Student Nurse Midwife here and I heard of EVB in my courses and I absolutely loveeee your videos and content! Thank you for taking time to present this evidence to us in such a succinct manner. I learn soooo much.
Would love to see studies start to take into consideration the mother's satisfaction with either technique after the birth. When a provider is touching your perineum without permission or despite your objections, it can be traumatic. That is a huge missing piece of the puzzle if mom is being traumatized during birth. How might that affect her physically?
Love this series! Even though it's not necessarily evidence-based, it's also important to consider if mom is comfortable with a hands-on approach. I'm sure her comfort can play a role in relaxation and tension in the pelvic floor, therefore affecting tearing, too!
Reviewing any of Rebecca Dekker’s work and using the phrase, “not-necessarily evidence-based” is pretty much an oxymoron. This highly-trained nurse has her PhD and is essentially evidence-based by nature. She sites much research in this episode. What I’m hearing you say is that the evidence sited here is not looking at whether or not mom is comfortable with hands-on, hands-off and application of warm perineal compresses. The studies tell of lower rates in the following with warm compress: 8.7>4.2% tearing and 9vs22.4% urinary incontinence, as well as less pain during birth & postpartum. Listening to this twice has me deciding that considering morbidity matters as pain and incontinence suggests that the mom’s feelings were definitely taken into consideration.
@@jeannettenapoleon2753 thank you for your input, but you misunderstood my statement. I meant that mom's MENTAL comfort during the hands-on process affects the outcome too, but including mom's comfort as a factor is not necessarily evidence based because it hasn't been included as a factor in the studies :)
@@TheNaturalBirthShow I totally agree and commented something similar. I am someone who was touched despite asking not to be touched, and I wonder how that affected the physical/medical outcome. Study designers need to start thinking about this, but sadly in an obstetric context many institutions and providers still think of birthing women as objects or specimens.
@@MrsMacWifey I'm sorry that happened! Hopefully obstetric practices will continue to change for the better they will all start respecting our autonomous rights soon! And hopefully they will all also have this awesome knowledge from Rebecca, too!
Thank you so much for this. Really helping me to have more knowledge or at least to feel like I have a little control. Im in the south of England and I know that there is a lot more of a hands on approach recently, I think due to the training. I am due March 1st. Just wish they can stay in long enough for your next podcast of perineal massage. Well I have been doing it anyway so I guess I can be my own test case.
I think, to differentiate different techniques by simply "Hands off" or "Hands off" is way too broad, which is why their isn't a definite answer here. "Hands on" can mean many different things. I love that the more experienced midwives have fewer tears. That says something. I assume that each midwife's technique is different. I am 1,705 births experienced and I can say that I have way fewer tears now than I used to when I was a new midwife. Preventing tears is a refined skill. There are too many variables to judge only between "hands on" and "hands off," and no one technique works in every case. There is a time to keep your hands off and a time to get in there and help. Knowing the difference is the key. Thank you for lots of good information.
I love that you put this information out there for all of us, and I always go to your RUclips-channel or podcast for information. What I sincerely don’t understand though is why episiotomy is described in a something that just happens, as if it wasn’t a doctor actively choosing to cut in a woman’s vagina? In your other video it seems like episiotomy’s have no benefits?
@@pointsofinterest4300 thanks! I listened to that episode as well. Does that mean these studies were mostly conducted a long time ago and/or in countries outside the US?
Student Nurse Midwife here and I heard of EVB in my courses and I absolutely loveeee your videos and content! Thank you for taking time to present this evidence to us in such a succinct manner. I learn soooo much.
Would love to see studies start to take into consideration the mother's satisfaction with either technique after the birth. When a provider is touching your perineum without permission or despite your objections, it can be traumatic. That is a huge missing piece of the puzzle if mom is being traumatized during birth. How might that affect her physically?
Love this series! Even though it's not necessarily evidence-based, it's also important to consider if mom is comfortable with a hands-on approach. I'm sure her comfort can play a role in relaxation and tension in the pelvic floor, therefore affecting tearing, too!
Reviewing any of Rebecca Dekker’s work and using the phrase, “not-necessarily evidence-based” is pretty much an oxymoron. This highly-trained nurse has her PhD and is essentially evidence-based by nature. She sites much research in this episode. What I’m hearing you say is that the evidence sited here is not looking at whether or not mom is comfortable with hands-on, hands-off and application of warm perineal compresses. The studies tell of lower rates in the following with warm compress: 8.7>4.2% tearing and 9vs22.4% urinary incontinence, as well as less pain during birth & postpartum.
Listening to this twice has me deciding that considering morbidity matters as pain and incontinence suggests that the mom’s feelings were definitely taken into consideration.
@@jeannettenapoleon2753 thank you for your input, but you misunderstood my statement. I meant that mom's MENTAL comfort during the hands-on process affects the outcome too, but including mom's comfort as a factor is not necessarily evidence based because it hasn't been included as a factor in the studies :)
@@TheNaturalBirthShow I totally agree and commented something similar. I am someone who was touched despite asking not to be touched, and I wonder how that affected the physical/medical outcome. Study designers need to start thinking about this, but sadly in an obstetric context many institutions and providers still think of birthing women as objects or specimens.
@@MrsMacWifey I'm sorry that happened! Hopefully obstetric practices will continue to change for the better they will all start respecting our autonomous rights soon! And hopefully they will all also have this awesome knowledge from Rebecca, too!
Thank you for the information. I’m giving birth soon and this part is one of my fears, aside from pain. 😅
Thank you so much for this. Really helping me to have more knowledge or at least to feel like I have a little control. Im in the south of England and I know that there is a lot more of a hands on approach recently, I think due to the training. I am due March 1st. Just wish they can stay in long enough for your next podcast of perineal massage. Well I have been doing it anyway so I guess I can be my own test case.
I think, to differentiate different techniques by simply "Hands off" or "Hands off" is way too broad, which is why their isn't a definite answer here. "Hands on" can mean many different things. I love that the more experienced midwives have fewer tears. That says something. I assume that each midwife's technique is different. I am 1,705 births experienced and I can say that I have way fewer tears now than I used to when I was a new midwife. Preventing tears is a refined skill. There are too many variables to judge only between "hands on" and "hands off," and no one technique works in every case. There is a time to keep your hands off and a time to get in there and help. Knowing the difference is the key. Thank you for lots of good information.
Would be great to add your techniques here for us all to gain from.
Would the warm washcloth be considered hands on?
I love that you put this information out there for all of us, and I always go to your RUclips-channel or podcast for information.
What I sincerely don’t understand though is why episiotomy is described in a something that just happens, as if it wasn’t a doctor actively choosing to cut in a woman’s vagina? In your other video it seems like episiotomy’s have no benefits?
The video sound is pretty good, beyond my imagination
Why are the episiotomy rates so high all around?
She goes over it in Episode 206!
@@pointsofinterest4300 thanks! I listened to that episode as well. Does that mean these studies were mostly conducted a long time ago and/or in countries outside the US?