In this episode, we discuss the latest recommendations for treatments for osteopenia and osteoporosis, including vitamin D and calcium, as well as bisphophonates and other medications. Then we discuss new literature about best methods for induction of labor and risks factors for uterine rupture during a trial of labor after Cesarean. We also discus…

In this episode, Dr. Stuart Winkler returns to discuss new evidence about the risks and benefits of radical hysterectomy for cervical cancers. Also, for fun, we torture a Gyn-Onc with a four tips for managing cord prolapse. Also, we discuss a new commentary on activity restriction after gynecologic surgery. 00:00:02 Management of Cord Prolapse in L…

In this episode, we discuss which laparoscopic ports need to be closed and how. Plus, we discuss more evidence that the current narrative about maternal mortality in the US is false. Finally, we answer listener questions about oxytocin protocols and the history and utility of the Bishop's Score. 00:00:02 Closing Laparoscopic Ports 00:13:32 The Mate…

In this episode, we discuss four tips for breech vaginal delivery. Then, we respond to the Alabama Supreme Court's decisions about embryos and the impact on IVF and reproductive rights. Finally, we discuss the best methods for initial laparoscopic entry and discuss the history of laparoscopy. 00:00:02 Four Tips for Vaginal Breech Deliveries 00:13:1…

In this episode, we discuss the use of supplemental oxygen for fetal decelerations. Then we get into part 2 of our discussion of interpreting clinical studies and when to adopt new interventions into practice, including a discussion of intranasal metoclopramide, elagolix, and a new study about an app based doula service. Finally, we answer user que…

In this episode, we discuss four tips for external cephalic version. Then we dive into the basics of interpreting scientific studies. Finally, we discuss the pregnancy history of Jackie Kennedy. 00:00:20 Tips for External Cephalic Version 00:17:10 Evaluating Clinical Studies 00:53:13 Jackie Kennedy's Impact on Cesarean Deliveries Follow us on Insta…

In this episode, we discuss performing Cesarean for fetal weights at lower thresholds than currently recommended. Then we discuss new literature regarding utility of pelvic exams or screening asymptomatic women and early rupture of membranes after cervical ripening with a Foley bulb. Then we discuss an editorial discussing selecting the best test a…

In the first episode of our new season, we introduce a new segment with Four Tips for managing fetal heart tracings. Then we discuss the new mammography guidelines. And finally we discuss a case of a viable pregnancy in a woman who had had a hysterectomy. 00:20:45 Mammography Guidelines 00:30:12 Debating the Effectiveness of Mammography Screening 0…

In this episode, we discuss five more myths about hormone replacement therapy. Also, we discuss the utility of cervical exams at later pregnancy visits and the history of synthetic hormones. 00:00:02 Intro and Routine Cervical Exams 00:07:51 Myth #6: Lowest dose, shortest duration 00:17:27 Myth #7: Women without a uterus need progesterone 00:22:44M…

In this episode we debunk the first of five myths about menopausal hormone replacement therapy. 00:00:02 Hormone Replacement Therapy For Smokers, HTN 00:11:42 Misinformation from Women's Health Initiative 00:17:18 Myth 1: Estrogen and Breast Cancer 00:28:06 Myth 2: HRT and BRCA Patients 00:33:17 Myth 3: Estrogen and Cardiovascular Disease 00:39:14 …

In this episode, we discuss several new articles related to treatment of vaginal atrophy or genitourinary syndrome of menopause, including literature that clarifies the role of vaginal estrogen cream. Plus, we discuss the role of washings at the time of management of adnexal masses. We also discuss new literature about the true impact of oxytocin o…

In this episode, we review the literature regarding the use of magnesium sulfate for neuroprotection to prevent CP in preterm infants. 00:00:02 Magnesium Sulfate for Neuroprotection 00:11:00 The Controversy Surrounding Magnesium Sulfate 00:36:37 Research Study Mistakes and Bias 00:46:33 Magnesium Sulfate's Effects on Preterm Birth 00:52:24 Magnesiu…

In this episode, we discuss neonatal circumcision and the pros, cons, and ethics. Prepare for controversy. We also discuss the utility of labs for fetal growth restriction. 00:00:02 Circumcision Controversy 00:05:00 Labs for Fetal Growth Restriction 00:15:31 Global Perspectives on Male Circumcision 00:26:17 Significance of Male Circumcision in Hist…

In this episode, we speculate about the near future of advancement of obstetrics, including new vaccines, new uses for cell-free DNA screening, advancement in diabetes monitoring, the use of artificial intelligence and remote monitoring in obstetrics, and artificial womb technology. Also, do you need to stick the GBS swab in you know where? 00:00:0…

In this episode, we discuss the utility of repeat antibody testing at 28 weeks. Plus, new evidence about early screening for GDM, the concept of tension in the pelvic floor, the evidence about vaginal prep at the time of unplanned Cesarean, new literature about interventions for preterm birth, and the safety of Mayo (or raw eggs) during pregnancy. …

In this episode we welcome back Stuart Winkler to discuss over-consulting in OB/GYN and how to improve surgical eduction in our training programs and how to balance generalists vs subspecialists. Plus, colace! 00:00:02 Misuse of Docusate Sodium 00:09:24 Appropriate Specialty Referrals in Gynecology 00:20:51 Considerations for EIN Management and Ref…

In this episode we discuss the evolution and evidence behind vaginal delivery techniques. Plus, we discuss the importance of the golden hour after birth for the mother and baby. 00:00:02 Golden Hour Care After Birth 00:09:23 Traditional Practices in Vaginal Deliveries 00:20:54 Optimal Practices for Labor Management 00:26:10 Monitoring and Positions…

In this episode, we discuss guidelines about bulb suctioning at the time of delivery. Then we discuss the nearly 100 year old schedule of prenatal visits and how these can be modernized. Finally, we discuss the next Eat, Sleep, Console approach for neonatal abstinence. 0:02 Neonatal Suctioning 11:33 Reforming Prenatal Visits and Outdated Recommenda…

In this episode, we discuss screening for BV to prevent preterm birth. Then new data about the safety of obstetric care in rural vs urban hospitals of different sizes. Plus, new evidence that prophylactic salpingectomy is working and new data about vaginal cuff dehiscence and the analogy between clinical studies and lab tests. 0:02 Treating Bacteri…

In this episode, we discuss current evidence about post-surgical activity restrictions. Plus, we explore probiotics for GBS prevention, vaginal seeding, barbed sutures, disposable staples, and how to be faster during surgery. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss current evidence about potential cross-reactivity for patients with penicillin allergy who receive a cephalosporin. Then we discuss the safety of antidepressant medications in pregnancy. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss the death of Tori Bowie and new data about maternal mortality and the closing gap of black to white mortality in hospital birth. Plus, we discuss pelvic rest after childbirth. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss the practice of IV hydration for preterm contractions. Then we take a look at the ARRIVE trial and some recent studies about this controversial study. Plus, we look at several articles from the Labor and Delivery special edition of the Gray Journal. Follow us on Instagram @thinkingaboutobgyn.…

In this episode, we discuss data about the methods of breech vaginal delivery, including new studies describing the forces with different maneuvers and the ideal position for maximizing pelvic side. Plus, can pregnant women eat sushi? Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss ten things we wish ER docs knew. Also, the history of IUDS, new mammogram guidelines, over the counter birth control, and urine screening for pregnant women with sickle cell trait. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss several new articles, including evidence about operative delivery in obese women, lactation, cookies, propranolol for labor arrest. We also discuss virgin birth in America, whether to place IUD's early in women who have had chorioamnionitis, and the history of hand-washing. Featuring guest co-host Jamie Perry, MD. Follow…

In this episode, we discuss a variety of commonly ordered prenatal labs that are unnecessary. We also discuss new studies that affect both surgical and medical management of miscarriage. Finally, we debunk a new study that claims that induction of labor leads to lower test performance in children. Follow us on Instagram @thinkingaboutobgyn.…

In this episode, we discuss routine labs for patients with a history of hypertension. Then, we take a deeper dive into in vitro fertilization (IVF). Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss the repair of cystotomies along with the scope of general OB/GYN. Plus, COVID and maternal mortality updates. Then some new literature including an update on Clomiphene vs Letrozole and Azithromycin for vaginal birth. Finally, the best female eponym ever and the removal of Makena from the market. Follow us on Instagram @…

In this episode, we discuss Polycystic Ovary Syndrome and discover a couple of more female eponyms. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discover three more female eponyms, plus we review the utility of premedication for IUD placement. We review new literature about maximum dose of oxytocin in labor, surgery vs pessary for pelvic organ prolapse, buprenorphine vs methadone for management of addiction in pregnancy, new guidelines for male infertility evaluation, fa…

In this episode, we have our new favorite guest Stuart Winkler, to discuss eponyms and also a touch of oncology, including the appropriate work up of unilocular ovarian cysts. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss the use of RhoGAM in the first trimester. Then we discuss the timing of birth and why babies are born more commonly in some months and days than others. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss caffeine and other supplements and breast pain, then we continue our discussion of management of obstetric emergencies, focusing on amniotic fluid embolism, shoulder dystocia, cesarean under local, and eclamptic seizure. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss the management of nuchal cords at the time of delivery. Then we begin part 1 of our review of obstetric emergencies, focusing on postpartum hemorrhage, uterine inversion, cord prolapse, breech deliveries, and other not so fun stuff. Follow us on Instagram @thinkingaboutobgyn.…

In this episode, we discuss the newest evidence for two layer closure at the time of Cesarean. Plus, delivery vs birth, a clarification from the prior episode about sexism. Finally, we take a deep dive into the angle of progression and how it can be used to reduces cesareans and promote safety during delivery. Follow us on Instagram @thinkingabouto…

In this episode, we discuss the utility of amnioinfusion for both variable decelerations and meconium stained fluid. Plus, how fast do we need to go when doing a Cesarean under general anesthesia. Then we talk about how Braxton-Hicks is still relevant today. Finally, new studies about TikTok and the placebo effect in menopause treatments. Follow us…

In this episode, we discuss the pros and cons of iron supplementation during pregnancy. We take a big of a dangerous dive into chauvinism and sexism in OB/GYN. Then, we discuss rethinking the postpartum visit(s) to better serve patients. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss management of soft markers of aneuploidy on ultrasound. Also, on update on Makena's potential withdrawal by the FDA. And finally, we discuss value based care for vaginal induction and delivery, including methods of inductions, routine labs, methods of hemorrhage control, sterilization, etc. Follow us on Instagram @thinki…

In this episode, we discuss the value of eating fish during pregnancy and the potential harm of warning women about fish. Plus, we discuss factors driving an increase in maternity deserts in the US and discuss value based care in obstetrics and how that may reverse this dangerous trend. In Part 1 of this discussion, we discuss value decisions at th…

In this episode, we discuss the utility of cord blood gases. Then we discuss the impact of THC exposure during pregnancy. Plus, new studies about cord milking, tighter glycemic control during pregnancy, the effects of maternal infection on the development of autism, appropriate dosing of Lovenox after Cesarean, dermatoses of pregnancy, and the meta…

In this episode we discuss the history of Queen Elizabeth's birth and the the birth of her children - which includes home Cesareans and home VBACs. Plus, we discuss checking IUD strings, rising blood pressure rates, and draining the placenta after birth. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we catch up on a lot of recent literature including differences in surgical outcomes by gender, preferences for race of obstetrician, a new study about cut-offs for gestational diabetes screening, suture vs staples for Cesarean, and vitamin D screening and treatment. Plus, we discuss the evidence for fetal kick count recommendation…

In this episode, we finish up our dive into fertility issues with a discussion of basic fertility treatments and answer several fundamental questions with current evidence. Also, 36-37 weeks routine ultrasounds: yea or nay? Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we continue our discussion of fertility with a discussion of the basic fertility evaluation. Plus, should you sound before placing an IUD? Or use a tenaculum? Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode we discuss the evidence behind stress dose steroids. Then we discuss scientific ways of optimizing natural fertility (and debunk some myths as well). TLDR: save your money on those Facebook fertility testing gimmicks. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell

In this episode, we discuss routine use of LDH and uric acid in evaluation of hypertension. Plus, new studies about caffeine use during pregnancy, the efficacy of home visits to pregnant patients, and the declining value of mammography. We also discuss emergency contraception and birth control in a world post Dobbs and how many women died of illega…

In this episode, we discuss appropriate use of internal fetal monitors. Then an update on abortion legislation, thoughts about lawsuits, and a discussion of why the US actually has the best maternal and infant care system in the world, not one of the worst. Plus, how abortion restrictions affect our rates of maternal and infant mortality. And a lot…

In this episode, we discuss the Second Victim Syndrome and Just Culture. We also discuss progesterone levels and vaginal progesterone for prevention of preterm labor, a new study about Exparel, the ARRIVE trial and news of a lower primary Cesarean rate, piercings and surgery, and whether we should include the endometrium in the closure of Cesareans…

In this episode, we discuss the science of fundal heights, a captivating new article about the science of continuous electronic fetal monitoring, and other whatnots, including the formula shortage, SIDS breakthrough, the optimal age of prophylactic oophorectomy, overdose deaths in America, and few other things (including calcium!). Follow us on Ins…