a sustainable income.
Inspired by an episode of the Flipped Lifestyle podcast about memberships, she sent an email to her then 5,000 email subscribers letting them know how they could join her new professional membership.
She was terrified after hitting send.
I couldn’t sit around and watch. It was too painful to imagine the crushing failure I’d feel when, hours from now, I would open up my email to find zero sales and a host of angry emails from people, incensed that I had the nerve to charge for my work.
In the birth world, there’s a lot of internalized sexism. Several women I knew who blogged about childbirth for a living had been openly criticized – no, outright shamed – for charging for online services.
The prevailing thought among many in the field was that women like me should be doing this work for free (for surely, there must be a man paying my bills).
Rebecca avoided her inbox for as long as she could. Until “curiosity got the better of me.” By the time she checked, 35 people had already joined.
I couldn’t believe it. And the emails coming into the inbox weren’t negative. Instead, people seemed excited I was creating this opportunity.
One hundred people joined in that first launch, and that’s when she and Dan knew this could work. As the evidence grew, so did her courage.
Rebecca quit her job and went full-time on Evidence Based Birth.
“Rebecca reminded me that this was my birth and my baby.”
Through that membership, online courses, the website, and eventually in-person birth classes and a book, Rebecca helped expectant parents, birth doulas, midwives, and healthcare professionals learn the evidence and find the kind of empowerment she’d experienced in her second birth. Many who worked in hospitals also took her courses.
Labor and delivery nurses were a smaller part of my audience in the beginning, but now they're a huge part because I think the culture of labor and delivery nursing is changing.
After working online for a while, Rebecca missed the classroom. To help with that, she created a childbirth class in her own community of Lexington, Kentucky in 2017 with some expecting parents. That went so well that she then created a course for childbirth educators so they could bring her live classes to people around the world.
And in the fall of 2019 she volunteered at the local high school for pregnant teenagers, meeting with them once a week to teach prenatal classes to still maintain that connection with her own community.
Today, millions of people around the world have been inspired and empowered by Rebecca’s work; many of them wrote in to share their thoughts for this story, like Shannon who said, “Rebecca reminded me that this was my birth and my baby.”
Or Naomi who said, “Without her deep dive into research, birth professionals would not know near as much as we do today to pass on to birthing mothers.”
But what struck me most were all the women who wrote in to say how Rebecca has intentionally worked to create space for birth workers of color.
Like Denise who shared:
I am a Black certified birth doula in New York City and I had participated in other childbirth education trainings that I did not feel were a good fit. Evidence Based Birth validated me as a birth professional and as a Black woman.
It gives me hope to see images and material that sincerely represents my race and ethnicity.
Early on in her research journey, Rebecca learned all about how Black birthing professionals were marginalized and silenced. She spent years educating herself on systemic racism in the world at large and in the birthing professions.
She even created scholarships for birth workers of color to have access to her memberships and is incredibly intentional that the images, dolls, and other props she uses in her classes are representative.
As Dawn wrote, “Rebecca and the people that she employs in her organization promote Black Lives Matter.
“With the unfortunate growing disparities in birth and African American communities, I and my clients feel supported, respected, and recognized by Rebecca and Evidence Based Birth.”
“If I really wanted to make an impact, I really had to just tell my story.”
Rebecca says for her the biggest transformation she’s experienced in this journey was writing her first book.
I never thought in a million years I would author a book.
Before the book, no one knew her birth stories.
But while creating her live childbirth classes, her virtual assistant Katie said a book would help get the word out about the classes. Rebecca thought it sounded like a good idea.
When she gave the first draft to a trusted friend, the friend said the best parts of the book were when she shared her personal stories, and that she should tell more of her personal story and weave the research throughout, instead of making it too much about the research.
That was a big transformation because I'm a very introverted person, and so I would talk about the research evidence, but I kept it strictly focused on evidence like, “We're not going to talk about my personal experiences.”
Nobody knew that I'd had a baby at home with a midwife, nobody, except my family and a few people.
I didn't talk publicly about my personal life.
In the book, though, I began to realize that people learn through storytelling.
If I really wanted to make an impact, I really had to just tell my story.
Sidenote: I bought her book a few days before writing this story and read the whole thing within 24 hours. Halfway through, I was texting it to all my friends.
For me, her book and story (and research) elucidated how easily women are silenced and disregarded – and how often those ways are hidden in plain sight, accepted as “institutional” or “traditional” – so much so that even an incredible woman with a PhD still needed someone to tell her, “Honey, it’s your baby.”
Before I go, Rebecca shows me around her office, and that’s when I learn that where she’s been sitting this whole time for our interview is actually where she gave birth to her second child – her son Henry – in the inflatable tub in his nursery.
Her office used to be his nursery.
Rebecca then shows me all the props she uses in her childbirth classes as if it’s Christmas morning, like the special birthing doll she has complete with a placenta, umbilical cord, and a baby that can also come out of the doll via C-section.
There’s also a plush womb and placenta: “This is baby's first roommate,” she says delightedly. “When we have an in-person class, we always throw this around the room. When you want to talk you’ve got to toss the placenta to someone.”
In her classes, she also shares her birth stories, including her first.
She doesn’t cry anymore, but others often do.
They identify with my story.
But why are they crying, even if it’s been years – sometimes decades – after giving birth?
Because what happens in birth stays with you the rest of your life.