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PODCAST

Thinking About Ob/Gyn

Antonia Roberts and Howard Herrell

A fresh and evidence-based perspective of all things related to obstetrics and gynecology. Follow us on Instagram @thinkingaboutobgyn or visit thinkingaboutobgyn.com for show notes and more.

health & fitness medicine

All Episodes

60:13

Episode 10.10 Habits That Help Doctors Thrive

Thinking About Ob/Gyn ·

2025/11/13

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 low‑friction wins • two micr...

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66:36

Episode 10:9 Fibroids, Facts, False Beliefs, and More!

Thinking About Ob/Gyn ·

2025/10/30

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 rate...

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55:19

Episode 10.8 Speed in Surgery (+Circs & Autism)

Thinking About Ob/Gyn ·

2025/10/16

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 • evi...

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62:06

10.7 Tylenol and Autism

Thinking About Ob/Gyn ·

2025/10/02

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 • Conflicts of interest, pay-to-publish venues, and bias • Why correlation isn’t causation; confoun...

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58:56

Episode 10.6 Natural Birth Claims

Thinking About Ob/Gyn ·

2025/09/17

Dr. Howard Harrell 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 decreased 173-fold since 1850, coinciding with the rise of modern obstetrics • The "cascade of i...

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57:40

Episode 10.5 The Dense Breast Dilemma

Thinking About Ob/Gyn ·

2025/09/04

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 important distinction between possibility and probability when evaluating medication safety in pregna...

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59:32

Episode 10.4 Noah

Thinking About Ob/Gyn ·

2025/08/21

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 the spectrum nature of trisomy 18 and the importance of accurate, unbiased counseling. • Receivin...

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71:23

Episode 10.3 Post-Cesarean Antibiotics, Hysteroscopy,...

Thinking About Ob/Gyn ·

2025/08/07

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 preterm infants • Baby born at 21 weeks and zero days celebrates first birthday, highlighting advances...

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73:03

Bridging Obstetrics and Neonatology: Saving Our...

Thinking About Ob/Gyn ·

2025/07/23

Dr. Scott Guthrie joins us to explore the significant advances in neonatal care and the critical partnership between obstetricians and neonatologists to improve outcomes for newborns. Highlights include: • Successful implemented delayed cord clamping across Tennessee hospitals through collaborative quality improvement project • Neonatal mortality has decreased 30% between 1999-2022 due to advances in medical care and prenatal management • Survival rates for 22-week premature infants ha...

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67:09

Episode 10.1: VBAC Updates, Estrogen Packs,...

Thinking About Ob/Gyn ·

2025/07/09

Howard and Antonia dive into their tenth season with a critical look at several new studies. Topics include: • Estrogen-soaked vaginal packing after surgery lacks evidence for benefits while carrying unnecessary costs • Recent studies on vaginal birth after cesarean deserve careful interpretation beyond aggregate outcomes • Hospital uterine rupture rate is 0.2-0.4%, with only 8% resulting in catastrophic outcomes when properly managed • Warnings against infant co-sleeping date back to ancien...

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65:53

Episode 9.13 The Surgical Maze: Trocars, Cuff...

Thinking About Ob/Gyn ·

2025/06/25

Surgical techniques in gynecology vary widely between surgeons, creating both excitement and frustration for residents trying to learn the "right way" to perform procedures. Howard and guest host Maddie White discuss this and more: • Trocar placement during laparoscopy requires careful consideration of patient factors and potential adhesions • Elevating the abdomen during trocar placement remains standard practice, though definitive evidence on its necessity would require studies of over 100...

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64:54

Episode 9:12 Serial Cervical Lengths, MAHA, and More!

Thinking About Ob/Gyn ·

2025/06/11

Howard Herrell and Antonia Roberts explore evidence-based practices in obstetrics and gynecology, examining both established protocols and emerging research with critical perspectives on medical misinformation. • Serial cervical length monitoring after LEEP procedures lacks evidence for improving outcomes despite being common practice • SMFM's 2016 recommendation explicitly advises against routine cervical length screening for patients with history of cervical procedures • Retrospective stud...

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65:24

Episode 9.11 Cervical Cancer with Stuart Winkler

Thinking About Ob/Gyn ·

2025/05/28

Cervical cancer represents a success story in developed countries due to screening and vaccination, yet remains a significant global health problem with over 340,000 deaths annually worldwide. We explore the current state of cervical cancer prevention, screening, and treatment while discussing exciting advances that could eventually eliminate this disease. • Different levels of prevention for cervical cancer: primordial, primary, secondary, tertiary, and quaternary • HPV vaccination as the m...

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66:37

Episode 9.10 Pit Breaks, Cannabis, and IUDs for...

Thinking About Ob/Gyn ·

2025/05/14

Howard and Antonia explore the evidence behind pit breaks in labor, cannabis use in pregnancy, and IUD options for hormone replacement therapy. • Pit breaks in labor lack substantial evidence of benefit when used in active labor • Current research suggests stopping oxytocin during active labor may slightly increase cesarean rates rather than decrease them • Long pit breaks (up to 8 hours) in latent labor may be beneficial by allowing rest and promoting patience • Recent systematic review sho...

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57:12

Episode 9.9 Pediatric & Adolescent Gynecology Essentials

Thinking About Ob/Gyn ·

2025/04/30

Join Howard and Janeen Arbuckle for this discussion of pediatric and adolescent gynecology essentials. Pediatric and adolescent gynecology is a newer discipline bringing specialized care to young women with unique gynecologic needs, with a focus on counseling, education, and age-appropriate interventions. • Abnormal uterine bleeding in adolescents is rarely caused by structural problems (unlike in adults) and typically relates to immaturity of the hypothalamic-pituitary-ovarian axis • Hemat...

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65:20

Episode 9.8 Rethinking Bacterial Vaginosis and More!

Thinking About Ob/Gyn ·

2025/04/17

In this episode, Antonia and Howard explore the groundbreaking study on treating male partners for bacterial vaginosis, revealing significantly reduced recurrence rates and challenging our traditional understanding of BV pathophysiology. Plus: • Evidence doesn't support treating mild gestational hypertension with antihypertensives • Studies confirm acetaminophen in pregnancy doesn't cause ADHD or autism • New research questions the benefit of routine postpartum thromboprophylaxis • The...

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61:45

Episode 9.7 OB Triage Essentials (plus The Pitt)

Thinking About Ob/Gyn ·

2025/04/03

This episode features our favorite podcast ninja, Dr. Maddie White. She and Howard discuss how medical dramatizations misrepresent obstetric emergencies (yes, we are watching The Pitt). Then, we dissect evidence-based approaches to common triage scenarios including labor evaluation, rupture of membranes, and preterm labor assessment. • Television shows like "The Pitt" and "ER" portray shoulder dystocia and postpartum hemorrhage inaccurately, lacking proper urgency and technique • Hospital-ba...

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65:53

Episode 9.6 New Birth Control Products and Other Updates

Thinking About Ob/Gyn ·

2025/03/19

Antonia Roberts and Howard Herrell review several new articles: • Epifoam for postpartum pain lacks evidence of effectiveness compared to simple ice packs while costing nearly $100 per unit • AMH levels above 5.39 are associated with PCOS diagnosis, providing a specific threshold for clinical use • External aortic compression demonstrated as a life-saving technique during severe obstetric hemorrhage • Vaginal estrogen in breast cancer survivors shows no increased risk of cancer recurren...

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60:00

Episode 9.5 Operative Vaginal Deliveries

Thinking About Ob/Gyn ·

2025/03/05

We discuss the pressing issues surrounding operative vaginal deliveries, including trends in their usage and the disparities impacting delivery outcomes. Join us as we navigate these critical insights with expert guests Jamie Perry and Howard Herrell, revealing the complexities and nuances surrounding forceps and vacuum deliveries. • Examining the historical context of operative vaginal deliveries • Analyzing the decline in forceps and vacuum usage since the 1990s • Discussing the rise of ...

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65:22

Episode 9.4: Barbs, Birth Control Risks, Maternal...

Thinking About Ob/Gyn ·

2025/02/20

This episode dives into the debate surrounding the efficacy and cost of barbed sutures in surgical practice, questioning whether their time-saving advantages are justified compared to traditional techniques, especially for uterine closure. Additionally, it explores the implications of non-invasive prenatal testing for cancer detection and recent maternal mortality statistics, while advocating for evidence-based practices in both surgical and obstetric care. • Analysis of barbed suture u...

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127 results

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