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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

69:01

Episode 11.4 Syphilis and lots more!

Thinking About Ob/Gyn ·

2026/02/19

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 testing in pregnancy before closing with pragmatic magnesium use after delivery. • overdose and violen...

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61:45

Episode 11.2 Preventing Surgical Complications

Thinking About Ob/Gyn ·

2026/02/04

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 hysterectomy and favoring safer routes • bladder repair tactics by size and location • ureter injury rec...

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60:00

Episode 11.2 Rethinking VBAC Risk and a Lot More!

Thinking About Ob/Gyn ·

2026/01/22

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 c...

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55:40

Episode 11.1 Smarter Hysterectomies, Lower Costs

Thinking About Ob/Gyn ·

2026/01/08

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 a lever to reduce waste • Three-arm robotics and smarter instrument choices • Laparoscopic tips:...

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62:47

Episode 10.13 Estrogen, Free Birth, And Misinformation

Thinking About Ob/Gyn ·

2025/12/25

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 breast cancer diagnosis and mortality • combined estrogen plus progestogen neutralizing estrogen’s p...

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60:00

Episode 10.12 The V-Word

Thinking About Ob/Gyn ·

2025/12/11

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...

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57:13

Episode 10.11 Smarter Cancer Screening, Safer Obstetrics

Thinking About Ob/Gyn ·

2025/11/27

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 education improving informed consent and test completion • one in four patients meeting...

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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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134 results

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