Building a Mission-Focused Business from the Ground Up - Episode 21

Rebecca makes research on childbirth publicly accessible. An entrepreneur for 10 years, she’s been making a living off her company for 6 years. She shares how starting a continuing education business allowed her and her husband to achieve total independence from outside employers.

Make sure to check out my episode on the Evidence Based Podcast.

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About Our Guest: Rebecca Dekker, a nurse with her PhD, is the founder and CEO of Evidence Based Birth® and the author of “Babies Are Not Pizzas: They’re Born, Not Delivered!” Previously, Dr. Dekker was an Assistant Professor of Nursing at the University of Kentucky. In 2016, she left academia to focus full time on the mission of Evidence Based Birth.® Dr. Dekker and her truly diverse remote team are directly creating positive change for health care workers and parents -- by boldly making the research evidence on childbirth publicly accessible. And their Evidence Based Birth® podcast just surpassed 4.5 million downloads! Dr. Dekker and Team EBB are committed to creating a world ok in which all families have access to safe, respectful, evidence based, and empowering care during pregnancy, birth, and postpartum.

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TRANSCRIPT:

[00:00:00] Naseema: What's up? What's up? My financially intentional people to say that I am super juiced to have Rebecca Decker on this podcast today would be a drastic understatement because I just love what she is doing in our community. Rebecca is the founder of the Evidence-based Birth. Platform, podcast network, all of those things, teaching people how to find resources and sharing resources about evidence-based birth.

So, hey Rebecca, thanks for joining. Thank you so much for having me. Of course, and I had the honor of being on Rebecca's podcast and sharing my story around some birth experiences that I've had as both a per, well, mostly as a professional, but now as I'm expecting my third girl going through some of those things as well.

And I can honestly say that my first two deliveries were pretty benign, but for some reason, after I have been. And like becoming a more publicly known advocate for, you know black maternal health practices and advocacy. These things are happening to me as well. So we're gonna talk about Rebecca's platform, but we'll also share why her platform is so important.

And kind of affecting the way that we experience birth in this country. So I'm excited, excited, excited to talk to you. So we will start by just like kind of sharing your background of just being a nurse and then how you went from being a nurse to an entrepreneur and why you chose this specific niche to start educating

[00:01:46] Rebecca: on.

Yeah, so I graduated from nursing school in 2002, and after practicing for a couple of years, I went to grad school and I specifically moved to Kentucky to go to the University of Kentucky because I did a lot of research and it was really important for me to go to grad school and not pay for it. So.

An important decision, and I know there was some like privilege involved in, like, I didn't have to face certain barriers when I was applying and interviewing, et cetera. But I did end up with a full ride to graduate school for about six years. And they also paid me a stipend. So I got to do research and teaching while I was getting my master's and my doctorate, and I loved it.

I loved working with nursing students. I loved working with data and numbers and human research, like actually finding out what works and what doesn't work to help people live healthier, happier lives. And when I graduated, I took a job as a nursing professor at the same university, and I loved it there.

Like I loved my colleagues, I loved the students, and there's just something really energizing. Being around like young people all the time. I don't know. It just, it, it was, it was my jam. It was all I wanted to do. And then while I was. Finishing up my doctorate. I did get pregnant with my first baby and I planned a hospital birth at that same academic medical center and I was, I did not have an OB background, so, but I, I did, you know, go through my OB rotation in nursing school and I knew OB professors and that sort of thing.

And my sister was in medical school and she was really worried for me because she knew how bad. It is in the American healthcare system for pregnant women and specifically pregnant women of color, which I was not, but overall, the health outcomes are bad across the board. And I just wanted to be a good patient.

I did not wanna be the, the kind of patient that they gossiped about at the nurse's station, which we all have been there, and those of you who are listening, her nurses. And so I wanted to do, as I was told, What they told me to do didn't really make sense, but I didn't question it at the time. I was told like, you're not allowed to eat once you arrive in labor.

They wouldn't even let me have clear liquids and I was put on total bedrest. I was not allowed to even walk to the bathroom because my water had broken. And they said, well, your water's broken, so if you stand up, the cord will prolapse. And which didn't make any sense because that's only two centimeters dilated in the head.

Was engaged. So there was, there was no point in that. Yeah. Okay. So instead of going to the bathroom, they made me use a bed pan and when I couldn't use a bed pan, cuz it's hard to use a bed pan, they actually catheterized me even though I didn't have an epidural or anything, rather than let me stand up and just like walk to the bathroom.

So that kind of started this whole like, you know, cascade of things happening to me. Lots of pressure to experience different interventions and I really, I avoided a cesarean by like the skin of my teeth. I just barely was able to have a vacuum assisted vaginal delivery, even though my baby was pretty small.

She was only six and a half pounds and I pushed for more than three hours and I was exhausted because this went on. 24 hours. And then as soon as she was born, they whisked her away to the nursery and said, we have to observe her. Even though there was nothing wrong with her, her Apgar scores were normal.

And for three hours I kept pressing my call light like, where's my baby? When can I see my baby? I need to breastfeed for context.

[00:05:24] Naseema: How long ago was this?

[00:05:26] Rebecca: So this, my daughter

[00:05:27] Naseema: just turned 14. Mm-hmm. So it wasn't that long ago. It, and

[00:05:31] Rebecca: it wasn't, and it's interesting because over the last 14 years I've seen like incremental ships, you know, like now maybe they'll let you drink liquids, but they won't let you eat.

You know? So there, there's like, there has been some improvements. And then I think the year after she was born, they switched to being baby friendly or they were applying to become baby friendly. So they stopped separating moms from their babies. If you have a C-section, it's pretty standard. You won't see your baby for a couple of hours.

So there are, you know, yeah, there are still lots, there's still lots of room for improvement, but it really made me start questioning, you know, what happened to me? And so I made a list of everything that happened and then I went and pulled up all the research studies because that's what I was doing for my.

And I read all the studies and I was like, wow. Like all of these things that they said I had to do or I couldn't do are shown my research to be unhelpful. Like the fact that I labored on my back for 24 hours and was never encouraged into any other kind of position. And the fact that, you know, they basically starved me for 24 hours and I wasn't able to keep my energy up.

And the fact that they didn't know the nurses didn't have training in breastfeeding, you know, so there, there's a lot that was happening there. So I made very different decisions the next time around. By then, I was in that professor job I told you about. I was in a STEM professor. I was just awarded a really big grant.

From the nih and I actually got the email that I got the grant while I was in labor, but that, that baby was born with the help of a midwife who was practicing without a license because at that time, in Kentucky, this was 11 years ago and up until 2020 certified professional midwives. Obtain a license.

So it was a little bit of an underground birth, so, but it was completely different because I had these really long prenatal visits where she got to know me and everything about me and my family and my health, and she spent a lot of time counseling me on nutrition. And activity and pregnancy symptoms and like things like with my first pregnancy, whenever I had a sore back or my hips would hurt, my doctor would just be like, oh, well that's pregnancy.

And they're like, nothing you can do about back pain and pregnancy. And my midwife was like, no. Like we're gonna get you to a chiropractor and we're gonna get you in this, and get you in that. Yeah, so completely different experience. And that baby was born without even a single cervical exam like, and he was born in the water and I lifted him up myself and he was this giant baby.

I pushed him out in only 15 minutes. He weighed like nine pounds, two ounces, and he just looked up at me. I was like so in awe that my body did that, but also on reflection, just how I was treated, the whole process like I was a human being and that what I needed mattered. And it wasn't about safety or policy, it was more about like what was best for me and my, my family.

And so I realized, If I could get that, why can't everyone have that experience? Even if you're having a hospital birth or a cesarean link, why can't we have that same attitude? It's just like an attitude shift. And that's when I started evidence-based birth. So I was about five or six weeks postpartum and I just started a blog and started posting articles and it caught on like wildfire and yeah, so that was 11 years.

That I started evidence-based birth

[00:09:13] Naseema: and I love it. I love it because just in you sharing those two different experiences, you see the difference in just changing, like shipping one variable, which was, you know, you getting this midwife involved. Change the whole course of your pregnancy, even your delivery.

But the whole thing about being pregnant is that there's in, just in the healthcare system in general, right, like it's just not like a disease process or a condition or just like in labor and delivery, just having a baby. It's all of those little things that lead up to the event are the little variable.

That compound. Mm-hmm. Now, Rebecca, I would say you're a little more privileged than most people. Mm-hmm. Because you're educated, you're a nurse. You are a white woman in Kentucky, but still, still you experienced things that could have been way better in your pregnancy, had the healthcare system. Be built to sup, actually support your birth process.

And I found, I find it astounding. Like I, I cannot, I, I did not even know that you couldn't be a licensed midwife in Kentucky until 2020. Can you speak to like the history around that, and I'm sure it ties into like the medicalization of the birthing process and all of these things. So can, can you speak to like why and how that happened?

[00:10:45] Rebecca: Yeah. So there is a lot of history behind it, and it actually goes back to racism. Um, Because in the south for many, many years, hundreds of years, black midwives and indigenous midwives and some immigrant midwives were the ones delivering all of the babies, even the white babies. They're called grand midwives.

And then around the early 19 hundreds, the. The specialty of obstetrics was kind of getting its footing and they realized that birth would be a big business and that they could make a lot of money off of delivering babies because then they would become the doc. You know, they could kind of get the whole family life cycle.

And they, but they realized midwives were standing in their way. And so they actually got together and there's transcripts from their conferences where they discussed the midwife problem and they said, we have got to get rid of these midwives. They are dirty and ignorant and Yeah, and dangerous. So you think of about the racist implications of that right there and.

They then went systematically in most states and made midwifery legal. In some states it was worse than others, but you went from having like, 80 to 90% of all babies in Kentucky being delivered by black midwives to like almost none. And what they eventually did in our state is they just stopped issuing licenses.

So,

[00:12:15] Naseema: so, but the, but not only did they stop issuing licenses, they made it illegal to practice a practice that people have been practicing hundreds and it wasn't years

[00:12:24] Rebecca: safely. Yeah. It can be legal, illegal, or illegal. Illegal is kind of where they're not like, It's not legal, but if they really wanted to, they could prosecute you for practicing medicine without a license.

So in our state, they were not. They were not arresting the underground midwives, but they could have and easily it could have switched to that. And in some states they still do. So that is still a problem in some states. And we could have nurse midwives practice. But nurse midwifery is a fairly new like evolution of midwives.

And it was started by white nurses who wanted to kind of like, You know, almost be like a white savior kind of issue and push out the black midwives. So that's

[00:13:07] Naseema: why there's, and also it's a gatekeeping issue as well. Yeah. Lots of gate. It is a ma, there's a master's degree program. Mm-hmm. The requirements to get into these master's degrees, even if you have, you know, The background is still pretty strenuous.

And then like, who is selecting the people to get into the program? For context I went to nursing school and I went through accelerated program, which means that I have to apply for my for the master's program. So in my cohort are are people who are going to be midwives and every other specialty.

So in my class of 83 in San Francisco, California, in 2008, I was the only black person and I'm in the family nurse practitioner program. So there's tons of midwives, but they're. Primarily white women. Mm-hmm. Well, they're, I think they were all white women. All, yeah. They're all there might have been, I think there was like one half Hispanic woman in that program.

Mm-hmm. So there was their diversity for that. But I'm just putting that into context, like this is still happening modern day. There's a lot of gatekeeping in this industry. Mm-hmm. That, like you said, traditionally for hundreds of years, women of color have, like from generations, been practicing as midwives safely.

Mm-hmm.

[00:14:29] Rebecca: Yeah. And in many cases safer than the doctors in their community. If you look at the. Very old statistics, but there was it was a concerted effort. It was on purpose. Like the reason why we have fewer black midwives today than, than we should is it was on purpose. And I think people forget that, and they also forget that there's never been any reparations paid for that.

So, You know, we have the American Medical Association that and the acog American Congress of Obstetricians and Gynecologists that have these huge budgets. They can just spend money on lobbying to prevent midwives from getting licensed. There's all kinds of things they do to suppress midwives still today, and they have never once paid reparations.

Meanwhile, we have. Black midwifery students who struggle to, to get through midwifery school with all the financial barriers when I feel like it should be free for all of them. Like,

[00:15:24] Naseema: come on now,

[00:15:27] Rebecca: go to school,

[00:15:28] Naseema: but also, In addendum to that, we have a national maternal, black maternal, yeah, black maternal and morbidity health crisis, like black women are dying and are injured, or black babies are dying or injured at three to four times higher rates than white women.

Mm-hmm. With. The, and, and that's taking out resources, that's taking out economics, that's taking out e education levels. Cuz you know they'll use the excuse. Yeah. Oh well black people are just unhealthy. Well, black people are just uneducated and they're own welfare Black people, you know, just don't know how to access the services.

Meanwhile, there's me who goes to the clinic where I work with all the doctors and I have all the access and the resources, and I'm seeing my. Maternal fetal medicine doctor. Just doesn't know me because I don't work with him and being denied care because I bring my children to the clinic. Mm-hmm. Like it's those stupid things that just compound because of the institutionalization of the birthing process into this broken system that was built off of, you know, Building on black bodies and using black bodies in experimentation and never providing the same level of care, and there're never being real corrections around them.

And the solution to that is to actually have more providers in of color because they are more compassionate. They understand the little intricacies of, you know, mm-hmm. That that goal. You know, just they can just provide better culturally responsive care. Yeah, right. In general, the outcomes are just better across the board, but.

There is intentional gatekeeping and there has been systemic intentional gatekeeping to keep providers of color out of healthcare so that we have better outcomes and so mm-hmm. Thank you for bringing that up, and thank you for sharing that historical context of it, because I don't think people will just kind of understand why and how we are so underrepresented in he.

[00:17:42] Rebecca: And it's not just gatekeeping to get in, which I witnessed, you know, when I was there. But once you get in, it can be such a toxic environment for black students that it, it's very hard to keep going. You know when, when you're being confronted with constant aggression against you, constant

[00:18:01] Naseema: aggression, and it's not just, it's the school, it's the professors, it's the clinical sites, sometimes even the patient.

All of these things, Yeah. The patients, the patients refuse to have you. Yes. Did you see that lawsuit of that nurse that said that, you know, all these white patients were refusing to have her as a nurse and her nurse manager told her, well, you should just dip yourself in some bleach and that'll solve the problem.

Mm. So it's like silly stuff like that, but I experienced it. I got held back in graduate school, I'll say like in the 18th grade, cuz I've been in school forever. It was my second master's degree and it was nothing but racism involved in that. Like I said, I was one of 83 going into the program so you can understand what I was up against and the toll that

[00:18:50] Rebecca: based on you.

Yeah. On your body

[00:18:52] Naseema: and this Yeah, exactly. Emotionally, physically, everything. And this is in, you know, liberal San Francisco, so I can only imagine, I don't even wanna imagine actually how it is in Kentucky. Well, it depends

[00:19:08] Rebecca: where you, like, in any, any state you have pockets where it's better in places where it's worse.

And I think in general, you know, there there's gonna be racism anywhere you go in the United States, cuz we. Uniquely racist history and it just, you know, it really depends where you are, I think.

[00:19:26] Naseema: Right. And like I, I said I was in San Francisco, but you're still based at this u Yeah, at this university.

Mm-hmm. It's still very much a old boys club. Exactly the nursing school, it's like more of a white women lesbian, a white woman, the the white lesbian women who are like the second under the old boys club, but they gate keep obviously. I mean, like you could see it with the midwifery, like it's still the same problems even if it's home woman.

Yeah. I mean, I, I

[00:19:55] Rebecca: have thought about that a lot. Would there's, there's no way I'd. Yeah, I wouldn't have been offered the same luck or opportunities, you know, if I had been dark skin, I can guarantee you. But as it is, I can't help you know, how I was born. So I just have to do what I can with what I

[00:20:14] Naseema: have. But what you are doing is giving a voice to people and presenting it to people that just don't have that experience.

So people that don't have the experience have the privilege to kind of be like, well, I didn't even know that existed. So is that even a real thing? Mm-hmm. What you're saying is no historically, This is what happened. This is the evidence based you know, research around this and you're giving people resources.

And it's not just anecdotal. It's not just, this is what my experience is. This is like, no, this is what the numbers say. So you are using your resource and your privilege to educate other people to. Affect change. And so I think that's even more powerful because you're in a position that you can do that.

So, you know, I really appreciate what you're doing, but you have been able to take your knowledge base and transition out of teaching and being in like nursing to create. A business around this. Can you talk about that shift?

[00:21:28] Rebecca: Mm-hmm. Yeah. So at first it was just like a passion project, a hobby where I, there was this fire lit underneath, underneath me and I, I would spend every night and every weekend reading research and then trying to write it up.

Because what I was trying to do was take the research out from behind the paywall and. Publicly available online and I was in a unique position to do it cause I had access to the research. I could read and understand it. And then I, and one of my skills has always been to like take complicated subjects and make them easy to understand.

I used to teach pathophysiology and pharmacology, so I was like used to take in hard stuff and making it so you could pass an exam and. With birth, it was really no different. It was that same concept, taking the hard stuff out of the research, making it publicly available, and that information is really powerful because then it puts the people who are patients, I say patients in quotation marks, but if you're pregnant, it kind of levels the playing field anymore because they can't tell you, oh, well we don't do that because it's not safe.

Because then you can look at the statistics and be like, well, actually, the research shows this, and it kind of gives you that. Ammunition to advocate for yourself, and that I did that for for several years until it became clear that I was kind of losing the battle physically, like my health was declining.

I had another baby. So I had three kids at that point. I was working a full-time faculty job and trying to be a mom and having childcare issues. So it, at some point I had to, to pick like, what am I gonna do with my life? And we had already kind of turned it, my husband and I, into a small family business a few years earlier.

We would sell online courses for continuing education hours for nurses, and there was enough income coming in that he could quit his job to be a stay-at-home dad, where that way we didn't have to pay for childcare for three kids. Plus, you know, the money that came in through the blog kind of made up.

For the fact that we lost his income and the weight off of me in that like, kind of reversing those roles. Like I know it's like gender roles are really embedded in our society, but having someone who handled like pickups and drop offs and laundry and grocery shopping and cooking and like errands and all that stuff made me, I, it, it bought me a couple of years cuz then I was able to keep.

Both jobs, essentially the faculty job during the daytime, the blogging at night. But eventually I came to kind of like a breaking point where I realized that the university wasn't gonna let me keep using my voice. You know, we talk about academic freedom. And it should be important, but there's always politics involved.

And the first time I got pulled into a meeting with my supervisor who told me that the hospital was, you know, really upset about one thing that I'd said, I was like, I think that's when I knew I had to quit. Because as like, as soon as they start censoring me, I can't bring my true self anymore. And if I had to choose, like I just choose like.

You know, pregnant families, like, and birthing families over this job. So I had to walk, I ended up walking away from that job, you know, just a couple years away from getting tenure and leave, leave that whole career behind. And it was really, really hard. Cuz academia can be a little bit of like, almost like a cult-like atmosphere.

Like where you feel like it's, there's a whole brand, you know, attached to being with the university and, and. And there was not, it's not celebrated. If you leave academia, it's, you're seen as like, I don't think they thought of me as a trader, but they definitely did not celebrate that I had started my own business.

Like, it was kind of like, now if you, if I had gotten a job at like another university, they would've given me like a big. Going away party, but this kind of like, what you're, you, you're going to do your own thing. Like that was a little strange for people, I think. But,

[00:25:39] Naseema: but, and I also think like, because you were bringing evidence to people and empowering people that can kind of be seen as something that might be a conflict.

Right. But also I think it speaks to like the importance, and this is a financial independence podcast, obviously. Mm-hmm. But it speaks to the importance of you being aligned financially in a way that. That did not so much affect your life because if you had been dependent on this job, you could have easily just let go of this business because you needed to work there.

But I think what you kind of said throughout this process is, You and your husband had to make some really tough decisions early on. I mean, you had three kids financially. That's, that's a lot. Ask me how I know. But you know, you guys had three kids. You already had to shift finances to be dependent on just your end income.

One person. Yeah. Yeah. And And so that had to come with a lot of money conversations and in those money conversations mm-hmm. You could kind of see, well, what's gonna be important for me, like as far as my values and versus like financially. And it seemed like you were in a good financial enough position to be like, This job could go and I know how I can make up, you know, what I was making at that job in my business is, is, is that a correct assumption?

[00:27:12] Rebecca: Yeah. And I love, like the name of your podcast, financially Intentional. It was a very intentional decision and I left my job in 2016, so it was four years after I started my blog, but we took steps in 2015 to prepare for that, knowing that I was. The only source of revenue at that point for our family. We knew the business would have to be able to replace eventually had to replace the income.

We knew it wouldn't do it right away. So one of the things we did is any extra income that came in from the business, we just saved it up. Cuz I was like, we have to have a really good emergency savings if we're totally self-employed. And I think everybody, some people will quit their. To start their own business without the emergency fund.

But having three kids, I just felt like I couldn't, that wasn't an option. And then the other thing we did to set ourselves up is we kind of calculated, all right, how much. How many memberships did we need to sell to our continuing education platform in order to like replace at least a certain percentage of my salary so we can pay our bills?

Because it was all about like, how do we pay our bills and pay for food And like as long as we can do those things, we'll be okay. And so we set it all up and then as soon as we hit that number we were like, okay, I can give my notice. And it's a little bit different academia cuz you, I think I had to give.

Six months notice or something like that. Yeah, it's, it's a very different hi Jobb. And I will say that like my mentors and some of my close friends that work were very supportive of me, but I just felt like as a whole, their culture, like people I think kind of look at you like you're a little bit crazy to go start your own business.

And I don't know about you, but when I was a kid, they never had career day where they came and. Women or girls especially like that you can own a business. You can run a business someday. That was not, I mean, I didn't know any of my friends who went to business school or majored in business in college.

Like now, today, I see my kids. I think they're doing more of that in schools. Like they have these special days where they practice, you know, being business owners or managers or whatever, but it was never even. Considered as an option like it felt, no, I don't really like a total career shift.

[00:29:29] Naseema: So, yeah, I mean for me it's very different too because it was like this whole thing ingrained in me.

Like, you know, go to the best college you can get that good job. You know, preferably a government job because those are real stable and they have really good pensions and then retire. Like, it was more of that path, more of a stability thing. Mm-hmm. My dad, I. Working with my dad in his business, but that always felt unstable to me.

Okay. Yeah. Cause he never really made a lot of money, so I saw that example. Mm-hmm. But it still wasn't like something that I felt like being a business owner was like. Something that was a possibility for me at all. Yeah. It just seemed like it was just too complex. Like that's not Uhuh. Yeah. It's more, it's more, it's safer, right?

It's safer to have a job and get a paycheck. It's more stable. Yeah. Yes. To get that paycheck guaranteed, you know, every two weeks you're gonna get paid and

[00:30:25] Rebecca: there are totally benefits to that path because some, some days, I will not lie there, I lose a lot of nights of. Over, over running evidence-based birth.

I have to set really strict boundaries. But there are times when I just wanna give up and I can't. Like I cannot walk away. It's like having another child. Yeah. And sometimes I think, gosh, I would love to just be able to just go to work, do my job, and come home and owning a business, it's more like it's with you all the time, like a child.

And it's hard. It's. It is. You can try to unplug and you can unplug, but it's like going on, it's like going on a vacation without your child. You still have to come back and like, you know, it's

[00:31:06] Naseema: hard and it's hard to set those boundaries when it's your business. Right. So like at work, like I, like I don't necessarily always advocate giving up the nine to five because a lot of people just are not made.

To you know, have businesses and I think it's possible to get where you wanna get to financially with a nine to five. You just have to be intentional. Right.

[00:31:26] Rebecca: Or, or a little bit creative with what you're doing. Yes, exactly. Or have maybe side hustles and that sort of thing, but depending, like your whole family, depending on.

Your business and, and now we have, you know, a team of, of more than 10 people and Nice. I feel there's an obligation to them too. Like, you know, we all kind of are obligated to each other and that we're all responsible for one another, like keeping us all employed. But I can't just walk away cuz like all these people count on us.

And people obviously are customers and our readers and listeners. So not that I want to go away and I'm not resentful, but I don't want to get to that point where I resent the business, you know? So I've been doing it 11 years now, and I have to think about like, you know, what do, when will I retire? Like what will that look like?

And yeah, how do I exit eventually? Not that I'm going to anytime soon, but there's definitely, like I said, it's like, it's like growing up a. And then figuring out what you're gonna do with how you're gonna, how you're gonna raise. So, so

[00:32:29] Naseema: talk to us more about the business. Like how has it grown? Like, as far as product, service and offering.

Mm-hmm. Like from, from the beginning and where you are right now.

[00:32:38] Rebecca: In the beginning one of the first things I did is I bought a microphone and I bought Camtasia, which is like a screen capture software. And, and I also had to. Pay to become a board of nursing, like a continuing education provider, which was actually not that expensive or hard.

And so I was selling kind of one off courses, like you'd buy one course on this birth subject or, and I, I gradually grew up till I had about four or five individual courses and then I had the idea to turn it into a membership, like an all-inclusive, where you get all the courses plus the community. And so that's what I did in 2015 that allowed me to quit in 2016.

And then it's just been growing every year and we keep adding more and more benefits and features. We have like a library of PDFs and we have weekly peer support meetings and specialty calls, and we have live monthly training. So it's this whole, like when you join the membership, you really get. All of this stuff and community and support.

And then we also have another thing that was actually one of the first things I started was an instructor program where you could apply to teach our classes as a, a nurse or a childbirth educator or a doula. And so we started that in. 2015 as well. And we have a really nice group of instructors and, and what they do is they, once they become an instructor, they renew every year, but then they also teach our childbirth class.

So we have workbooks that they can purchase from us to teach their class. So we have some physical products as well that the workbooks, we have t-shirts. That's a very small part of our business. But another big component of our business is about three or four years ago, I had the idea to turn, Some of our research evidence into little pocket guides.

So they are on a key chain and they're laminated and they fit in like a scrub pocket. And so we have one on comfort measures for labor and birth. We have one on labor induction, which covers all the research evidence on why people are being induced and all the medical ways of inducing labor and the natural ways of inducing labor.

And then last year we came out with a brand new pocket guide called The Pocket Guide to Interventions for Childbirth. So like anything that could possibly be done to you in the hospital while you're in labor. We have the background, the research, the benefits, and the risks and alternatives, and it's like all in that like pocket size.

Fuck.

[00:35:15] Naseema: So lemme just tell people out there, even if you're not a nurse, I know all people are always looking for things to put into, like gifts for nurses, all of those kind of things. Okay? Like we love the pizza, we love the chocolate, but I'm just saying like if you just provided some of those pocket guys to some of these nurses, you can change the game.

So even if you're a nurse, I'm gonna link to those guys in the show notes because I really feel. I actually, I'm gonna buy some for my staff because, you know, especially the comfort measured ones, we're not trained in those things. Mm-hmm. Don't think it's offensive. Don't think it's like, oh, well these are things that you should know.

You never know. Especially, you know, for people, you know, actually, I was gonna say this and what I really wanna say is like, first of all, I'm sad you're not in education because we need more teachers like you, but we need this even more. So I'm glad I'm what you're doing.

[00:36:10] Rebecca: Well then I might go back someday.

You know, like, yeah. I mean it's, the part of my retirement plan I think is like when I no longer need the income when I have. My goal saved, like, and I get to quote unquote retire. Yeah. I wanna go back to university and teach part-time or something, you know? Cause I, that's the part I miss the most is working with students, but in the meantime,

[00:36:33] Naseema: yeah.

Yeah. But what I was saying is that we don't. Have really good quality continuing education. Mm-hmm. Kind of the continuing education that we, I mean, there's some out there, but the ones that are readily available and accessible to us are like kind of what the, what the institutions choose. And so they're not always gonna be in the best interest of the patients.

They're gonna be more like making sure that they meet their licensure require or their insurance requirements. Like we have to do this thing every year called, it's called No. Right? And, and that's from the people that provide, are. Insurance of stress insurance. And so it's gonna be heavily based around making sure we don't get sued, you know what I'm saying?

But it's not necessarily based around, there might, there are evidence-based things in there, but not necessarily the things that we need to really provide high quality care. So I think your reference in your pocket guys are, you know, a really good tool to share with colleagues, share with your nurses, share with people.

That are giving birth so that you know they can, like I said, it's a really good gift if you really wanna get a,

[00:37:46] Rebecca: well, I wish there are more of them idea, you know? Do you remember nursing school when you would go to the bookstore? Cuz back when I was there, there was still a bookstore and they would have those like laminated, like.

Card. Yeah. So it's kind of like what I, what inspired was one of the things that inspired me, but I told my brother-in-law is a travel nurse and emergency room nurse. I was like, you need to have like a pocket guide to travel nursing or a pocket guide. Mm-hmm. ER nurse. And there's like, there's just not, I don't, so yeah, there's a business idea at vie.

[00:38:20] Naseema: Like that is, that is like, first of all, they sell like

[00:38:23] Rebecca: hotcake cakes. Like I'll tell you what we, yes, we sell out every time we offer them. So you can check 'em out in the shop, but they're likely not there. So I tell people to get on our email list because we will, what we often do is we will place. Big order, we'll get 'em in stock and then they sell out in a few days.

So they're hard to keep in stock because it, it is like a very like time intensive thing to assemble and everything. So, yeah.

[00:38:49] Naseema: Yeah, I can imagine. But excellent resource. So you see how excited I got when you mentioned them. I know they sell like hotcakes and yeah. Very good business idea for anybody to sell hockey guys, especially nurses.

First of all, nurses. Everything. The rumor is that's what we do at the nurses station is just shot. I will ne I won't, I will neither like deny that or verify that, but you know.

[00:39:21] Rebecca: Well, and they, they're good patients. The word on the street for people who are pregnant too, because like Yes. Sent one to my, my sister-in-law was having a labor induction, so I sent her the labor induction one and.

She brought it with her and it, it's really helpful when you're planning, you know, 42% of Americans have a labor induction, so it's really common way to have a baby. And she took it in and the nurses were like, oh my gosh. You know, like Ewing and Awing and reading it and can we borrow this for a minute and look at it and see?

And they were like, so impressed. And then I think she got really good care because they were like, wow, she knows her stuff. Like she, you. Has this pocket died. Yeah. And I learned things from her and it, it was, ended up making a, a really good experience. So,

[00:40:02] Naseema: but typically your, your target audience is gonna be your nurse midwives, your doulas, your mm-hmm.

Birth support people, labor nurses. Yeah. Okay. That knee continuing

[00:40:14] Rebecca: education, I would say it's about like half and half I would say. We have a podcast and a blog and email us, and probably about half of them are birth workers or healthcare workers, and half of them are pregnant families or support partners.

Yeah. But the, the birth workers are typically the ones who like to shop, like as well. Well, so,

[00:40:34] Naseema: but your membership is geared towards continuing education, so it's gonna be,

[00:40:38] Rebecca: so that's the birth workers and healthcare workers. Exactly. And then the the parents will buy like the childbirth class from an instructor, and so they get a workbook through their instructor or they buy a pocket guide.

[00:40:49] Naseema: Can I just say I love how you incorporated the instructors to teach the course, because it just expands how much reach you have. Mm-hmm. And I know that, I mean, I'm sure you would love to teach the course all the time. It's, it's like this day you business where you have to balance like how many hours in a day do I have to do certain things?

So I love how you incorporated that feature of like just. Providing them the education and then the curriculum, so

[00:41:17] Rebecca: mm-hmm. I think that's, and that came directly from like our audience and listeners. Mm-hmm. And customers, they were emailing me constantly, like, I wanna become, you know, I wanna teach your content.

I wanna be affiliated with you. I want to teach whatever classes you create. And so I just listen to. And, and offered it. And same thing goes with, with most of what we create and offer. It comes from requests from our community. Yes. So right now, this March of 2023, we're launching a new peer reviewed article and it's, you're gonna love this, this the evidence on anti-racism and healthcare and birth.

[00:41:58] Naseema: Come on with it. Okay.

[00:42:01] Rebecca: I love it. Sections. The first part is solidarity and Soul family. The second part is about Afrofuturism and birth, and the third part is about equity tools. And it was authored by Tu Ali and she actually. Reached out to me. She is a black doula and body worker and doctoral student in Minnesota, and she was on the front lines in Minneapolis during the uprisings after George Floyd was murdered and she reached out to me and, well, I had sent out an email about it, and then she wrote back and was like, You know, we need help like this.

And so I said, well, what do you need? And I thought, you know, she would write back a couple items. But what she ended up going is going to the Minnesota Healing Justice Network. And they discussed my offer to help and they sent me back like a huge long list of everything they needed. And towards the top of the list, one of the things they wanted is they wanted evidence-based birth to publish the research on like racism and how it impacts maternal health and what we can do about it.

So we started doing that just through like small things we posted on social media called Black Tiles. And you can go, you can see those on our, our Birth Justice page, on our website. We have 'em archived there. But Iho two actually came and joined the team as a paid team member to help write those black tiles.

And then in 2020, end of 2021, she started compiling all of them into a really big. A research article that presents solutions. So because she said we're done with statistics, like we have enough statistics, we need the research solutions and uplifting the black and brown birth workers who have the solutions.

So that's coming out this march and we're really excited about. But again, that's another example of something that is a request, like a, a true request from our audience. And we try to listen like what do people want? You know, if you're not sure, you just have to ask and they'll tell.

[00:44:00] Naseema: Dang, I'm, I'm super juice for that to come out.

But again, just speaks to the power of you using your voice in your platform to empower people that have resources and support, but don't have the reach that you have. Yeah. And so that's what I'm saying, like, and I hate to use the word ally, but you know what I'm saying, like, use what you can. Mm-hmm. Use what you have available.

To you to try to make changes, even if it doesn't directly affect you. And I just think that that speaks to the person that you are, right? It's like they're. Are these huge, huge, huge issues. There's these huge gaps in care but you are actively creating solutions to address them. So I just wanna give

[00:44:49] Rebecca: you Yeah, and I think it's important gratitude to remember to like, you know, we, all we have to do is listen and follow black leadership, and that is just what we have to do.

So if you're not sure what to. Read the article that Iho two wrote and at evidence-based birth, and there will be a hundred suggestions in there for things you can do and including steps to get started. But I think it's gonna be really inspirational. I'm really excited, especially for the, the Afro-futurism and like envisioning a future where black women and birthing people are, are respected and supported and centered in what they need and like, That will help everyone.

You know, like imagine

[00:45:29] Naseema: that. Yeah, imagine that. Can we say that again? And Rebecca, that helps everyone. If we raise the quality of care for one person, we are raising the quality of care for everyone else. Exactly. So people who shoot down the concepts of making sure that people get better care are only.

Hurting themselves, so, right. Anyway, so what is next, Rebecca, for her? The evidence space? I mean, you do, but

[00:45:57] Rebecca: Yeah, but I know, oh, you know, we have lots of plans. I, one of the things I've realized is I really need to have a weight, a system of training people who work on our team. And so I'm, I'm, I'm working through a program called the Leadership Lab to develop that and we.

Building up the next generation of researchers who can kind of do what I do cuz I won't be around forever is really important to me. And there's no program that like graduates. Nurse researchers or any kind of researcher on how to, how to publish for the public, like how to make research accessible. So I've created a research fellowship and we have our first research fellow who just started and I hope to have at least one a year.

So, you know, you can always go to the evidence-based birth website and look at the careers page. There's always like, There's a, a form for people to submit if they wanna be considered for future positions. And then we also are gonna start recruiting for next year's research fellows. That's something I'm excited about, mainly because, like I said, I don't wanna feel like trapped or that I'm the only one.

Like, it really has to be a, a team effort and we really need to have like a deep pool of people who. Do this kind of work. So that's one thing I'm excited about. Oh shoot. I

[00:47:12] Naseema: might have to go check out that application,

but, so where can people find you? I know your hub is gonna be your evidence-based birth website. Is there some other places they want people to check out? She has an incredible podcast. Yeah, I

was

[00:47:30] Rebecca: gonna say that Evidence-based birth podcast, you know, check us out. We have a lot of really.

Episodes coming out this year our blog, and we have a free crash course on our homepage, like where you can learn all about evidence-based care and childbirth and what that means. And that's for free, if you sign up on our email list and we have handouts on like. Oh, so many different subjects, and those are also included if you join the email list.

Lots of free handouts and that's, I love creating that kind of stuff because it's like so practical and us usable. And obviously if you, if you just Google evidence-based birth, you'll, you'll. One of the things I love about it is if you Google evidence-based, it's usually, you know how like it fills in, it'll say like, evidence-based medicine, evidence-based birth, it like fills in for you.

So I'm like, nice. So before I started Evidence-Based Birth, you, you couldn't find it anywhere on Google. There was nothing, you know, you might be able to find like evidence-based maternity care, but that's one reason we were able to get the trademark is because nobody was like using those three words together.

And yeah, evidence-based birth, you can just google any topic with those words and you'll often find something we've written. So we have a, a long list of subjects. We've covered that. All the research is free on our blog.

[00:48:46] Naseema: I love it. And I just wanna thank you again for being, and I don't, like I said, I'm not gonna say Ally, I'm gonna say you are a writer for the community because it's not like you're just talking the talk.

You're actually providing tools and resources for people to learn and grow and actually provide. And get access to better care. So I really, really appreciate what you're doing and I'm so honored to know you. I'm so honored to be able to be featured on your platform, but keep on doing what you're doing, keep on training the next generation and you know, I just wanna give you so much love because of what you are doing is so necessary.

So I appreciate you so, so, so much for being here and.

[00:49:28] Rebecca: You're welcome and listeners, you can check out namas interview with me, episode two fifty one of the Evidence Space Birth podcast. It was a really inspirational episode. Thank you, Rebecca.

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