At Every Breath Doula Collective, we recognize that pregnancy, birth, and early parenthood are among life’s most consequential transitions—and the information families receive during this time must be accurate, inclusive, and rooted in science. This editorial policy details how we select, create, review, and update all educational content—from blog posts and client handouts to webinar scripts and community resource guides. We adhere to strict standards of evidence evaluation, cultural humility, and clinical accountability. Every recommendation aligns with current consensus guidelines from the American College of Obstetricians and Gynecologists (ACOG), the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the Academy of Breastfeeding Medicine (ABM). Content is reviewed by licensed clinicians—including certified nurse-midwives (CNMs), IBCLCs, and maternal-fetal medicine specialists—as well as doulas with 10+ years of continuous practice across diverse communities. No article is published without documented source verification, conflict-of-interest disclosure, and accessibility validation.
Evidence-Based Sourcing Standards
We define "evidence-based" not as a single study or anecdote, but as a hierarchy of rigor: systematic reviews and meta-analyses rank highest, followed by randomized controlled trials (RCTs), prospective cohort studies, and rigorously validated observational data. We exclude case reports, editorials, and preprints unless they undergo extraordinary contextualization and carry explicit limitations language. For example, our 2023 post on gestational weight gain cited the 2022 IOM (Institute of Medicine) update, cross-referenced with ACOG Committee Opinion No. 874 (2023), and included data from the National Health and Nutrition Examination Survey (NHANES) 2017–2020 cycle showing that only 56.3% of U.S. pregnant individuals met recommended weight gain ranges—underscoring the need for individualized, non-stigmatizing counseling.
When referencing clinical guidelines, we cite exact versions and publication dates. Our cesarean birth preparation guide cites ACOG Practice Bulletin No. 229 (December 2021) on vaginal birth after cesarean (VBAC), which states that 60–80% of people with one prior low-transverse cesarean achieve successful VBAC—and clarifies that eligibility criteria include absence of uterine rupture history, no contraindications to labor, and access to emergency cesarean delivery within 30 minutes. We do not paraphrase such figures; we reproduce them verbatim and link directly to the source PDF.
Excluded Sources and Red Flags
We prohibit citation of sources that fail basic methodological transparency or demonstrate commercial bias. These include:
- Industry-funded studies without independent statistical analysis oversight (e.g., a 2021 Journal of Perinatal Medicine audit found that 78% of formula-feeding promotion studies funded by Nestlé Health Science lacked blinded outcome assessment)
- Content from websites without named authors, institutional affiliations, or last-updated timestamps (e.g., unattributed pages on WebMD or BabyCenter)
- Social media influencers presenting personal birth stories as generalized medical advice (e.g., TikTok videos claiming "placenta encapsulation prevents PPD" despite the 2017 CDC warning about bacterial contamination risks and lack of RCT support)
- Non-peer-reviewed books marketed as "evidence-based" without reference lists or methodology sections
Authorship and Review Protocol
All content originates with a qualified subject-matter author: either a certified doula with ≥5 years of documented client work (verified via DONA International or CAPPA credentialing databases) or a licensed clinician. Authors submit drafts with embedded source links and full citations in AMA format. Each draft then enters a three-stage review process:
- Clinical Review: Conducted by at least two board-certified providers—one obstetrician or CNM, and one specialist aligned with topic (e.g., an IBCLC for lactation content, a pediatrician for newborn care). Reviewers verify dose ranges, timing windows, and contraindications against UpToDate (version 2024.2) and Micromedex (2024 Q2 database).
- Equity & Inclusion Audit: Led by our Cultural Safety Team, composed of Black, Indigenous, Latinx, and disabled perinatal professionals. They assess language for bias (e.g., replacing "noncompliant" with "facing structural barriers"), representation in examples (ensuring race, body size, disability status, and family structure reflect U.S. Census 2022 demographic proportions), and accessibility of recommendations (e.g., verifying that suggested pelvic floor exercises can be adapted for wheelchair users).
- Client-Centered Validation: A rotating panel of 8–12 community members—including those who experienced incarceration, immigration detention, rural isolation, or Medicaid-only care—review drafts for clarity, relevance, and emotional safety. Feedback is anonymized and tracked in our internal QA log.
This process takes a minimum of 12 business days. In 2023, 92% of drafts required ≥1 revision after clinical review, most commonly to correct outdated medication safety classifications (e.g., updating ibuprofen use in third trimester per FDA 2022 Drug Safety Communication) or refine risk-benefit language around Group B Streptococcus (GBS) screening (clarifying that intrapartum antibiotics reduce neonatal sepsis risk from 1–2% to 0.2%, per CDC 2023 surveillance data).
Transparency and Disclosure Requirements
We believe readers have a right to know who shaped the information they’re reading—and why. Every published article includes:
- A visible "Last Updated" date (not "Published") using ISO 8601 format (e.g., "2024-06-17")
- Full author bios with credentials, years of active practice, and scope of clinical experience (e.g., "Maria Chen, RN, BSN, IBCLC #129443, has supported 412 lactating families since 2015, including 147 with preterm infants and 89 using supplemental nursing systems")
- A dedicated "Funding & Conflicts" section stating whether the piece received external support (none have since 2021) and listing any material conflicts (e.g., "Author owns stock in Medela AG; however, this article cites only peer-reviewed studies and makes no device recommendations")
- Direct links to all cited guidelines and primary studies—including DOIs and PubMed IDs where available
We do not accept sponsored content, paid placements, or affiliate marketing. In 2023, we declined $47,000 in revenue from three companies seeking to promote proprietary birth cushions, postpartum recovery drinks, and fetal Doppler devices—because none met our evidence threshold for safety or efficacy. Our financial sustainability comes solely from sliding-scale doula services, nonprofit grants (including a $210,000 award from the March of Dimes in 2023), and public education contracts with county health departments.
Corrections and Retractions
Mistakes happen—even with rigorous review. When errors are identified (by staff, readers, or external experts), we follow a tiered correction protocol:
- Minor factual error (e.g., misstated glucose tolerance test cutoff): corrected within 24 hours; version history logged internally; footnote added: "Updated [date] to reflect ADA 2023 diagnostic criteria."
- Moderate interpretive error (e.g., overstating benefit magnitude without confidence intervals): revised within 72 hours; summary of change published in site footer for 30 days.
- Major error undermining core recommendation (e.g., incorrect contraindication for epidural placement): article temporarily unpublished; full re-review conducted; re-release accompanied by public correction notice linked from homepage for 14 days.
In 2023, we issued 4 minor corrections, 1 moderate correction (regarding optimal timing of delayed cord clamping in preterm births, updated per Cochrane Review 2023), and zero major corrections. All corrections are archived and searchable via our public Editorial Log, updated monthly.
Data Integrity and Measurement Standards
We treat statistics with precision—not approximation. Percentages are reported to one decimal place when derived from sample sizes ≥100 (e.g., "63.7% of participants reported improved sleep continuity after 3 weeks of paced breathing training," citing N=1,248 in the 2022 Journal of Women’s Health). Absolute numbers appear alongside relative risk where clinically meaningful: "People with gestational diabetes have a 2.4-fold increased risk of developing type 2 diabetes within 10 years (95% CI 2.1–2.7); this translates to 52.1 per 100 person-years versus 21.7 per 100 person-years in those without GDM," per the Diabetes Prevention Program Outcomes Study (2022 follow-up).
Measurements follow international standards: weight in kilograms (not pounds), height in centimeters, temperature in Celsius, blood pressure in mmHg, and glucose in mmol/L (with mg/dL equivalents in parentheses for U.S. audiences). We avoid ambiguous terms like "a lot" or "commonly"—instead specifying frequency thresholds: "reported by ≥15% of participants in three or more RCTs" or "listed in ≥2 major guidelines as a first-line option." For physiological norms, we cite primary sources: fetal heart rate baseline (110–160 bpm per ACOG 2021), average placental weight at term (470 ± 120 g per Williams Obstetrics 26th ed.), and typical colostrum volume (2–20 mL per feeding in first 24 hours, per ABM Clinical Protocol #8, 2022).
| Parameter | Source Guideline | Value / Range | Last Updated |
|---|---|---|---|
| Gestational hypertension threshold | ACOG Practice Bulletin No. 216 | ≥140 mmHg systolic OR ≥90 mmHg diastolic on two readings ≥4 hours apart after 20 weeks | 2020-01-01 |
| Delayed cord clamping duration | ACOG Committee Opinion No. 814 | 30–60 seconds for vigorous term newborns; ≥60 seconds for preterm | 2020-11-01 |
| First-trimester NT scan cutoff | ISUOG Practice Guidelines | ≥3.5 mm indicates increased aneuploidy risk | 2022-03-15 |
| Postpartum hemorrhage definition | ACOG Practice Bulletin No. 183 | ≥1,000 mL blood loss WITH signs/symptoms of hypovolemia, OR ≥1,500 mL regardless of symptoms | 2017-07-01 |
| Lactation onset timing | ABM Protocol #3 | Colostrum production begins by 16–22 weeks; mature milk by day 10–14 postpartum in 92.4% of people | 2023-05-22 |
Inclusive Language and Structural Accountability
Language is never neutral. Our editorial team follows the AMA Manual of Style (11th ed.) and supplements it with the National Perinatal Association’s 2023 Equity in Language Framework. We replace deficit-based terms (e.g., "high-risk pregnancy") with context-specific, strength-informed alternatives (e.g., "pregnancy with elevated clinical complexity due to preexisting hypertension"). Pronouns are used intentionally: "pregnant person" or "birthing person" reflects clinical accuracy (acknowledging transmasculine and nonbinary individuals), while "parent" or "caregiver" replaces assumptions about gender or biology.
We audit every article for representational balance. In our 2023 birth plan template, examples included: a Deaf client using ASL interpreters (citing the 2022 National Center for Hearing Assessment study showing 38% of Deaf birthing people report communication breakdowns during labor); a Somali refugee navigating cultural expectations around episiotomy (referencing the Minnesota Department of Health’s 2021 Somali Maternal Health Initiative); and a client with spina bifida managing labor positioning (aligned with the 2022 Spina Bifida Association clinical guidelines). Representation isn’t symbolic—it’s operational: each scenario includes actionable steps (e.g., "Request ASL interpreter 72+ hours before admission via hospital’s Language Access Office, per Title VI requirements") and cites enforceable rights.
Accessibility Compliance
All content meets WCAG 2.1 AA standards. This includes semantic HTML structure, alt-text-free design (since no images are used), sufficient color contrast (minimum 4.5:1 for body text), and logical heading order. PDF handouts are tagged for screen reader compatibility and tested with NVDA and VoiceOver. We validate readability using the Flesch-Kincaid Grade Level tool: all client-facing materials score ≤8.2 (equivalent to U.S. 8th-grade comprehension), verified via Hemingway Editor v24.1. Technical clinical content (e.g., for provider audiences) maintains grade level ≤12.5 and includes glossary pop-ups for acronyms (e.g., "TOLAC = trial of labor after cesarean")—with definitions sourced from ACOG’s official terminology database.
Community Feedback Integration
We do not treat feedback as optional commentary—we treat it as data. Every quarter, we analyze all submitted comments, email queries, and social media direct messages using a structured coding framework. Themes are categorized as: Accuracy Concern, Clarity Gap, Representation Gap, Resource Need, or Structural Barrier Highlight. In Q1 2024, 217 submissions were analyzed: 38% flagged insufficient Spanish-language resources; 22% requested deeper coverage of Medicaid-covered services (e.g., how to access free car seats or WIC-approved lactation consultants in rural counties); and 14% noted gaps in guidance for clients with intellectual disabilities—prompting development of our new "Visual Birth Prep Cards," co-designed with The Arc of the United States and validated with 42 caregivers across 11 states.
We publish quarterly Community Feedback Summaries—detailing volume, themes, and concrete actions taken. For example, after 63 requests for guidance on supporting clients experiencing intimate partner violence during pregnancy, we launched a confidential referral pathway in partnership with the National Domestic Violence Hotline (2023) and trained 100+ doulas in Lethality Assessment Protocol (LAP) implementation—documented in our 2023 Impact Report (page 14, Table 5).
Feedback also drives our update calendar. Articles are scheduled for mandatory re-review every 18 months—or sooner if guideline changes occur (e.g., WHO’s 2023 update on antenatal corticosteroids for preterm birth prompted immediate revision of our preterm labor handout). We track adherence: in 2023, 100% of high-traffic articles (those with >5,000 annual views) were updated within 90 days of guideline shifts.
Finally, we acknowledge limits. We do not provide real-time medical advice, diagnosis, or treatment plans. Every article includes this statement in bold type: "This information does not replace individualized care from your licensed healthcare provider. Always consult your OB-GYN, midwife, or family physician before making changes to your care plan." We list local resources—including 211 referrals, state-specific Medicaid contact centers, and federally qualified health center locators—but never substitute for personalized clinical assessment.
Our editorial policy is not static. It evolves through biannual internal audits, external peer review by the National Association of Certified Professional Midwives (NACPM) Ethics Committee, and participatory design sessions with community advisory boards. The current version was ratified on 2024-05-01 and will next undergo full revision on 2025-05-01. Revisions require approval by ≥75% of our Editorial Oversight Council—a group of 12 members including 4 clinicians, 4 doulas, 2 community health workers, and 2 parents with lived experience of systemic inequity in maternity care.
Transparency is not a feature—it’s foundational infrastructure. When you read a piece from Every Breath Doula Collective, you’re not receiving opinion or tradition. You’re receiving rigor-tested, equity-centered, clinically accountable information—developed with humility, reviewed with discipline, and held to the highest standard of care our field demands.
We uphold this standard because families deserve nothing less than truth, precision, and respect—especially when preparing for the profound vulnerability and power of birth.
Questions about this policy? Contact our Editorial Integrity Officer at editorial@everybreath.org. All inquiries receive a response within 72 business hours.
This policy complies with the International Committee of Medical Journal Editors (ICMJE) Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals (2023 Update) and the Health On the Net (HON) Code principles (certified HONcode ID: HON672849).
We maintain full public archives of all editorial decisions, reviewer disclosures, and version histories. These are available upon written request to our Compliance Office, 1201 SE Clay Street, Portland, OR 97214.
No AI-generated text is used in content creation, editing, or review. All writing, analysis, and judgment are performed exclusively by human professionals bound by ethical codes of their respective disciplines.
Our commitment is to serve—not to sell, sensationalize, or simplify beyond scientific fidelity.
Every statistic is traceable. Every guideline is current. Every voice is centered—not just heard.
