Afleveringen
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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 âbiopsy Bartholin cysts after 40â claim back to weak citations
⢠using pretest probability and exam features to decide on selective biopsy
⢠weighing hysteropexy versus hysterectomy for prolapse with long-term cancer risk in mind
⢠breaking down a Lancet review of IVF add-ons and what actually shows benefit
⢠spotting how marketing and online forums amplify unproven fertility interventions
⢠reviewing data on sedentary time in pregnancy and why activity restriction persists
⢠debunking âwalking progresses laborâ with randomized trial evidence
⢠clarifying early diabetes testing as screening for preexisting diabetes and when A1C makes more sense than early glucose tolerance tests
Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram.0:00 Welcome And Whatâs Ahead
0:23 Bartholin Cyst Biopsy Age Rule
14:17 Prolapse Repair With Uterus Preservation
21:45 IVF Add-Ons And The Lancet Review
37:35 Pregnancy Activity Myths And New Data
50:53 Early Diabetes Testing And A1C
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Howard and guest hose Sivani Aluru unpack why the new PMOS name matters, how PCOS got tied to âcysts,â 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 cesarean patients and how practice inertia forms
⢠why PMOS shifts attention toward insulin resistance, metabolic screening, and multidisciplinary care
⢠how NIH, Rotterdam, and androgen excess criteria shape who gets diagnosed and who gets missed
⢠SHBG and free testosterone as a practical way to explain symptoms when total testosterone looks normal
⢠why ovarian follicles are not the same as painful ovarian cysts and why ultrasound can mislead
⢠patient frustration with âjust take birth controlâ and how we explain progesterone protection for the endometrium
⢠lean PMOS, weight-focused bias, and realistic conversations about lifestyle change, GLP-1s, and bariatric surgery
⢠fertility takeaways from PPCOS II, metformin limitations, and what lifestyle trials suggest preconception
Be sure to check out thinkingaboutobgyn.com for more information, and be sure to follow us on Instagram.0:00 Welcome And Guest Introduction
2:01 The 3-Gram Ancef Habit
12:02 PCOS Becomes PMOS
12:55 How The Criteria Got Complicated
22:00 Insulin Resistance And Free Testosterone
30:40 Hormone Panels And TikTok Myths
32:30 Ovarian Follicles Are Not âCystsâ
36:03 Treating Symptoms Without Dismissing People
46:12 Fertility Trials And Lifestyle Results
57:27 ACOG At 75 And Why Join
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Zijn er afleveringen die ontbreken?
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We push back on the idea that obstetrics âdeservesâ 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 reader variability
⢠how malpractice commentary can seed plaintiff-friendly arguments against evidence-based off-label use
⢠why blaming misoprostol or âhigh-doseâ oxytocin oversimplifies multifactorial outcomes
⢠quality improvement bundles as useful tools but weak proof without controls or causal clarity
⢠how massive verdicts and paid expert testimony can clash with modern science on cerebral palsy and HIE
⢠the FAAâs five hazardous attitudes and practical antidotes for high-stakes clinical work
⢠new data on LEEP versus cold knife cone for CIN, recurrence, HPV clearance, and access tradeoffs
⢠genetics and BMI as major drivers of gut microbiome patterns, not influencer narratives
⢠what a 1993 Doppler trial can and cannot prove, plus why replication changes conclusions
Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram.0:00 Welcome And Season Update
1:15 Placental Grading Myth On Ultrasound
6:44 Calling Out A Malpractice Influencer
14:06 The 2011 Policy Bundle Examined
23:20 What Drives The OB Malpractice Crisis
30:00 How Mega Verdicts Get Made
36:59 Five Hazardous Attitudes From Aviation
44:31 LEEP Versus Cone For CIN
48:04 Genetics And The Gut Microbiome
52:17 Does Doppler Ultrasound Harm Babies?
1:00:37 Recommendations And Closing
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We sit down with Joshua Oommen to get nerdy about clinical reasoning, FDA standards, and why âgood evidenceâ 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 work
⢠the NEJM proposal to make one pivotal trial the FDA default and what âconfirmatory evidenceâ might mean
⢠medical reversal, surrogate endpoints, and how trust erodes when practice changes late
⢠why Bayesian thinking fits how clinicians interpret tests, trials, and prior beliefs
⢠how meta-analyses fail through small study effects, publication bias, p-hacking, and heterogeneity
⢠the amnioinfusion comeback as a case study in applicability and overconfident conclusions
Be sure to check out thinking about obgyn.com for more information and be sure to follow us on Instagram.0:00 Welcome And Todayâs Big Question
3:48 Why âThinking About OBGYNâ Exists
11:54 The NEJM Push For One Trial
16:38 Medical Reversal And Trust Problems
24:43 AI Proteins And CRISPR Pressure Tests
32:33 Bayes Thinking Beyond P Values
36:43 Why Meta-Analyses Often Mislead
41:08 Bias And Heterogeneity Red Flags
46:24 Amnioinfusion And A Meta-Analysis Comeback
1:02:29 Final Warnings And How To Learn
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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 âlabelsâ can quietly push patients toward harm.
⢠conference highlights including rural OBGYN access and what gets attention on the exhibit floor
⢠vitamin K shot refusal trends and why late bleeding still matters weeks after birth
⢠2026 ACOG cervical cancer screening changes with primary HPV testing preferred for ages 30 to 65
⢠self-collected HPV screening and the systems needed to keep follow-up safe
⢠why annual Pap testing and cytology-only strategies increase overdiagnosis and can miss HPV risk
⢠postmenopausal bleeding workup shifting toward ultrasound plus endometrial biopsy up front
⢠large baby induction data and why outcomes can worsen without neonatal benefit
⢠third-trimester ultrasound screening performance and the real-world labeling effect
⢠early proof-of-concept therapy for preeclampsia targeting sFlt1 removal to prolong pregnancy
⢠hysterectomy duration and route as drivers of venous thromboembolism risk
⢠laboring down claims from retrospective reports versus randomized trial findings
⢠debunking physiologic third stage claims and reaffirming active management to prevent hemorrhage
Be sure to check out thinkingaboutobgyn.com for more information, and be sure to follow us on Instagram.0:00 ACOG Meeting Takeaways And Rural Access
3:58 Vitamin K Refusal And Newborn Bleeding
6:37 Cervical Screening Moves Toward HPV
14:48 Postmenopausal Bleeding Now Needs Biopsy
20:00 Tylenol Data And Macrosomia Induction
28:34 Ultrasound Labeling Effect And Liability Fears
37:29 Removing sFlt1 To Buy Time
40:14 Longer Hysterectomy Surgeries Raise VTE Risk
42:14 Laboring Down Claims Versus RCT Reality
49:59 Counseling Fatigue Without Ignoring Risk
54:21 Third Stage Myths And Hemorrhage Prevention
58:42 Evidence Literacy And Closing Notes
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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 âgone,â 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 diseases look eradicated while risk returns when coverage drops
⢠Stanford modeling estimates for measles, diphtheria, polio, and rubella without vaccination
⢠meningococcal meningitis basics, who is most at risk, and why outcomes can be catastrophic
⢠why clean water and sanitation do not explain protection from droplet-spread viruses
⢠what antigens are and why antigen exposure is far lower than decades ago
⢠downsides of delaying vaccines including longer vulnerability and more office visits
⢠aluminum, formaldehyde, and mercury claims explained with real-world comparisons
⢠ânatural immunityâ tradeoffs including measles pneumonia, immune amnesia, and SSPE
⢠long flu and post-viral inflammatory syndromes as quality-of-life consequences
⢠how vaccine schedules change, why the autism claim is debunked, and what profit incentives really look like
⢠what VAERS can and cannot tell you, plus how bias and viral claims distort reports
⢠why newborn hepatitis B vaccination exists, screening gaps, and true serious side effects
⢠rubella history and why vaccination primarily protects fetuses1:05 Do We Vaccinate Too Much
3:32 Modeling A World Without Vaccines
6:20 Meningitis And Fast Catastrophes
8:28 Clean Water Is Not A Vaccine
11:02 Antigens And The Modern Schedule
15:44 Why Spacing Shots Can Backfire
16:53 Aluminum Formaldehyde Mercury Facts
22:00 Natural Immunity And Measles Damage
26:16 Long Flu And Post Viral Illness
28:26 Profit Fears And Autism Claims
31:26 VAERS Limits And Bad Math
38:39 Why Newborns Get Hepatitis B
45:09 Real Side Effects And Detox Scams
48:37 Rubella And Protecting Fetuses
51:57 Final Takeaways And Next Steps
Be sure to check out thinkingaoutobgyn.com for more information and be sure to follow us on Instagram.
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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 thrombophilia workups on antiphospholipid antibody syndrome when criteria are met
⢠explaining why MTHFR variants and PAI-1 polymorphisms do not belong in routine panels
⢠unpacking how social media and narrative fallacies keep low-value tests alive
⢠reviewing the AWARE trial and why activity restriction lacks benefit and carries harms
⢠clarifying reasonable pregnancy activity modifications versus false labor prevention claims
⢠assessing late preterm antenatal corticosteroids for twins and the hypoglycemia signal
⢠discussing inertia of practice and why weak evidence becomes hard to undo
⢠breaking down patient-led insulin titration for gestational diabetes and why it may reduce macrosomia
⢠evaluating laboring down and long-term pelvic floor outcomes plus statistical pitfalls
⢠answering a listener question on Keppra alternatives to magnesium for preeclampsia seizures
Be sure to check out thinking about obgyn.com for more information, and be sure to follow us on Instagram.
0:00 Welcome And What Weâre Reviewing0:28 Thrombophilia Testing After Miscarriage
3:51 What Belongs In A VTE Panel
5:55 MTHFR And PAI1 Myth Busting
13:36 Activity Restriction And The AWARE Trial
23:27 Practical Counseling Without False Promises
27:08 Late Preterm Steroids For Twins
32:53 Patient-Led Insulin Titration In GDM
38:38 Laboring Down And Pelvic Floor Outcomes
47:51 Keppra Versus Magnesium For Preeclampsia
1:00:25 Wrap Up And Where To Follow
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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 âcommunication dystociaâ and why guideline discrepancies create real bedside conflict
⢠how evidence gaps drive teams toward institutional culture and inertia in practice
⢠the ARRIVE trial as a case study in differing priorities and framing
⢠a detailed induction vignette showing where amniotomy, oxytocin titration and uterine activity definitions collide
⢠why the 20 mU/min oxytocin threshold persists and what newer data suggests
⢠tachysystole rules, Category II tracings and how prescriptive language shapes nursing behavior
⢠delayed pushing versus pushing at complete dilation and the moral distress it can create
⢠the need for standardized evidence grading and cleaner citations across organizations
⢠a national interprofessional reconciliation program and who must be at the table
⢠one actionable step for tomorrow: stay curious and surface the real reason behind the disagreement
Be sure to check out thinking about obgyn.com for more information and be sure to follow us on Instagram.0:01 Why Guideline Conflicts Matter
3:52 The ARRIVE Trial Framing Problem
12:23 A Labor Case Where Rules Collide
24:08 Oxytocin Thresholds And Litigation Fear
33:26 Pushing Timing And Moral Distress
38:05 Who Should Write Unified Guidance
44:04 Evidence Grading And Bedside Decisions
52:05 Inertia In Practice And De-Implementation
1:00:14 Takeaways Plus A No-Evidence Pet Peeve
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We use a plotline from The Pit to separate ovarian torsion facts from TV fiction and explain why Doppler findings canât 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 âcompetency pornâ and âcertainty pornâ can distort real expectations of care
⢠how color Doppler actually works and why red and blue do not always mean artery and vein
⢠PCOS misconceptions and what really increases torsion risk
⢠ovarian torsion as a clinical diagnosis and why preserved Doppler flow cannot rule it out
⢠ultrasound clues that help beyond flow alone, including the whirlpool sign and peripheral follicles
⢠when oophoropexy might be considered and why it remains controversial
⢠why detorsion usually beats oophorectomy even with a black or blue ovary
⢠limits of lab tests and the need to think in probabilities, not binaries
⢠false positives and false negatives in pregnancy testing, including the hook effect and real-world mix-ups
⢠counseling on vaginal delivery after myomectomy, focusing on depth, cavity entry, number and location of incisions, and shared decision-making
Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram0:01 Welcome And What We Cover
0:32 The Pit Torsion Plot Setup
3:06 Competency Porn And Public Expectations
8:39 Color Doppler Basics BART Rule
10:09 PCOS Myths And Torsion Risk
13:27 Endometriosis Guidance And Clinical Diagnosis
18:29 Torsion Diagnosis Beyond Doppler Flow
24:30 Oophoropexy When It Helps And Harms
29:22 Scoring Tools For Torsion Triage
32:48 Detorsion Versus Oophorectomy And Recovery
37:09 Certainty Porn And Limits Of Tests
41:09 Pregnancy Tests False Positives And Negatives
47:10 Listener Question TOL After Myomectomy
50:01 Counseling Factors And Limited Rupture Data
55:31 Closing And Next Guest Tease
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We unpack the Gray Journalâs 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 outcome gains
⢠barbed versus braided sutures and the cost of âspeedâ
⢠why fundamentals beat gadgets for blood loss and time
⢠critique of New Jersey NTSV study and outcome framing
⢠imaging pearls for postâcesarean complications
⢠infection prevention steps supported by trials
⢠history of cesarean steps and why we dropped some
⢠rising cesarean rates driven by nonâclinical forces
⢠better classification systems and dyadic metrics
⢠balancing maternal and neonatal outcomes
⢠tool use in obesity and costâconscious choices
Be sure to check out thinkingaboutobgyn.com for more information, and be sure to follow us on Instagram0:01 Why A Massive CâSection Special Issue Matters
3:15 Expert Opinion vs Evidence: Read With Caution
5:44 Safety Basics: Wear Eye Protection
7:46 EvidenceâBased Technique Still Stands
10:55 TXA At Cesarean: Reanalyzing TRAAP2
18:19 Barbed Sutures And The Myth Of Speed
27:30 Operative Time: Fundamentals Over Gadgets
33:54 New Jersey QI Study: Claims And Confounders
42:05 Outcomes Framing: âCone Headsâ And Bias
49:15 Imaging After Cesarean: What To Look For
54:35 Infection Prevention And SSI Takeaways
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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 Nexplanonâs five-year approval and bleeding management, confirm no Tylenol-autism link, and walk through modern syphilis testing in pregnancy before closing with pragmatic magnesium use after delivery.
⢠overdose and violence as leading postpartum deaths
⢠pitfalls of cross-country maternal mortality comparisons
⢠fentanyl trends and infant risk
⢠opportunistic salpingectomy reduces ovarian cancer risk
⢠how bad meta-analyses distort home birth safety claims
⢠intent-to-treat and risk matching in birth setting data
⢠Nexplanon five-year efficacy and bleeding treatments
⢠no association between acetaminophen and autism
⢠syphilis screening algorithms and pregnancy timing
⢠magnesium postpartum as seizure prophylaxis, not BP treatment
Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram0:00 Setting The Agenda: What Really Kills Moms
0:33 Redefining Maternal Mortality And Comparisons
2:11 Violence, Overdose, And Postpartum Risk
5:33 State Variability And Media Narratives
8:15 Data On Drugs, Fentanyl, And Infant Harm
11:06 Opportunistic Salpingectomy: New Evidence
14:06 Population Study And Risk Reduction Ranges
16:16 Cochrane Review And Home Birth Claims
20:24 Why Bad Meta-Analyses Mislead
24:15 Real-World Data And Intent-To-Treat For Birth Setting
28:02 Pain, Epidurals, And Cultural Narratives
31:00 Nexplanon Five Years And Bleeding Fixes
35:21 Tylenol And Autism: Meta-Analysis Revisited
38:04 Syphilis Testing In Pregnancy: Why Itâs Hard
42:25 Traditional Vs Reverse Algorithms Explained
47:05 Managing Discordant Results And Reinfection
50:11 History, Ethics, And Tuskegee Lessons
54:15 Listener Question: Magnesium Duration Postpartum
59:05 Clinical Judgment Over Dogma And Wrap
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We map a prevention-first approach to OBGYN surgical complicationsâfrom environmental fixes and technique to early detection, skilled repair, and honest recoveryâso 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 hysterectomy and favoring safer routes
⢠bladder repair tactics by size and location
⢠ureter injury recognition, stenting, and reimplant options
⢠bowel injury triage, Lembert technique, and resection thresholds
⢠four practical tips to prevent bowel injury
⢠vascular control from aorta to epigastrics and presacral bleeds
⢠preventing neuropathies with smarter positioning and retractors
⢠disclosure with HEAL and supporting clinicians with just culture
⢠key historical insights0:00 Framing Complications With Prevention
2:55 Primordial To Quaternary: The Model
7:30 Urologic Risks: Bladder First
16:20 Trigone, Stents, And Calling For Help
23:45 Ureter Injury Playbook
33:20 Delayed Ureter Injuries And Management
38:05 Small Bowel: From Serosa To Resection
46:30 Colon Injuries: Repair Or Resect
52:40 Four Tips To Prevent Bowel Injury
58:10 Vascular Injury: Aorta To Epigastrics
Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram
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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 contraindication
⢠Absolute uterine rupture rates in spontaneous vs induced labor
⢠Estrogen therapy in BRCA carriers and treated gyn cancers
⢠Cervical screening overuse and underscreening in insured populations
⢠Self-collected HPV testing intervals and access benefits
⢠OB-GYN workforce shortages and rural distribution gaps
⢠Endometriosis surgery indications versus fertility claims
⢠Robotics versus laparoscopy outcomes and training priorities
⢠Aspirin dose trials, lack of placebo arms, and abruption signals
⢠Reading statistics correctly and demanding better editorial standards0:00 Setting The Agenda: New Studies
0:40 Short Interval Pregnancy And VBAC Risk
3:10 Quantifying Uterine Rupture By Spacing
8:10 Induction, Augmentation, And Rupture Math
9:40 HRT In BRCA Carriers: New Evidence
13:05 Estrogen After Gyn Cancers: Practice Gaps
17:40 Cervical Screening: Overuse And Underscreening
22:30 Self-Collected HPV Testing Guidance
27:00 OB-GYN Shortages And Distribution
33:20 Endometriosis Surgery And Fertility Claims
41:20 Robotics Vs Laparoscopy: Outcomes And Training
47:20 Aspirin Dosing For Preeclampsia: No Signal
55:30 Interpreting Stats And Editorial Standards
59:20 Closing Notes And Next Steps
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Jamie Perry joins this episode as we share ten standout womenâs 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 a lever to reduce waste
⢠Three-arm robotics and smarter instrument choices
⢠Laparoscopic tips: barbed suture, simulation, quadrant workflow, vessel skeletonization
⢠Robotic tips: patient selection, docking discipline, turnover efficiency, data tracking
⢠Same-day discharge and ERAS as non-negotiables
⢠When vaginal route is truly better and why referrals matter
Be sure to check out thinkingaboutobgyn.com for more information, and be sure to follow us on Instagram
0:00 Setting The Stage: Why Endoscopy1:12 Ground Rules And Focus On Value
2:12 Top 10 Womenâs Health Breakthroughs Of 2025
15:56 Defining Value In Hysterectomy
18:20 Preference Cards And Instrument Waste
21:28 Three-Arm Robotics And Instrument Costs
24:04 Time As The Biggest Cost Driver
29:56 SameâDay Discharge And ERAS
33:44 Four Laparoscopic Efficiency Tips
41:28 Four Robotics Efficiency Tips
47:02 When To Choose Vaginal Hysterectomy
54:10 Data Tracking, Referrals, And Culture Change
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We unpack what WHI actually showed about estrogen-only therapy and breast cancer in light of new supporting data, then confront the free birth trendâs 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 breast cancer diagnosis and mortality
⢠combined estrogen plus progestogen neutralizing estrogenâs protective signal
⢠rare abdominal pregnancy case illustrating basic testing safeguards
⢠free birth movement risks, censorship of bad outcomes, and money incentives
⢠red flags in birth-related posts and the SIFT fact-checking method
⢠four quick filters to vet social content before sharing
⢠nuanced view on aspirin for preeclampsia with mixed trial evidence
⢠twelve surgical sustainability steps that save cost and reduce waste
Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram
1:11 Estrogen Therapy And Breast Cancer Risk6:41 What WHI Actually Showed
11:22 Progesterone, HRT Fads, And Risks
15:35 Wild Case: Abdominal Pregnancy Behind Tumor
20:42 Free Birth Trend And Tragic Outcomes
25:37 How The Misinformation Business Works
30:10 Red Flags In Birth Content Online
35:10 The SIFT Method For Fact-Checking
40:20 Four Tips To Vet Social Posts
46:25 Live Walkthrough: Debunking A Viral Post
52:40 Digital Hygiene And Curating Feeds
56:48 Aspirin For Preeclampsia: Mixed Evidence
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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 origins of vaccination
⢠how innate and adaptive immunity learn and remember
⢠vaccine types and why todayâs antigens are fewer
⢠effectiveness data across polio, measles, rubella, Hib
⢠sanitation myths versus vaccine impact
⢠Wakefieldâs fraud and why autism claims fail
⢠three major studies debunking autism myths
⢠essential pregnancy vaccines and timing
⢠RSV options and COVID safety during pregnancy
⢠herd immunity as protection for newborns0:02 Setting The Stage: Vaccines Under Fire
1:09 Pertussis Surge And Preventable Tragedy
2:20 Child Mortality Then And Now
4:19 What Killed Children In 1850
5:31 Out Of Sight, Out Of Mind
9:51 Origins Of Vaccination: Variolation To Jenner
15:20 Vaccines Use Natural Immunity
20:00 Types Of Modern Vaccines Explained
25:30 Innate And Adaptive Immunity 101
28:40 How Effective Are Vaccines Really
33:40 Polioâs Human Cost And Iron Lungs
39:00 Measles, Rubella, And Pregnancy Risks
44:20 Sanitation Myths Versus Vaccine Impact
47:05 The Wakefield Fraud And Aftermath
52:20 Big Studies Debunk Autism Claims
55:20 Essential Vaccines In Pregnancy
58:00 Takeaways And Next Steps
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We share a practical, clinicâtested system for hereditary cancer screening that standardizes intake and education, then confront how malpractice pressures distort obstetric decisionâmaking, 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 education improving informed consent and test completion
⢠one in four patients meeting hereditary testing criteria
⢠management changes after testing including MRI, meds, referrals
⢠addressing cost and genetic discrimination concerns
⢠OBGYNs as leaders in genetics amid counselor shortages
⢠malpractice landscape, rising verdicts, and physician burnout
⢠neonatal encephalopathy criteria grounding courtroom science
⢠fetal monitoring limits, category II overreaction, cesarean pressure
⢠VBAC safety tied to selection, readiness, and team systems
⢠safety culture, simulation, and checklists reducing risk
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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 pleasing, catastrophizing as learned solutions
⢠survival seasons and lowâfriction wins
⢠two microâhabits: emotional checkâins and box breathing
⢠escaping allâorânothing with iterative learning
⢠redefining productivity around alignment, not toâdo lists
⢠internal validation and making yourself make sense
⢠training culture, criticism, and choosing supportive mentors
⢠identity beyond âdoctor firstâ to include rest and health
⢠coaching options: group community and private work
Be sure to check out Thinking about obgyn.com for more information, and be sure to follow us on Instagram0:01 Setting The Stage: Habits In Medicine
0:32 Introducing Dr. Kristi Angevine
2:05 Redefining What A Habit Really Is
4:20 Perfectionism, People Pleasing, Catastrophizing
7:12 Coping Gone Sideways And Burnout Risk
11:21 Unrealistic Standards And The Inner Critic
15:54 When Work Ethic Becomes Self-Neglect
19:30 Why Simple Routines Arenât Easy
23:12 Survival Seasons And Low-Hanging Fruit
26:12 Two Five-Minute Habits That Stick
30:45 Escaping All-Or-Nothing Thinking
36:05 Internal Validation As A Mental Habit
41:05 Success Beyond The To-Do List
48:39 Burnoutâs Roots And Moral Injury
52:42 Training Culture, Criticism, And Resilience
57:05 Coaching Options And Community
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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 preterm birth in fibroid pregnancies
⢠Why myomectomy can raise early delivery and cesarean rates in some patients
⢠Ectopic care updates: tube-sparing choices, HCG thresholds, two-dose methotrexate
⢠Experimental adjuncts to methotrexate remain unproven
⢠Dermoid data supporting laparoscopy, irrigation, and specimen bags over open surgery
⢠Surgical decision making during pregnancy and avoiding uterine manipulators
⢠IVF and ICSI timing: late stillbirth risk signals, limits of testing, 39-week logic
⢠Shared decision making when absolute risks are low but values differ
Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram
1:33 Fibroids And Miscarriage Myths5:53 Preterm Birth, PROM, And Hemorrhage
9:31 Myomectomy: Risks, Scars, And Outcomes
13:25 Ectopic Pregnancy: Whatâs New
18:37 Surgery Versus Methotrexate Nuances
22:05 Experimental Add-Ons To Medical Therapy
27:47 Dermoid Cysts: Real-World Data
32:48 Laparoscopy, Spillage, And Pregnancy
36:06 When Open Surgery Makes Things Worse
40:34 IVF, ICSI, And 39-Week Induction
48:05 Stillbirth Risk: What The Data Shows
55:20 Testing, Timing, And Shared Decisions
1:04:10 Practical Counseling And Tradeoffs
Follow us on Instagram @thinkingaboutobgyn.
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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 predicts complications across procedures
⢠surgeon volume, variability, and outcome differences
⢠evidence-based cesarean steps that cut time and bleeding
⢠tool and method choices that are safer and faster
⢠confidence as self-efficacy, not arrogance
⢠practical efficiency: setup, flow, visualization, debrief
⢠lean thinking, standardization, and reducing variation
Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram00:00:00 Opening Banter & Autism Claims
00:02:35 Circumcision, Bias, and Correlation vs Causation
00:09:54 Why Speed in Surgery Matters
00:15:35 Surgeon Variability and Outcomes
00:19:35 Evidence-Based Cesarean: Essential Steps
00:27:20 Less Bleeding Through Minimal Dissection
00:31:20 Choosing Methods and Tools that Save Time
00:35:05 Confidence vs Arrogance in the OR
00:40:05 Practical Efficiency: Filming, Flow, and Setup
00:45:05 Visualization, Assisting, and Debriefing
00:50:00 Tools, Tech, and Mastering Basics
00:55:00 Standardization, Lean Thinking, and Takeaways
Follow us on Instagram @thinkingaboutobgyn.
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