What Does “Evidence-Based” Really Mean, and Why Does it Matter During Your Pregnancy?

I joined my local doula association the day after I finished my training. I’d been told that most doulas in my area got their clients through the Association’s website. Each doula had a profile on the site, and because it’s the first result when you Google “Nova Scotia Doula,” many families found their doula simply by scrolling through those profiles.

I was so excited to add mine. I felt confident that pregnant people would see my research background listed in my bio and say, “That’s my doula.” I was certain that my focus on evidence-based doula support would make me an instant standout.

As I scrolled through the other doulas’ profiles, my confidence started to waver. Nearly every single doula mentioned “evidence-based approaches” in their bio. Suddenly, my unique selling point didn’t seem so unique.

The same thing happened when I started exploring the pregnancy and birth space on social media. Everyone—and their dog—was “evidence-based.”

At first, I was thrilled. It felt like the birth world was filled with people who cared about research and evidence. These were my people!

But it didn’t take long for the cracks to show. I’d see a doula share solid, evidence-based information about the risks and benefits of epidurals—then turn around and recommend lactation cookies as though they were a magic fix for milk supply. Birth influencers would confidently cite journal articles to back their claims but miss basic concepts, like the difference between correlation and causation.

I started to realize something important: not all “evidence-based” claims are created equal. Not everyone sharing “research” understands how to interpret it. And not everything that’s labeled “evidence-based” actually is.

Which raises some really important questions: What does it actually mean to be “evidence-based”? AND why does it matter to your pregnancy, birth, and postpartum journey?

First things first: The term “evidence-based” is often co-opted, especially on social media, where it’s thrown around without much context or accountability. Originally, “evidence-based” referred specifically to evidence-based practice.

Evidence-based practice developed in the 1990s as a response to gaps in medicine. At the time, medical decisions often relied on tradition, individual expertise, or anecdotal experiences. Researchers like Dr. David Sackett argued that patients deserved care grounded in the best available research, not just opinions or habits passed down over time. This shift changed medicine by combining rigorous, data-driven research with clinical expertise and, importantly, the values and preferences of the patient.

At its core, evidence-based practice integrates three things:

1. High-quality research evidence

2. Clinical expertise

3. Individual values and preferences (Sackett et al., 1996)

What does “high-quality research evidence” mean? Well, not all research is created equal. Some types of evidence are considered more reliable than others. Let’s say you’re deciding whether to pack an umbrella. If you check one person’s social media post saying it’s sunny where they are, that’s like relying on anecdotal evidence—limited, biased, and based on a single perspective. But if you check a weather forecast, which uses data from satellites, past patterns, and meteorologists, that’s like a systematic review or meta-analysis, what we might call empirical evidence. It’s more reliable, broader in scope, and designed to reduce errors. You wouldn’t plan your day around one person’s window view, just like you shouldn’t plan your birth based on one influencer’s opinion.

“Evidence-based care” takes that high-quality evidence (AKA. the weather forecast) and balances it with your values and preference (whether you mind being a little wet or cold; if you really enjoy warm weather). In a clinical context, if your doctor is practicing evidence-based care, this might look like using high-quality research studies to explain the benefits of skin-to-skin contact immediately after birth, but respecting your comfort level and your specific preferences. An evidence-based approach doesn’t just point to the research and say, “This is what’s best.” It brings the research to you, explains the evidence clearly, and allows you to make the choice that feels right for you and your baby.

When we shift from evidence-based practice to evidence-based information—the kind you see on social media, blogs, or shared by doulas—it gets murkier. Evidence-based information should rely on the same principles (using the highest-quality research and respecting individual needs and values), but it often doesn’t. Instead, what gets presented as “evidence-based” is often cherry-picked, incomplete, or misinterpreted. Someone might pull a single sentence from a study without understanding its limitations. Or they’ll latch onto low-quality research that confirms their opinion, ignoring better evidence that challenges it.

And here’s the tricky part: the internet has made access to research easier than ever, but access doesn’t automatically equal understanding. A well-meaning doula or influencer might cite a study they found on PubMed, but if they haven’t evaluated how strong that study is—or if they misunderstand the results—they’re not actually providing evidence-based information.

So how can we know if information is evidence-based? What does evidence-based information look like? (Although, I totally recognize that some of this is hard to check while you are scrolling through IG posts).

Evidence-based information uses peer-reviewed research: Peer-reviewed means the research has been evaluated by other experts in the field for accuracy and reliability. Peer review acts as a quality filter, catching errors or questionable claims before they reach publication. For example, a study published in the Cochrane Database of Systematic Reviews, which is known for its rigorous standards, carries far more weight than a blog post that doesn’t cite sources.

Evidence-based information understands the quality and hierarchy of evidence: Not all evidence is created equal. Think of evidence as a ladder, where the higher rungs are stronger and more reliable. At the top, you’ll find meta-analyses and systematic reviews of randomized controlled trials (RCTs)—these combine data from multiple studies to give us the clearest picture of what’s happening (Guyatt et al., 2008). On the lower rungs, you’ll find case studies, observational reports, or anecdotal experiences—valuable in context, but much less reliable.

It avoids cherry-picking data: Evidence-based information doesn’t just pull from studies that confirm a particular bias; it considers the entire body of research on a topic. Let’s say someone wants to argue that eating pineapple induces labor. They might share one small study suggesting pineapple contains enzymes that could affect the cervix, but they’ll ignore the larger body of evidence showing no meaningful impact. True evidence-based information doesn’t just focus on convenient results—it looks at the big picture.

It separates correlation from causation: Just because two things happen together doesn’t mean one causes the other. Imagine someone claiming that babies born during full moons are more likely to arrive early. Maybe they noticed a few coincidences, but that doesn’t mean the full moon caused anything—there’s no evidence to support it. Correlation is interesting, but causation is what matters when we’re making decisions based on research.

High-quality, evidence-based information is both nuanced and honest. It takes into account the strengths and limitations of the research, and it avoids making sweeping claims that the evidence can’t support. Most importantly, it respects you—giving you the full picture so that you can make an informed decision that aligns with your values, not someone else’s agenda.

So where does this leave us? Even the best evidence doesn’t make your decision for you—it informs it. Evidence is a tool, not a rule. It gives you information about what’s likely to happen, but it can’t tell you what should happen. That’s where your values come in.

For example, let’s say you’re deciding whether to induce labor at 39 weeks. Evidence from the ARRIVE trial shows that elective induction at 39 weeks can reduce the risk of cesarean birth for some people (Grobman et al., 2018). That’s valuable information, but it’s not the whole picture. Your preferences matter, too. Maybe you feel strongly about avoiding interventions unless they’re medically necessary, or maybe you’re dealing with anxiety and would feel more comfortable scheduling the induction. The evidence gives you a foundation, but your values—what matters most to you and your family—help you make the choice that’s right for you.

This is the heart of why evidence-based information is SO important for your pregnancy and birth– it helps you make informed decisions. Evidence + Values = Informed Choice. When you understand the research, you’re not just handed a recommendation—you’re given clarity. You can weigh the risks, benefits, and trade-offs while staying connected to what matters most to you.

Whether you’re deciding where to give birth, how to feed your baby, or whether to accept a particular intervention, you deserve evidence-based information that empowers you to make choices—not information that pressures you toward someone else’s agenda.

Because at the end of the day, evidence-based care isn’t just about research. It’s about you.

Since I’ve added my profile to the Doula Association’s website, I’ve come to realize just HOW important my research background is. Evidence-based practice and information play a crucial, essential role in our ability to make informed choices and decisions throughout our pregnancies, births, and postpartum journeys. But all too often, what is presented as “evidence-based” on social media falls short of its promise. Whether you’re scrolling through profiles, following social media advice, or navigating conversations with your care provider, understanding what makes information truly evidence-based gives you power. It allows you to filter out the noise, trust the process, and choose what feels right for you and your family. Because being evidence-based isn’t just about research—it’s about making decisions that center on your needs, your values, and your voice.

TL;DR – What Does “Evidence-Based” Really Mean?

1. “Evidence-based” comes from evidence-based practice: It integrates high-quality research, clinical expertise, and individual values and preferences.

2. Not all evidence is created equal: Systematic reviews and randomized controlled trials (RCTs) are more reliable than case studies or anecdotes.

3. Beware of cherry-picking and misinterpretation: True evidence-based information considers the whole body of research, not just studies that confirm a bias.

4. Correlation doesn’t equal causation: Just because two things happen together doesn’t mean one causes the other—context and quality matter.

5. Evidence + Values = Informed Choice: Evidence informs your decisions, but your values help you decide what’s right for you.

   References

   Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011). The levels of evidence and their role in evidence-based medicine. Plastic and Reconstructive Surgery, 128(1), 305–310. https://doi.org/10.1097/PRS.0b013e318219c171

   Grobman, W. A., et al. (2018). Labor induction versus expectant management in low-risk nulliparous women. New England Journal of Medicine, 379(6), 513–523. https://doi.org/10.1056/NEJMoa1800566

   Guyatt, G. H., et al. (2008). GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 336(7650), 924–926. https://doi.org/10.1136/bmj.39489.470347.AD

   Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. BMJ, 312(7023), 71–72. https://doi.org/10.1136/bmj.312.7023.71