Thinking About Ob/Gyn

We follow the footnotes on a common gyn rule, then use that same evidence-first lens to question popular fertility add-ons and persistent pregnancy myths. Along the way, we talk pretest probability, counseling tradeoffs, and why simple cutoffs often replace better clinical reasoning.  • tracing the “biopsy Bartholin cysts after 40” claim back to weak citations  • using pretest probability and exam...

Howard and guest hose Sivani Aluru unpack why the new PMOS name matters, how PCOS got tied to “cysts,” and what the evidence actually says about diagnosis, metabolic risk, and treatment. We also challenge a few habits we have all inherited, from pre-op antibiotic dosing to the way we talk about hormones, weight, and fertility with patients.  • the evidence gap behind 2 g vs 3 g cefazolin in obese...

We push back on the idea that obstetrics “deserves” a malpractice crisis and explain how bad incentives and junk science can turn normal evidence-based care into courtroom blame. We also break down a few widely shared clinical myths and new research so we can practice with clearer eyes and less narrative noise. • placental grading on ultrasound as low-value data with poor predictive power and high...

We sit down with Joshua Oommen to get nerdy about clinical reasoning, FDA standards, and why “good evidence” is harder to define than most of us admit. We challenge the reflex to trust p-values and meta-analyses, then test our instincts against real OBGYN examples where the literature has whiplashed practice.  • why the podcast is called Thinking About OBGYN and how clinical reasoning shapes our w...

We bring back the biggest takeaways from the ACOG ACSM, then move fast through the newest guidance and the newest hype shaping real OBGYN care. We focus on what the evidence actually supports, where practice still lags behind, and how “labels” can quietly push patients toward harm. • conference highlights including rural OBGYN access and what gets attention on the exhibit floor  • vitamin K shot r...

We answer vaccine questions head-on, using real numbers to separate online fear from how vaccines, immunity, and public health actually work. We break down why diseases feel “gone,” what the modern schedule really exposes babies to, and how to spot misleading claims around ingredients, autism, and VAERS. Featuring Kate Moloney and our vaccine-hesitant friend Anah.  • why vaccine success makes dise...

We take on four stubborn myths in modern obstetrics and follow the evidence instead of the vibes, from thrombophilia testing to bed rest to seizure prophylaxis. We also spotlight a patient-empowering insulin strategy that may improve gestational diabetes outcomes faster than usual care.  • distinguishing recurrent pregnancy loss evaluation from venous thromboembolism testing  • focusing thrombophi...

We talk with Dr. Emily Donelan about how conflicting labor management guidelines can derail communication between nurses and physicians and quietly raise patient safety risks. We map the biggest friction points and lay out practical ways to reconcile guidance locally while pushing for a unified national approach.  • defining “communication dystocia” and why guideline discrepancies create real beds...

We use a plotline from The Pit to separate ovarian torsion facts from TV fiction and explain why Doppler findings can’t replace clinical judgment. Then we answer a listener question on trial of labor after myomectomy and how we counsel when the data are thin and the details matter.  • why “competency porn” and “certainty porn” can distort real expectations of care  • how color Doppler actually wor...

We unpack the Gray Journal’s special edition on Cesarean Delivery, separating strong evidence from expert habit, and spotlight where technique, culture, and policy collide. From TXA and barbed sutures to better metrics and imaging, we share what to adopt now and what to question. Featuring Maddie White. • evidence versus expert opinion across the special issue • TXA at cesarean shows no meaningful...

We examine why U.S. maternal mortality headlines mislead, showing overdose and violence dominate early postpartum deaths while obstetric causes decline. We then cover strong evidence for opportunistic salpingectomy, debunk a shaky Cochrane-fueled home birth claim, clarify Nexplanon’s five-year approval and bleeding management, confirm no Tylenol-autism link, and walk through modern syphilis testin...

We map a prevention-first approach to OBGYN surgical complications—from environmental fixes and technique to early detection, skilled repair, and honest recovery—so fewer patients are harmed and clinicians carry less hidden burden. Practical steps, board-level reasoning, and real cases bring it to life. • applying primordial to quaternary prevention to surgical harm • avoiding unnecessary hysterec...

We unpack new studies that reshape how we counsel on VBAC after short intervals, update what we tell BRCA carriers about estrogen therapy, and explore how self-collected HPV tests can reduce screening gaps. We also question surgical marketing, workforce trends, and the shaky evidence behind aspirin dosing for preeclampsia. • Short interpregnancy interval as a VBAC risk factor, not a contraindicati...

Jamie Perry joins this episode as we share ten standout women’s health breakthroughs from 2025 and then get practical about value in endoscopic hysterectomy. The focus is simple: cut waste, save time, protect quality, and expand access through better selection, technique, and team flow. • Key 2025 breakthroughs shaping care and counseling • Why OR time outweighs device price • Preference cards as...

We unpack what WHI actually showed about estrogen-only therapy and breast cancer in light of new supporting data, then confront the free birth trend’s preventable harms and the business model behind it. We share clear tools to spot false claims, review new aspirin data on preeclampsia, and outline twelve practical ways to cut waste in gyn surgery. • estrogen-only therapy associated with lower brea...

We trace the arc from variolation and Jenner to mRNA, show how vaccines leverage natural immunity, and explain why maternal shots protect both parent and newborn. Data, history, and personal stories make the case that prevention beats cure for OBGYN care. • pertussis surge in Kentucky and preventable infant deaths • child mortality then and now and what changed • variolation to Jenner and the orig...

We share a practical, clinic‑tested system for hereditary cancer screening that standardizes intake and education, then confront how malpractice pressures distort obstetric decision‑making, fetal monitoring, and access to care. Former ACOG president Dr. Richard Waldman offers data, history, and solutions we can use now. • digital workflow that screens every patient annually from age 18  • video ed...

Antonia and special guest Kristi Angevine explore how physicians can rethink habits beyond routines to include default thoughts, feelings, and reactions, and how that shift relieves burnout and restores purpose. Practical micro-habits, internal validation, and redefining productivity help us lead better and live better. • habits as automatic thoughts, feelings, reactions • perfectionism, people pl...

We challenge long-held beliefs about fibroids, highlight new ectopic pregnancy nuances, and dig into real-world dermoid cyst outcomes. We also unpack the evidence and ethics of 39-week induction after IVF and ICSI, balancing small absolute risks with maternal tradeoffs. • Evidence overturning links between fibroids and miscarriage, PROM and abruption • Distinguishing spontaneous versus iatrogenic...

In this episode, Howard and Maddie White challenge shaky claims linking autism to circumcision and Tylenol, then zero in on speed as the byproduct of essential, evidence-based surgery. We show how essentialism, confidence, and efficiency reduce complications, lower costs, and improve outcomes in the OR. • correlation vs causation in autism narratives and bias in research • why operative time predi...

We push back on claims that Tylenol or vaccines cause autism and explain how weak methods, conflicts of interest, and cherry-picked data fuel public panic. We also unpack why diagnoses have risen—broad criteria, screening, and access—not because of a new environmental villain. • Summary of claims made at the press event and why they fail • What the cited acetaminophen paper did and didn’t show • C...

Dr. Howard Herrell explores common questions about birth alternatives posed by Anna, a mom-to-be with questions, examining scientific evidence behind claims often found online that challenge evidence-based obstetric practices. The discussion separates facts from philosophy by analyzing actual research data on interventions like epidurals, oxytocin, and birthing positions. • Maternal mortality has...

Howard and Antonia explore the safety of medications during pregnancy and the controversial reporting requirements for breast density on mammograms, examining how science is being overshadowed by fear-mongering in healthcare decision-making. • Examining the evidence behind avoiding fluconazole (Diflucan) in first trimester, finding that short courses likely pose minimal risk • Discussing the impor...

Dr. Jacqueline Vidosh shares her powerful journey as both an obstetrician and mother to Noah, who has trisomy 18, challenging traditional medical understanding of this condition and providing insights into compassionate patient care. Her story, recently featured in The New York Times, illustrates how medical perspectives on chromosomal conditions can evolve through lived experience, highlighting t...

Recent evidence challenges the practice of prescribing oral antibiotics after Cesarean delivery in obese patients, finding no significant reduction in infection rates compared to standard preoperative antibiotics alone. Howard and Antonia analyze studies showing why this once-promising intervention may not be necessary. • ACOG updates delayed cord clamping guidance to minimum 60 seconds for preter...